In this literature review, researchers synthesized information about operational failures in primary care and found that such failures led to differences between "work as imagined" and "work as done." As a result, physicians compensated for suboptimal systems by undertaking additional work. Operational failures were defined as system-level errors in the supply of information, equipment and materials to health care personnel. This study synthesized results from 95 papers that aligned with the author's general definition of "operational failures," although none of the papers expressly used that term. From this, a gap was shown between what physicians perceived they should be doing and what they were doing because of operational failures. The most common failures were related to information technology and focused on the failures of the electronic medical record. These failures were tied into the extra work required to deliver the goals of care.
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Impacts of Operational Failures on Primary Care Physicians' Work: A Critical Interpretive Synthesis of the Literature
Carol Sinnott, MB, BAO, BCh, MMedSci, PhD, MICGP, MRCPI, et al
University of Cambridge, UK Imperial College, The Healthcare Improvement Studies Institute, Cambridge, United Kingdom
Post-embargo published article link (link is active on March 9, 2020, 5pm Eastern) http://www.annfammed.org/content/18/2/180
The Annals of Family Medicine