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44. Systems Safety: Identifying Facilitators, Barriers and Failure Modes on a Postnatal Unit
DescriptionThe postpartum period is critical for safeguarding the health and well-being of birthing people (BP). System-level barriers exist in postpartum care, including poor continuity of care and lack of adherence to safe staffing, impacting BP’s experiences and contributing to adverse outcomes.

We completed a secondary analysis of observational data collected in a postnatal unit to examine system-level barriers and facilitators impacting healthcare workers’ (HCW) care practices. Barriers and facilitators were identified and coded using the System Engineering and Initiative for Patient Safety 2.0 model and the Healthcare Performance Improvement Taxonomies of Individual and System Failure Modes. We identified barriers, including miscommunication between HCWs, insufficient patient education, space constraints, and shortages of tools and technology. Facilitators included securing informed consent from patients and good patient-provider communication. The findings from this research can inform the design and improvement of postnatal units to improve patient safety and support HCWs in providing high-quality care.
Event Type
Poster
TimeWednesday, September 11th5:30pm - 6:30pm MST
LocationMcArthur Ballroom
Tracks
Aerospace Systems
Cognitive Engineering & Decision Making
Computer Systems
Forensics Professional
Health Care
Human Performance Modeling
Individual Differences in Performance
Perception and Performance
Product Design
Safety
Training
Usability and System Evaluation
Extended Reality