Diagnosing rare diseases: A sociotechnical approach to the design of complex work systems
Applied Ergonomics(2020)
摘要
How do complex healthcare systems that are organised into distinct speciality areas achieve effective patient care transitions when patients present with a rare constellation of symptoms that affect multiple body systems? How do these patients challenge existing ways of organising tasks, clinical activities, and interdependent responsibilities? The current study applies a sociotechnical systems perspective to understand how these complex work design and care-related challenges were resolved by the Western Australian Undiagnosed Diseases Program. We conducted a two-year longitudinal, qualitative study of this program, conceived to improve the diagnosis and management of patients with rare, multi-system disorders by piloting a re-design of the local system of diagnostic work. Specifically, we (1) compared the configuration and effectiveness of the old system and the re-designed system; and (2) analysed the process of system re-design (i.e., the design, implementation, and operation of the program) in order to understand the factors that contributed to – or inhibited – its success. We discuss the theoretical and practical implications of our findings for effectively re-designing complex, trans-organisational work systems.
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关键词
Sociotechnical systems,Work design,Work re-design,Healthcare
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