@Article{info:doi/10.2196/39670，作者=“Tennant, Ryan and Tetui, Moses and Grindrod, Kelly and Burns, Catherine M”，标题=“了解大规模COVID-19疫苗接种诊所一线的人为因素挑战:人体系统建模研究”，期刊=“JMIR Hum Factors”，年=“2022”，月=“11”，日=“10”，卷=“9”，数=“4”，页=“e39670”，关键词=“认知工作分析;相关设计;COVID-19;决策;卫生保健系统;大流行;疫苗接种门诊;背景:在全球范围内实施COVID-19疫苗大规模接种诊所是一项成功的公共卫生活动。然而，这种紧密耦合的系统在后勤方面存在许多挑战，导致工作场所压力增加，这在整个大流行期间得到了证明。在非临床环境中结合多学科团队的大规模疫苗接种诊所的复杂性尚未从人类系统的角度得到理解。 Objective: This study aimed to holistically model mass COVID-19 vaccination clinics in the Region of Waterloo, Ontario, Canada, to understand the challenges centered around frontline workers and to inform clinic design and technological recommendations that can minimize the systemic inefficiencies that contribute to workplace stress. Methods: An ethnographic approach was guided by contextual inquiry to gather data on work as done in these ad-hoc immunization settings. Observation data were clarified by speaking with clinic staff, and the research team discussed the observation data regularly throughout the data collection period. Data were analyzed by combining aspects of the contextual design framework and cognitive work analysis, and building workplace models that can identify the stress points and interconnections within mass vaccination clinic flow, developed artifacts, culture, physical layouts, and decision-making. Results: Observations were conducted at 6 mass COVID-19 vaccination clinics over 4 weeks in 2021. The workflow model depicted challenges with maintaining situational awareness about client intake and vaccine preparation among decision-makers. The artifacts model visualized how separately developed tools for the vaccine lead and clinic lead may support cognitive tasks through data synthesis. However, their effectiveness depends on sharing accurate and timely data. The cultural model indicated that perspectives on how to effectively achieve mass immunization might impact workplace stress with changes to responsibilities. This depends on the aggressive or relaxed approach toward minimizing vaccine waste while adapting to changing policies, regulations, and vaccine scarcity. The physical model suggested that the co-location of workstations may influence decision-making coordination. Finally, the decision ladder described the decision-making steps for managing end-of-day doses, highlighting challenges with data uncertainty and ways to support expertise. Conclusions: Modeling mass COVID-19 vaccination clinics from a human systems perspective identified 2 high-level opportunities for improving the inefficiencies within this health care delivery system. First, clinics may become more resilient to unexpected changes in client intake or vaccine preparation using strategies and artifacts that standardize data gathering and synthesis, thereby reducing uncertainties for end-of-day dose decision-making. Second, improving data sharing among staff by co-locating their workstations and implementing collaborative artifacts that support a collective understanding of the state of the clinic may reduce system complexity by improving shared situational awareness. Future research should examine how the developed models apply to immunization settings beyond the Region of Waterloo and evaluate the impact of the recommendations on workflow coordination, stress, and decision-making. ", issn="2292-9495", doi="10.2196/39670", url="https://humanfactors.www.mybigtv.com/2022/4/e39670", url="https://doi.org/10.2196/39670", url="http://www.ncbi.nlm.nih.gov/pubmed/36219839" }