9
Weaknesses Considerations
High risk for bias due to the Hawthorne effect,
should not be used to determine rates of adherence
during routine care.
As part of competency-
based training, a systematic
approach may be used to
ensure ongoing, regular
assessments of knowledge and
skill among all HCP.
• High risk for observation bias.
• Observations potentially obstructed by physical
barriers (e.g., curtains).
• Time and labor intensive.
• Those observed may be skeptical of data.
• Feedback may be delayed or fail to penetrate to
those observed.
• Potential for patient harm if lapses not
immediately corrected.
• Facilities should engage
in strategies to reduce
observer bias.
• Observers should have clear
directions about how to
address noncompliance.
• Unable to evaluate technique.
• Wearable devices may hinder HCP acceptance or
completeness of analysis due to noncompliance
with wearable use.
• Recording errors may lead to HCP lack of
confidence in data, variability in reliability of data
between systems and in different physical settings.
• Resource investment is significant and typically
recurrent via annual client subscription.
• Rigorous evaluation is
needed to ensure validity.
• Collaboration with and
empowerment of HCP may
lead to better acceptance.
• Will not eliminate
need for observation or
improvement campaigns
but may allow for more
targeted interventions.
