Observations in a maternity ward: Usability considerations for EHRs in an interrupt driven environment

With the increasing demand on healthcare systems it is imperative that all care is provided as efficiently and effectively as possible. Technology within the medical domain offers an exciting opportunity to augment work practices in order to meet these needs. This research project explores the implications of the interrupt-driven nature of work in clinical situations on documentation within an environment that increasingly involves electronic health records (EHRs). Midwives in a busy maternity ward were observed and interviewed about the work practices they employed to document information associated with patient care. The results showed that the interrupt-driven nature of the workplace, a feature common to many healthcare settings, led to a tension between the work and the work to document the work. Further, the IT environment in which the information was collected was not designed to cater for frequent interruption of the data entry process. Several recommendations for improving the IT environment are proposed to support health professionals in documenting patient data whilst attending to the interruptions. The recommendations include timeout screens, push technology, use of handheld PDAs, and cues to augment documentation in an interrupted session. Copyright © 2008 RMIT Publishing

Evidence and information for health policy: a decade of change

Over the past decade or so, there has been increasing demand for greater clarity about the major causes of disease and injury, how these differentially affect populations, and how they are changing. In part, this demand has been motivated by resource constraints and a realisation that better health is possible with more informed allocation of resources. At the same time, there has been a change in the way population health and its determinants are quantified, with a much closer integration of the quantitative population sciences (such as epidemiology, demography and health economics) to strengthen and broaden the evidence base for healthcare policy.

Children’s respiratory health and daily particulate levels in ten non-urban communities

We conducted a study to assess the association between the acute respiratory health of children and the levels of particulates in communities near and away from active opencast coal mines. The study enrolled children aged 1–11 years from the general population of five socioeconomically matched pairs of nonurban communities in northern England. Diaries of respiratory events were collected for 1405 children, and information was collected on the consultations of 2442 children with family/general practitioners over the 6-week study periods during 1996–1997, with concurrent monitoring of particulate levels. The associations found between daily PM10 levels and respiratory symptoms were frequently small and positive and sometimes varied between communities. The magnitude of these associations were in line with those from previous studies, even though daily particulate levels were low, and the children were drawn from the general population, rather than from the population with respiratory problems. The associations among asthma reliever use, consultations with general practitioners, and daily particulate levels were of a similar strength but estimated less precisely. The strength of association between all respiratory health measures and particulate levels was similar in communities near and away from opencast coal mining sites.

An experimental study of the effects of work stress, work control, and task information on adjustment

The present study was designed to examine the main and interactive effects of task demands, work control, and task information on levels of adjustment. Task demands, work control, and task information were manipulated in an experimental setting where participants completed a letter-sorting activity (N = 128). Indicators of adjustment included measures of positive mood, participants' perceptions of task performance, and task satisfaction. Results of the present study provided some support for the main effects of objective task demands, work control, and task information on levels of adjustment. At the subjective level of analysis, there was some evidence to suggest that work control and task information interacted in their effects on levels of adjustment. There was minimal support for the proposal that work control and task information would buffer the negative effects of task demands on adjustment. There was, however, some evidence to suggest that the stress-buffering role of subjective work control was more marked at high, rather than low, levels of subjective task information.