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- Jarebrant, Caroline, et al.
(författare)
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Development of a tool for integrating Value Stream Mapping and ergonomics in healthcare - A Nordic Multicenter study.
- 2014
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Ingår i: The 7th Nordic Working Life Conference. Book of Abstracts and Programme. - 9789198119558 ; , s. 123-124
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To present the most recent draft Nordic version of the ErgoVSM tool for healthcare and some contextual factors influencing the intended impact of the tool. Material and Methods: The ErgoVSM tool is tested at 7 wards on 4 different hospitals in Denmark, Iceland and Sweden. The tests include assessment of tool usability and main factors facilitating or inhibiting the intended impact of the tool. On the basis of these trials a final version of the ErgoVSM is developed. The ErgoVSM tool: According to common VSM procedure the Current State is mapped (visualized) followed by a similar procedure regarding a wanted Future State. The Ergo-module includes assessments of physical exposures (posture, forces, variation, porosity) and psychosocial exposures (demands, control, variation, communication, porosity). It focuses task as well as values stream level. The exposures are assessed by ratings scales with verbally defined end points. The analysis includes discussion of solutions and establishment of an Action Plan needed to realize the wanted Future State. Main contextual factors influencing the intended impact of the tool seem to be previous Lean experience, management style, volume of competing projects and type of value stream analysed.
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| 2. |
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| 3. |
- Edwards, Kasper, et al.
(författare)
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A method for effect modifier assessment (EMA) in ergonomic intervention research
- 2018
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 0003-6870. ; 72, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- The numerous opportunities for effect modifications pose a major challenge in ergonomic intervention research. Even studies in systematic reviews that are assessed as being of high quality generally lack any proper consideration of the potential effect modifiers. We have developed a method for effect modifier assessment (EMA) in intervention research. The EMA method uses a participatory workshop consisting of representatives from all occupational groups in the investigated organization. The workshop identifies both intervention and modifier events including “confounders” and “effect modifiers” according to epidemiologic terminology. These are categorized into themes, then analyzed and evaluated for their potential effects on the investigated outcomes. The overall impact of the pooled modifier themes is finally estimated in relation to the estimated impact of the intervention events. In the present study, the EMA method was tested in two cases. The findings suggest that it provides information that strengthens inferences about the impact of the investigated ergonomic interventions. Further evaluation of the method is recommended.
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| 4. |
- Edwards, Kasper, et al.
(författare)
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A method for Effect Modifier Assessment in ergonomic intervention research – The EMA method
- 2016
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Ingår i: Abstract book of the 10th NOVO symposium, Reykjavík, 10 – 11 November, 2016. s. 13. - 9789935926555
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Ergonomic intervention research includes studies in which researchers arrange (or follow) changes in working conditions to determine the effects in risk factors and/or health. Often this research takes place at workplaces and not in a controlled environment of a laboratory. The effects may thus be due to other factors in addition to the investigated intervention – i.e. due to effect modifiers. Such effect modifiers need to be identified and assessed in terms of potential impact on the investigated outcome before proper inference can be drawn. A preliminary review of the literature revealed lack of or poor consideration of effect modifiers in ergonomic intervention research. We present a method that has been developed over the course of several years parallel to intervention studies in healthcare. Material and methods: The EMA method is a type of group interview including 3-6 employees representing the occupational groups in the investigated organization. With reference to the investigated period they are asked to recall important changes/events in and around the ward; 1) in general, 2) in work processes and equipment and 3) regarding their work environment. In each step the participants write their individual answer on post-it notes. The answers are then discussed in plenum, one at a time, and the post-it note is placed on a timeline. At the end this illustrates the sequence of significant events. All identified events are assessed for being caused by either the investigated intervention(s) or other causes (“the effect modifiers”) and their impact on the work environment. Following the workshop, events are entered into a database and reassessed by triangulation based on scientific evidence, researcher knowledge, reading the transcribed audio recorded workshop and other local sources. Conclusion: The EMA method seems to offer a feasible procedure to obtain significant knowledge on potential effect modifiers in ergonomic intervention research. However, further development and validation is suggested.
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| 5. |
- Edwards, Kasper, et al.
