Introduction to Macroergonomics
Filed under: ergonomics, health care, human factors, macroergonomics
According to Hendrick and Kleiner (2002), macroergonomics is “the subdiscipline of ergonomics that focuses on the design of the overall work system. Conceptually, a top-down sociotechnical systems approach to the design of work systems and the carry-through of the overall work system characteristics to the microergonomic design of human-job, human-machine, and human-software interfaces to ensure that the entire work system is fully harmonized” (p. 394). A work system consists of (1) personnel subsystem, (2) technological subsystem, (3) internal environment, (4) organization and management; and (5) external environment (Kleiner, 2008).
Hal W. Hendricks is considered the father of macroergonomics based on work he performed in the 1980s and 1990s, but its roots extend to research in sociotechnical systems theory from the 1940s and 1950s (Hendrick & Kleiner, 2002, p. 14).
Macroergonomic principles have been applied to a variety of industries, including:
- Aviation
- Construction
- Food
- Health Care
- High-Technology
- Manufacturing
- Petroleum
- Trucking
Interested readers are encouraged to review the following references to learn more about macroergonomics:
Hendrick, H.W., & Kleiner, B.M. (2002). Macroergonomics: Theory, methods, and applications. Mahwah, New Jersey: Lawrence Erlbaum Associates.
Haro, E., & Kleiner, B.M. (2006). Macroergonomics as an organizational process for systems safety. Applied Ergonomics, 39, 450-458.
Holden, R.J., Or, C.K.L., Alper, S.J., Rivera, A.J., & Karsh, B-T. (2008). A change management framework for macroergonomic field research. Applied Ergonomics, 39, 459-474.
Kleiner, B.M. (2004). Macroergonomics as a large work-system transformation technology. Human Factors and Ergonomics in Manufacturing, 14, 99-115.
Kleiner, B.M. (2008). Macroergonomics: Work system analysis and design. Human Factors, 50, 461-467.
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Dan Buettner on Universal Lifestyle Behaviors
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The Rise of the e-Patient
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Health IT and Patient Safety Report
Last November, the Institute for Medicine (IOM) issued a prepublication copy of a report entitled Health IT and Patient Safety: Building Safer Systems for Better Care. According to the press release, the purpose of the report is:
To protect Americans from potential medical errors associated with the use of information technology in patient care, a new report by the Institute of Medicine calls for greater oversight by the public and private sectors. The report examines a broad range of health information technologies, including electronic health records, secure patient portals, and health information exchanges, but not software for medical devices.
The report is the outcome of efforts performed by the Committee on Patient Safety and Health Information Technology “…to review the evidence about the impact of health IT on patient safety and to recommend actions to be taken by both the private and public sectors.” (p. ix). The report provides 10 recommendations, two of which specifically highlight human factors, although several others fall within the realm of the human factors and ergonomics discipline. They are:
Recommendation 5: All health IT vendors should be required to publicly register and list their products with ONC, initially beginning with EHRs certified for the meaningful use program.
Recommendation 10: HHS, in collaboration with other research groups, should support cross-disciplinary research toward the use of health IT as part of a learning health care system. Products of this research should be used to inform the design, testing, and use of health IT. Specific areas of research include: (a) User-centered design and human factors applied to health IT; (b) Safe implementation and use of health IT by all users; (c) Sociotechnical systems associated with health IT; and (d) Impact of policy decisions on health IT use in clinical practice.
The report can be downloaded here. Also, the briefing slides can be downloaded here (.pdf).
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U.S. Health Spending in 2010
In the January 2012 issue of Health Affairs, Martin, et al. published the latest National Health Expenditure Account estimates in their article “Growth in US Health Spending Remained Slow in 2010; Health Share of Gross Domestic Product was Unchanged from 2009.”
National Health Expenditure Accounts are estimates of the “… total annual dollar amount of health care consumption in the United States, as well as the dollar amount invested in medical sector structures and equipment and non-commercial research to procure health services in the future.” Additional definitions, along with the methodology behind calculating these estimates can be found here (.pdf).
Some of the highlights include:
- Total health expenditure: $2,593.6 trillion
- Health consumption: $2,444.6 trillion
- Investment: $149 billion
- Per person expenditure: $8,402
- Percent of GDP: 17.9%
- Annual growth from 2009: 3.9%
- Private health insurance (as a % of NHE spending): 33%; 2.4% growth from 2009
- Medicare (as a % of NHE spending): 20%; 5.0% growth from 2009
- Medicaid (as a % of NHE spending): 15%; 7.2% growth from 2009
References
Martin, A.B., Lassman, D., Washington, B., Catlin, A., & the National Health Expenditure Accounts Team (2012). Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009. Health Affairs, 31, 1, 208-219.
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