Table 1

Examples of PETT scan

Work system factorsExample: 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‡
  • Patients

  • Healthcare professionals

  • Others

Poor understanding of what would be needed once back at homeSharing nursing knowledge with bedside ICU nursesLack of communication skills of clinicians
Parent fatigue
Parent knowledge of their child’s condition
  • Physical

  • Socio-organisational

  • External

Collaboration from clinician: follow-up call after discharge to help patient with recovery at homeLack of acceptance of tele-ICU by ICU staffPositive teamwork and collaboration between tele-ICU and ICU
Quiet work environment
Interruptions and noise affecting team communication
ToolsToo many educational materialsToo many logins in multiple health information systemsAccess to comprehensive information on patientComputer as a physical barrier to communicationUse of computer to present and share visual information such as X-ray
TasksReceiving inadequate or incomplete instructions about patient care at homeMissing direct patient care in the ICUChallenging and interesting job content because dealing with various ICU patient problemsIntroduction of all team members and their roles
Interactions between people, environments, tools and tasksNegative 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.