Work-arounds in health care settings: Literature review and research agenda

被引:160
|
作者
Halbesleben, Jonathon R. B. [1 ]
Wakefield, Douglas S. [2 ]
Wakefield, Bonnie J. [3 ,4 ]
机构
[1] Univ Wisconsin Eau Claire, Dept Management & Mkt, Eau Claire, WI 54702 USA
[2] Univ Missouri, Ctr Hlth Care Qual, Dept Hlth Management & Informat, Columbia, MO 65211 USA
[3] Univ Missouri, Hlth Sev Res & Dev, Harry S Truman Mem Vet Hosp, Columbia, MO 65211 USA
[4] Univ Missouri, Sinclair Sch Nursing, Columbia, MO 65211 USA
关键词
work-arounds; work process; patient safety; errors; literature review;
D O I
10.1097/01.HMR.0000304495.95522.ca
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: As health care professionals seek to balance technological and regulatory demands with the need to provide patient-centered care, all in an efficient and cost-effective manner, they may see a greater need to improvise or work around intended work practices. Health care professionals acknowledge widespread use of work-arounds, and the literature documents their prevalence and influence on performance. Despite their importance, few studies have focused exclusively on work-arounds. This suggests a key area of need in the research, particularly because work-arounds are frequently cited in the context of serious patient safety consequences. Purpose: The purpose of this article is to review the existing literature concerning work-arounds to elucidate the definition and nature of work-arounds, how work-arounds can be differentiated from similar constructs (e.g., errors, mistakes, and deviance), and the potential causes of work-arounds and to explore potential consequences of work-arounds in health care settings. Approach: We conducted a systematic review of the literature concerning work-arounds to develop themes concerning the nature of work-arounds and ideas for future research on the topic. Implications for Practice: In this article, we develop links between work-arounds and potential outcomes, particularly safety outcomes. Moreover, we discuss the manner in which open discussion can allow work-arounds to facilitate work process improvement and the role that climate and culture play in reducing work-arounds.
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页码:2 / 12
页数:11
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