Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia

Appl Ergon. 2017 Oct:64:27-40. doi: 10.1016/j.apergo.2017.05.002. Epub 2017 May 13.

Abstract

Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 h of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes.

Keywords: Alzheimer's Disease; Dementia; Field research; Mental health; Work system analysis; Workflow Elements Model.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Appointments and Schedules
  • Communication
  • Community Mental Health Services / organization & administration*
  • Delivery of Health Care / organization & administration*
  • Dementia / therapy
  • Depression / therapy
  • Ergonomics
  • Female
  • Home Care Services*
  • Humans
  • Male
  • Middle Aged
  • Models, Organizational
  • Professional-Patient Relations
  • Systems Analysis
  • Travel
  • Workflow