Work system barriers and facilitators in inpatient care transitions of pediatric trauma patients

Abigail R. Wooldridge, Pascale Carayon, Peter Hoonakker, Bat Zion Hose, Benjamin Eithun, Thomas Brazelton, Joshua Ross, Jonathan E. Kohler, Michelle M. Kelly, Shannon M. Dean, Deborah Rusy, Ayse P. Gurses

Research output: Contribution to journalArticlepeer-review


Hospital-based care of pediatric trauma patients includes transitions between units that are critical for quality of care and patient safety. Using a macroergonomics approach, we identify work system barriers and facilitators in care transitions. We interviewed eighteen healthcare professionals involved in transitions from emergency department (ED) to operating room (OR), OR to pediatric intensive care unit (PICU) and ED to PICU. We applied the Systems Engineering Initiative for Patient Safety (SEIPS) process modeling method and identified nine dimensions of barriers and facilitators – anticipation, ED decision making, interacting with family, physical environment, role ambiguity, staffing/resources, team cognition, technology and characteristic of trauma care. For example, handoffs involving all healthcare professionals in the OR to PICU transition created a shared understanding of the patient, but sometimes included distractions. Understanding barriers and facilitators can guide future improvements, e.g., designing a team display to support team cognition of healthcare professionals in the care transitions.

Original languageEnglish (US)
Article number103059
JournalApplied Ergonomics
StatePublished - May 2020


  • Macroergonomics
  • Pediatric trauma care transitions

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Safety, Risk, Reliability and Quality
  • Engineering (miscellaneous)


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