Evaluating the use of systems thinking methods in healthcare: a RE-AIM analysis of AcciMap and Net-HARMS.

There are increasing calls for the application of systems ergonomics methods in healthcare, although evidence for their utility and uptake is limited. In this study, 67 Australian healthcare workers participated in a six-month longitudinal study where they were trained to apply the AcciMap adverse event analysis and Net-HARMS risk assessment methods. Data were gathered in line with the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) evaluation framework, including rates of organisational uptake and method validity, perceived workload, usability, and barriers and facilitators to use in practice.

Efficacy of a student-led interprofessional health clinic in regional Australia for preventing and managing chronic disease.

Increasing chronic disease rates in regional Australian communities necessitates innovative models of healthcare. We evaluated the efficacy of an interprofessional chronic disease program, delivered within a regional student-led nursing and allied health clinic in Southern Queensland, Australia. Changes to anthropometric, aerobic fitness and strength, and quality of life outcomes were examined at four time points spanning 16 months: intake, program transition (4 months), 6 and 12 months (post-transition).

Findings, progress, and lessons learned during the first 3 years of a student-led interprofessional health clinic in regional Australia.

We describe the establishment and operation of a student-led interprofessional chronic disease prevention and management clinic in regional Australia. Our aim was twofold. First, to report on service delivery, student placement, and health outcome data; and second, to discuss key lessons learned during the first 3½ years of clinic operations.

Testing the reliability of accident analysis methods: a comparison of AcciMap, STAMP-CAST and AcciNet.

Accident analysis methods are used to model the multifactorial cause of adverse incidents. Methods such as AcciMap, STAMP-CAST and recently AcciNet, are systemic approaches that support the identification of safety interventions across sociotechnical system levels. Despite their growing popularity, little is known about how reliable systems-based methods are when used to describe, model and classify contributory factors and relationships.

Understanding complexity in a safety critical setting: A systems approach to medication administration.

'Medication errors' are a significant concern and are associated with a higher incidence of adverse events and unintentional patient harm than any other aspect of healthcare. While much research has focused on adverse medication errors, limited studies have specifically examined 'normal' medication delivery performance and the interactions between tasks, agents, and information within the medication administration system. This article describes a study that applied the Event Analysis of Systemic Teamwork (EAST) model to study the hospital medication administration system to identify opportunities to optimise performance and patient safety.

Impact of the COVID-19 pandemic on student supervision and education in health care settings: A state-wide survey of health care workers.

Objective: To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID-19 pandemic.

Background: Studies on the impact of COVID-19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences.

The need for a complex systems approach in rural health research.

On a global scale, many major rural health issues have persisted for decades despite the introduction of new health interventions and public health policies. Although research efforts have generated valuable new knowledge about the aetiology of health, disease and health inequities in rural communities, rural health systems remain to be some of the most deprived and challenged in both the developing and developed world. While the reasons for this are many, a significant factor contributing to the current state of play is the pressing need for methodological innovation and relevant scientific approaches that have the capacity to support the translation of novel solutions into 'real world' rural contexts.

Towards a unified model of accident causation: refining and validating the systems thinking safety tenets.

The systems thinking tenets were developed based on a synthesis of contemporary accident causation theory, models and approaches and encapsulate 15 features of complex systems that interact to create both safety and adverse events. Whilst initial testing provided supportive evidence, the tenets have not yet been subject to formal validation. This article presents the findings from a three-round Delphi study undertaken to refine and validate the tenets and assess their suitability for inclusion in a unified model of accident causation.

Using systems thinking-based risk assessment methods to assess hazardous manual tasks: a comparison of Net-HARMS, EAST-BL, FRAM and STPA.

Formal risk assessment is a component of safety management relating to hazardous manual tasks (HMT). Systems thinking approaches are currently gaining interest for supporting safety management. Existing HMT risk assessment methods have been found to be limited in their ability to identify risks across the whole work system; however, systems thinking-based risk assessment (STBRA) methods were not designed for the HMT context and have not been tested in this area.

Testing the reliability and validity of risk assessment methods in Human Factors and Ergonomics.

There is growing interest in the use of systems-based risk assessment methods in Human Factors and Ergonomics (HFE). The purpose of this study was to test the intra-rater reliability and criterion-referenced concurrent validity of three systems-based risk assessment approaches: (i) the Systems-Theoretic Process Analysis (STPA) method; (ii) the Event Analysis of Systemic Teamwork Broken Links (EAST-BL) method; and, (iii) the Network Hazard Analysis and Risk Management System (Net-HARMS) method. Reliability and validity measures were obtained using the Signal Detection Theory (SDT) paradigm.

Human Factors and Ergonomics and the management of existential threats: A work domain analysis of a COVID-19 return from lockdown restrictions system.

Following strict "lockdown" restrictions designed to control the spread of the COVID-19 virus, many jurisdictions are now engaged in a process of easing restrictions in an attempt to stimulate economic and social activity while continuing to suppress virus transmission. This is challenging and complex, and in several regions, new outbreaks have emerged. We argue that systems Human Factors and Ergonomics methods can assist in understanding and optimizing the return from lockdown.

The impact of power on health care team performance and patient safety: a review of the literature.

