PT  - JOURNAL ARTICLE
AU  - Alastair Watson
AU  - Rahul Mukherjee
AU  - Dominic Furniss
AU  - Jane Higgs
AU  - Alastair Williamson
AU  - Alice Turner
TI  - A human factors approach to quality improvement in oxygen prescribing
AID  - 10.7861/clinmed.2021-0164
DP  - 2022 Mar 01
TA  - Clinical Medicine
PG  - 153--159
VI  - 22
IP  - 2
4099  - http://www.rcpjournals.org/content/22/2/153.short
4100  - http://www.rcpjournals.org/content/22/2/153.full
SO  - Clin Med2022 Mar 01; 22
AB  - The safe hospital administration of oxygen has been shown to improve outcomes for specific patient groups, including those with chronic obstructive pulmonary disease (COPD). Oxygen prescribing is therefore recognised as a quality standard within the COPD Clinical Audit of the National Asthma and Chronic Obstructive Pulmonary Disease Programme. Oxygen prescription within our hospital electronic prescribing system showed poor compliance, despite previous quality improvement (QI) interventions. Using the functional resonance analysis method (FRAM), a human factors methodology, alongside existing QI approaches allowed capture of everyday work (‘work-as-done’) using qualitative data. This confirmed the complexity of the socio-technical healthcare system in which care is delivered and the variability of steps in the process, and provided new potential interventions to improve the safe administration of oxygen. The use of human factors tools within QI projects may help bridge normative models of work-as-prescribed and inductive models of work-as-done to support improvement and sustainability of care delivery interventions.