{Reference Type}: Journal Article
{Title}: Work System Assessment to Facilitate the Dissemination of a Quality Improvement Program for Optimizing Blood Culture Use: A Case Study Using a Human Factors Engineering Approach.
{Author}: Xie A;Woods-Hill CZ;King AF;Enos-Graves H;Ascenzi J;Gurses AP;Klaus SA;Fackler JC;Milstone AM;
{Journal}: J Pediatric Infect Dis Soc
{Volume}: 8
{Issue}: 1
{Year}: Mar 2019 28
{Factor}: 5.235
{DOI}: 10.1093/jpids/pix097
{Abstract}: <B>BACKGROUND: </B>Work system assessments can facilitate successful implementation of quality improvement programs. Using a human factors engineering approach, we conducted a work system assessment to facilitate the dissemination of a quality improvement program for optimizing blood culture use in pediatric intensive care units at 2 hospitals.<BR><B>METHODS: </B>Semistructured face-to-face interviews were conducted with clinicians from Johns Hopkins All Children's Hospital and University of Virginia Medical Center. Interview data were analyzed using qualitative content analysis.<BR><B>RESULTS: </B>Blood culture-ordering practices are influenced by various work system factors, including people, tasks, tools and technologies, the physical environment, organizational conditions, and the external environment. A clinical decision-support tool could facilitate implementation by (1) standardizing blood culture-ordering practices, (2) ensuring that prescribing clinicians review the patient's condition before ordering a blood culture, (3) facilitating critical thinking, and (4) empowering nurses to communicate with physicians and advocate for adherence to blood culture-ordering guidelines.<BR><B>CONCLUSIONS: </B>The success of interventions for optimizing blood culture use relies heavily on the local context. A work system analysis using a human factors engineering approach can identify key areas to be addressed for the successful dissemination of quality improvement interventions.