(författare)
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A method for Effect Modifier Assessment in intervention research – The EMA method
- 2017
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Ingår i: European Association of Work and Organizational Psycholog. Dublin, Ireland: 17-20 May.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Intervention research includes studies in which researchers arrange (or follow)changes in working conditions to determine the effects on risk factor, health and/or performance. Often this research takes place at workplaces and not in a controlled laboratory environment. Effects may thus be due to other factors in addition to the intervention – i.e. effect modifiers. These need to be identified and assessed in terms of potential impact on studied outcomes before proper inference can be drawn. We present a method to estimate potential effects of modifiers in intervention research. Methodology: The EMA method is a type of group interview including 3-6 employees representing the occupational groups in the investigated organization. With reference to the investigated period they are asked to recall important changes/events in and around the organization; 1) in general, 2) in work processes and equipment and 3) regarding their work environment. In each step the participants write their individual answers on post-it notes which are then discussed in plenum, one at a time, and placed on a timeline. All identified events are assessed as due to the investigated intervention(s) or other causes (“effect modifiers”). Their impact on the outcomes is estimated by triangulation. Following the workshop, events are entered into a database and analyzed. Results: Preliminary evaluations of the method suggest that it offers a relevant overview of potential effect modifiers. Limitations: Further validation is needed. Implications: Using the EMA-method seems to facilitate proper inference regarding the impact of a workplace intervention. Originality: The EMA-method is a novel and systematic approach to estimate potential effect modifiers.
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| 6. |
- Edwards, Kasper, et al.
(författare)
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Accounting for effect modifiers in ergonomic intervention research
- 2016
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Ingår i: Proceedings of the 48th annual conference of Nordic Ergonomics and Human Factors Society (NES) “NES2016 - Ergonomics in Theory and practice”. Kuopio, Finland, August 14-17, 2016. - 1798-5730. - 9789526121925
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Konferensbidrag (refereegranskat)abstract
- The impact of ergonomic interventions may be offset by other changes at the work place, primarily rationalizations. These have previously been shown to imply a dominant negative effect on health and risk factors, thus causing effect modification. We present a method identifying potential effect modifiers in ergonomic intervention studies.
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| 7. |
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| 8. |
- Edwards, Kasper, et al.
(författare)
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Effect Modifier Assessment in intervention research by the EMA method - a variant of Chronicle Workshop
- 2018
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Ingår i: Proceedings of the 20th Congress of the International Ergonomics Association (IEA) 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A Chronicle Workshop (CW) is a participatory method for collecting information regarding defined events during a defined time period of an organization. The CW intends to facilitate a group-based process centered around their shared history. Occupational intervention research investigates whether defined changes at worksites have the desired positive work environment outcomes. However, the outcome may be affected also by other events not part of the investigated interventions, i.e. modifiers. Consequently, we developed a new method for effect modifier assessment (the EMA method) in ergonomic intervention studies including significant elements of the CW (Edwards and Winkel, conditionally accepted). This paper presents the method and includes preliminary examinations of its applicability in intervention case studies at Danish workplaces. Methodology: The EMA method estimates both modifier and intervention events and their impact on the investigated outcome(s). It is, as the CW method, using a type of group interview with 3-6 employees representing the occupational groups in the investigated organization. With reference to the investigated period they are asked to recall important changes/events in and around the organization; 1) in general, 2) regarding work processes and equipment and 3) regarding their work environment. The three levels form a funnel going from general to specific events. In each step the participants write their individual answer on post-it notes, which are then discussed in plenum, one at a time, and placed on a timeline. All identified events are assessed for being caused by either the investigated intervention(s) or other causes (“the effect modifiers”) and their impact on the outcomes. These assessments are thereafter validated by triangulation, entered into a database and analyzed. The EMA method has been tested in 51 workshops and some results are presented below. Results and Discussion: Industry Workshops Intervention Modifiers Bed wards 6 Ergonomic Value stream mapping Significant changes in the wards modify intervention effect. Mixed wards 13 Relational coordination as a change approach. Low compliance to intervention. Surgical ward 6 Lean project to improve performance and well-being. Poor leadership, managers not following rules. Merger caused collaboration problems. Industry 3 Agile State-Gate development in mid-sized hardware companies Method assumptions and procedures not met. Banking 23 Natural experiment - Investigating social capital and performance Performance management influence collaboration negatively. Total 51 The 51 workshops were performed as integrated parts of our development of the final version of the EMA method. Thus, not all the workshops have followed the instructions of the final version of the EMA method. Limitations: The event assessments and their impact are based on the participants’ subjective perceptions. A key issue is therefore the validity of these assessments. This may partly be reduced by the suggested triangulation. Further validations, such as inter-method reliability tests, are needed.
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| 9. |
- Edwards, Kasper, et al.
(författare)
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Some key issues in the development of ergonomic intervention tools
- 2016
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Ingår i: Proceedings of the 48th annual conference of Nordic Ergonomics and Human Factors Society (NES) “NES2016 - Ergonomics in Theory and practice”. - 1798-5730. - 9789526121925 ; , s. 175-178
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Konferensbidrag (refereegranskat)abstract
- Literature reviews suggest that tools facilitating the ergonomic intervention processes should be integrated into rationalization tools, particular if such tools are participative. Such a tool has recently been developed as an add-in module to the Lean tool “Value Stream Mapping” (VSM). However, in the investigated context this module seems not to have any direct impact on the generation of proposals with ergonomic consideration. Contextual factors of importance seem to be e.g. allocation of sufficient resources and if work environment issues are generally accepted as part of the VSM methodology.
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