From vision to reality:How human factors can inform the design of cardiac diagnostic services in community settings

Introduction: Expanding diagnostic capacity in healthcare systems requires new service delivery models like Community Diagnostic Centres (CDCs). Designing effective diagnostic services in the community requires attention to the practical realities of the work system in addition to the clinical vision. Methods: This study applied a human factors approach through the Systems Engineering Initiative for Patient Safety (SEIPS) model to inform the design of community cardiac diagnostic services, focusing on workforce design and the potential role of cardiac physiologists. The study setting was a cardiology department at a community hospital. Data were collected through observations, interviews and focus groups. Data were analysed using SEIPS and Thematic Analysis. Results: The analysis revealed three overarching design considerations: (1) Promoting professional growth and autonomy for the cardiac workforce in the community. (2) Focusing on the needs of patients in the community, including accessibility and communication. (3) Facilitating communication across organisational boundaries, particularly between CDCs and General Practitioners (GPs). Conclusion: Human factors offers valuable insights to bridge the gap between clinical vision and practical implementation of CDCs. Addressing identified design considerations can ensure effective workforce models, patient-centered care, and seamless collaboration within the healthcare system. Implications for practice: Integrating human factors expertise into community diagnostic services design and implementation teams can contribute to patient-centred and services and effective workflows. This requires access to specialised human factors expertise. Providers of diagnostic services could consider embedding human factors expertise into their settings and tap into existing educational human factors frameworks.