by elements of the system. If the individual is not sufficiently capable or the system’s demands are too high, then the tasks cannot be performed. In these situations, there are usually several solutions, the most appropriate of which will depend on the results of an analysis of the individual, the tasks, the technologies, and the environmental context. In some cases, tasks can be modified to reduce the demands on the individual; in others, the technology itself can be modified to augment the individual’s capabilities or simplify task execution. In still others, training to augment an individual’s skills is the most appropriate solution.

Members of the then-standing Committee on Human-Systems Integration1 at the National Research Council (NRC), a division of the National Academies, became interested in the topic of human factors and its role in improving health care in the home. The Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services agreed that the issues were worth exploring and agreed to fund this study.

To conduct the study, the NRC appointed the Committee on the Role of Human Factors in Home Health Care. This committee of 11 experts included physicians and nurses with knowledge of home health care and experts from various technological, social, and behavioral science disciplines. Members of the committee were selected following standard NRC procedures for committee formation that ensure individual member qualification and independence, as well as freedom from conflicts of interest and overall committee balance and diversity. Brief biographical sketches of the committee members are contained in the Appendix.

The charge to the committee is shown in Box 1-1. The committee’s overall objective was to gain a deeper understanding of (1) the role human factors can play in developing systems that address the relevant sensory, behavioral, and cognitive capabilities of care recipients and caregivers; (2) the nature of the care processes, procedures, and therapies increasingly occurring in the home; (3) the steady migration and use of medical equipment and technologies in the home environment; (4) the design of the physical home environment to facilitate the delivery of care; and (5) the impact of cultural, social, and community factors on home health care and healthy lifestyles.

This report, prepared by members of the committee, documents the current state of health care in the home and identifies existing problems and opportunities for the improvement of care through applying human factors knowledge and methods. Throughout our work, the committee was constantly reminded that delivery of health care in the home occurs in the larger context of the health care system and policies that impact that

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1In December 2010, the Committee on Human-Systems Integration was reconstituted as the Board on Human-Systems Integration.



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