了解人的因素在COVID-19大规模疫苗接种第一线面临的挑战卡塔尔世界杯8强波胆分析人类系统建模研究%A Tennant,Ryan %A Tetui,Moses %A Grindrod,Kelly %A Burns,Catherine M %+滑铁卢大学工程学院系统设计工程系，安大略省滑铁卢大学西大街200号，N2L 3G1，加拿大，1 519 888 4567，drtennan@uwaterloo.ca %K认知工作分析%K上下文设计%K COVID-19 %K决策%K卫生保健系统%K大流行%K疫苗接种诊所%K工作场所压力%D 2022 %7 10.11.2022 %9背景:在全球范围内实施大规模疫苗接种诊所进行COVID-19免疫接种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。目的:本研究旨在对加拿大安大略省滑铁卢地区的大规模COVID-19疫苗接种诊所进行整体建模，以了解以一线工作人员为中心的挑战，并为诊所设计和技术建议提供信息，以最大限度地减少导致工作场所压力的系统性低效率。方法:在背景调查的指导下，采用人种学方法收集在这些临时免疫设置中所做工作的数据。通过与临床工作人员交谈，明确观察数据，在整个数据收集期间，研究小组定期讨论观察数据。通过结合上下文设计框架和认知工作分析的各个方面来分析数据，并建立工作场所模型，以识别大规模疫苗接种诊所流程、开发的工件、文化、物理布局和决策中的压力点和相互联系。结果:2021年在6个COVID-19大规模疫苗接种诊所进行了为期4周的观察。 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. %M 36219839 %R 10.2196/39670 %U https://humanfactors.www.mybigtv.com/2022/4/e39670 %U https://doi.org/10.2196/39670 %U http://www.ncbi.nlm.nih.gov/pubmed/36219839