Communication failure within health care teams is a major cause of patient harm across health care settings. Factors which contribute to communication failure include actual or perceived 'power'. Whilst a great deal of ergonomics research has focussed on teamwork in health care, the role of power in relation to measurable patient safety and performance outcomes remains relatively unknown.

Complexity theory in accident causation: using AcciMap to identify the systems thinking tenets in 11 catastrophes.

The quest to explain and understand the cause of accidents is both ever-present and ongoing amongst the safety science community. In an attempt to advance the theory and science of accident causation, researchers have recently formalised a set of '15 systems thinking tenets' that cover the conditions and characteristics of work systems that are believed to contribute to the cause of accidents. The purpose of this study was to attempt to identify the systems thinking tenets across a range of different systems and accidents using the Accident Mapping (AcciMap) method.

Sports Organizations as Complex Systems: Using Cognitive Work Analysis to Identify the Factors Influencing Performance in an Elite Netball Organization.

There is increasing interest in the adoption of a complex systems thinking approach when attempting to understand and optimize sports performance. Despite this, few studies have attempted to model elite sports organizations. The aim of this study was to use methods from the Cognitive Work Analysis (CWA) framework to develop a model of an elite netball organization and identify wider organizational functions and constraints influencing performance.

A Systematic Review and Meta-analysis on Sodium Bicarbonate Administration and Equine Running Performance: Is it Time to Stop Horsing Around With Baking Soda?

Sodium bicarbonate administration in the hours prior to exercise has been used as a performance-enhancing substance in horses since the late 1980s. Although sodium bicarbonate administration to racehorses 24 hours before racing is a banned practice in most racing industries, whether or not it improves running performance in racehorses is currently unclear. The aim of this systematic review and meta-analysis was to establish whether or not acute sodium bicarbonate administration improves running performance in trained Standardbred and Thoroughbred horses.

Systems thinking-based risk assessment methods applied to sports performance: A comparison of STPA, EAST-BL, and Net-HARMS in the context of elite women's road cycling.

There is increasing interest in applying systems Human Factors and Ergonomics (HFE) methods in sport. Risk assessment (RA) methods can be used identify risks which may impact the performance of individual athletes, teams, and overall sports systems; however, they have not yet been tested in sport. This study sets out to apply and compare three systems thinking-based RA methods in the context of elite sports performance and report on the frequency and types of the risks identified.

Out of control? Using STAMP to model the control and feedback mechanisms surrounding identity crime in darknet marketplaces.

Darknet marketplaces have emerged as a facilitator of identity crime and trading. This study aimed to (1) understand the entities and control and feedback mechanisms that influence identity crime prevention and occurrence on the darknet in the Australian system and to (2) comprehensively identify the implications of control failures across all system levels. The Systems-Theoretic Accident Model and Processes (STAMP) was used to develop an identity crime control structure in consultation with subject matter experts and then the Systems-Theoretic Process Analysis (STPA) was applied.

Radical systems thinking and the future role of computational modelling in ergonomics: an exploration of agent-based modelling.

We are teetering on the precipice of the imminent Fourth Industrial Revolution. In this new age, systems are set to become more densely intraconnected and interconnected, and massive sociotechnical systems exhibiting unprecedented levels of complexity will increasingly take hold. At the dawning of this new age, the Ergonomics discipline must reflect on its preparedness for tackling problems in these novel systems.

Beyond the Tip of the Iceberg: Using Systems Archetypes to Understand Common and Recurring Issues in Sports Coaching.

Systems thinking, a fundamental approach for understanding complexity, is beginning to gain traction in sports science. Systems archetypes (SAs) describe common recurring patterns of system behaviors and have been used extensively in other domains to explain the system wide influences on behavior. SAs look at the deeper levels of systemic structure by identifying what creates system behaviors, which supports the development of interventions to identify and resolve problem sources.

A Systems Approach to Performance Analysis in Women's Netball: Using Work Domain Analysis to Model Elite Netball Performance.

Netball is a newly professional women's sport, as such there has been little research conducted investigating performance analysis (PA) in elite netball. The aim of this study was to develop a model of the elite netball performance system to identify the complex relationships among key performance indicators. Eleven elite subject matter experts (SMEs) participated in workshops to produce a systems model of the netball match performance.

The Association Between Changes in Weekly Running Distance and Running-Related Injury: Preparing for a Half Marathon.

Background: Sudden changes in training load may play a key role in the development of running-related injury (RRI). Because the injury mechanism depends on the runner's musculoskeletal load capacity, the running schedule followed prior to sudden change in training load may influence the amount of change that a runner can tolerate before the runner is at a higher risk of RRI.

Objectives: To investigate the association between change in weekly running distance and RRI, and to examine whether the association may be modified by the running schedule the runner follows.

Bad behaviour or societal failure? Perceptions of the factors contributing to drivers' engagement in the fatal five driving behaviours.

The so-called 'fatal five' behaviours (drink and drug driving, distraction and inattention, speeding, fatigue, and failure to wear a seat belt) are known to be the major behavioural contributory factors to road trauma. However, little is known about the factors that lead to drivers engaging in each behaviour. This article presents the findings from a study which collected and analysed data on the factors that lead to drivers engaging in each behaviour.