Applying Work Domain Analysis to a Healthcare Control Centre for Patient Flow Management

Abstract

Staff in hospital departments often focus on local goals for capacity management and patient coordination. Recently, centralised healthcare control centres (HCCs) have been developed that provide co-location of interdisciplinary teams who coordinate patient flow across a healthcare system with the goal of improving patient capacity and outcomes, patient and staff experience, and reducing costs. However, coordination problems may emerge with the implementation of HCCs and new models are needed to gain insight into the HCC’s working environment. In this study, we investigated constraints with the work of an HCC of a large healthcare service using work domain analysis and object worlds. We conducted field work in the HCC and used the data to construct work domain analysis models across key object worlds. Analysis focused on three challenges: (1) lack of integration of information systems within the HCC, (2) non-compatible information systems for transfer of patient records from the HCC to private hospitals, and (3) a reduction in service quality from commercial taxi services contracted by the HCC to transport non-urgent patients. Findings allow the sources of coordination problems to be examined, potentially helping workers coordinate their work more effectively. As demands on healthcare systems escalate, effective patient flow coordination becomes increasingly important for the quality and timeliness of patient care.