Examples of PETT scan
| Work system factors | Example: patient work System factors associated with transitions and rehospitalisations among patients discharged following abdominal surgery* | Example: clinician work System factors associated with tele-ICU nurses’ job performance† | Example: collaborative work System factors associated with family engagement in the paediatric hospital bedside rounding process‡ | |||
| Barriers | Facilitators | Barriers | Facilitators | Barriers | Facilitators | |
People
| Poor understanding of what would be needed once back at home | Sharing nursing knowledge with bedside ICU nurses | Lack of communication skills of clinicians Parent fatigue | Parent knowledge of their child’s condition | ||
Environments
| Collaboration from clinician: follow-up call after discharge to help patient with recovery at home | Lack of acceptance of tele-ICU by ICU staff | Positive teamwork and collaboration between tele-ICU and ICU Quiet work environment | Interruptions and noise affecting team communication | ||
| Tools | Too many educational materials | Too many logins in multiple health information systems | Access to comprehensive information on patient | Computer as a physical barrier to communication | Use of computer to present and share visual information such as X-ray | |
| Tasks | Receiving inadequate or incomplete instructions about patient care at home | Missing direct patient care in the ICU | Challenging and interesting job content because dealing with various ICU patient problems | Introduction of all team members and their roles | ||
| Interactions between people, environments, tools and tasks | Negative interaction in the discharge process: patients receiving insufficient instructions (tasks) in a hurried manner (environments), therefore not understanding what will be needed for home recovery (people) | Positive interaction between tele-ICU and ICU (organisational environment) facilitates communication and sharing of information (tasks) | High clinician workload (environments) may limit their availability and participation in bedside rounding, therefore affecting information exchange and communication (tasks) | |||
*Adapted from Acher et al’s study of system factors contributing to readmissions of surgical patients.22
†Adapted from Hoonakker et al’s study of tele-ICU nurses.24
‡Adapted from Carayon et al’s study of family engagement in bedside rounds in a paediatric hospital.23
ICU, intensive care unit; ;PETT, people, environments, tools and technologies.