Applied ergonomics · 2026
Formal responsibility and task execution: the importance of modelling task delegation in FRAM to optimise the identification of potential improvement strategies.
СтатьяНазвание и аннотация: Перевод в очереди
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Luijcks N M, Bazuin T, Marang-van de Mheen P J, van der Laan M J, Groeneweg J
Аннотация
OBJECTIVE: To investigate how task delegation for perioperative anticoagulation management is reported in protocols and daily practice, and how this translates to additional information in work-as-imagined and work-as-done using FRAM to identify improvement possibilities.
METHODS: Existing FRAM visualisations of perioperative anticoagulant management in a Dutch academic hospital were extended to include task delegation in protocols using document analysis and in daily practice using a focus group of eight healthcare professionals, analysed using content analysis.
RESULTS: Distinguishing between formal responsibility and task execution revealed additional functions and roles in both work-as-done and work-as-imagined, resulting in more discrepancies between work-as-done and work-as-imagined. Professionals experienced responsibility for delegated tasks, even without formal accountability, and needed to feel qualified and capable as well as complete clear information to accept these tasks.
CONCLUSIONS: Including task delegation in FRAM models improves the understanding of healthcare processes, communication about distribution of responsibilities and thereby development of more effective improvement strategies.
METHODS: Existing FRAM visualisations of perioperative anticoagulant management in a Dutch academic hospital were extended to include task delegation in protocols using document analysis and in daily practice using a focus group of eight healthcare professionals, analysed using content analysis.
RESULTS: Distinguishing between formal responsibility and task execution revealed additional functions and roles in both work-as-done and work-as-imagined, resulting in more discrepancies between work-as-done and work-as-imagined. Professionals experienced responsibility for delegated tasks, even without formal accountability, and needed to feel qualified and capable as well as complete clear information to accept these tasks.
CONCLUSIONS: Including task delegation in FRAM models improves the understanding of healthcare processes, communication about distribution of responsibilities and thereby development of more effective improvement strategies.