Developing healthcare process models: An example from the care home system

A major challenge in improving safety in complex socio-technical systems for example care homes is in the analysis and design. This study is part of a larger project examining medication safety in care home patients who have been admitted to hospital. For this study, the aim was to investigate the role of ward pharmacists in ensuring the safe delivery of medicines to patients in hospital with an emphasis on care home residents. Semi-structured interviews were conducted with 9 ward pharmacists in a district general hospital. Four main themes about the pharmacists' work emerged and Hierarchical Task Analysis (HTA) was used to model the ward pharmacists' tasks and processes. HTA was successfully applied in the first few levels of the process model, but the usefulness of the method was limited by the wide variation in task processes. There is a need for the application of other methods, such as CognitiveWork Analysis (CWA), that model the whole system and are able to capture the complexity of processes in a dynamic system like healthcare.