Richard J. Holden, Ph.D.

Assistant Professor (Department of Medicine, Department of Biomedical Informatics)

Email: richard.holden@vanderbilt.edu
Phone: (615) 936-4343
Fax: (615) 936-7373

Rich Holden, Ph.D., is an Assistant Professor of Medicine with a secondary appointment in Biomedical Informatics. He holds a joint Ph.D. in Industrial Engineering and Psychology, specializing in human factors engineering/psychology. Dr. Holden’s research concerns the impact of sociotechnical change on clinical cognition, work process, and healthcare quality and safety. He has investigated transformative sociotechnical changes such as new technology implementation and organization-wide quality improvement programs. Dr. Holden has particular interests in health IT, provider workload, problem solving and adaptation, social and cognitive processes, lean thinking, change management, and human factors methods and theories. He is dedicated to improving outcomes for both patients and healthcare professionals.

Education & Training
B.S. – Psychology, University of Wisconsin-Madison
M.S. – Psychology, University of Wisconsin-Madison
M.S. – Industrial Engineering, University of Wisconsin-Madison
Ph.D. – Industrial Engineering and Psychology, University of Wisconsin-Madison
Postdoctoral Research Fellowship – Royal Institute of Technology (Sweden) / University of Wisconsin-Madison

Recent Publications

1. Holden, R.J. What stands in the way of technology-mediated patient safety improvements? A study of facilitators and barriers to physicians' use of electronic health records. Journal of Patient Safety. [Forthcoming]
2. Alper, S.J., Holden, R.J., Scanlon, M.C., Patel, N.R., Kaushal, R., et al. Self-reported violations during medication administration in two pediatric hospitals. BMJ Quality & Safety. [Forthcoming]
3. Holden, R.J. Lean is a toolbox, not a tool. Annals of Emergency Medicine. [Forthcoming]
4. Holden, R.J. Social and personal normative influences on healthcare professionals to use information technology: Towards a more robust social ergonomics. Theoretical Issues in Ergonomics Science. [Forthcoming]
5. Holden, R.J., Brown, R.L., Alper, S.J., Scanlon, M.C., Patel, N.R., & Karsh, B. That’s nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of care. International Journal of Industrial Ergonomics, 41:370-379, 2011.
6. Holden, R.J., Scanlon, M.C., Patel, N.R., Kaushal, R., Escoto, K.H., et al. A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life. BMJ Quality & Safety, 20:15-24, 2011.
7. Holden, R.J. Lean thinking in emergency departments: A critical review. Annals of Emergency Medicine, 57:265-278, 2011.
8. Holden, R.J. Cognitive performance-altering effects of electronic medical records: An application of the human factors paradigm for patient safety. Cognition, Technology, & Work, 13:11-29, 2011.
9. Karsh, B., Wetterneck, T., Holden, R.J., et al. Bar coding in medication administration. In Y. Yih (Ed.) Handbook of Healthcare Delivery Systems. Boca Raton, FL: CRC Press. [Forthcoming]
10. Holden, R.J., Patel, N.R., Scanlon, M.C., Shalaby, T.M., Arnold, J.M., & Karsh, B. Effects of mental demands during dispensing on perceived medication safety and employee well being: A study of workload in pediatric hospital pharmacies. Research in Social & Administrative Pharmacy, 6, 293-306, 2010.
11. Holden, R.J. Physicians’ beliefs about using EMR and CPOE: In pursuit of a contextualized understanding of health IT use behavior. International Journal of Medical Informatics, 79, 71-80, 2010.
12. Holden, R.J. & Karsh, B. The Technology Acceptance Model: Its past and its future in health care. Journal of Biomedical Informatics, 43, 159-172, 2010.
13. Holden, R.J. People or systems? To blame is human. The fix is to engineer. Professional Safety, December, 34-41, 2009.
14. Karsh, B., Holden, R.J., Escoto, K.H., Alper, S.J., et al. Do beliefs about hospital technologies predict nurses’ perceptions of quality of care? A study of task-technology fit in two pediatric hospitals. International Journal of Human-Computer Interaction, 25, 374-389, 2009.
15. Holden, R.J. & Karsh, B. A theoretical model of health information technology usage behaviour with implications for patient safety. Behaviour & Information Technology, 28, 21-38, 2009.
16. Holden, R.J., Or, C.K.L., Alper, S.J., Rivera, A.J., & Karsh, B. A change management framework for macroergonomic field research. Applied Ergonomics, 39, 459-474, 2008.
17. Holden, R.J., & Karsh, B. A review of medical error reporting system design considerations and a proposed cross-level systems research framework. Human Factors, 49, 257-276, 2007.
18. Karsh, B., & Holden, R.J. New technology implementation in healthcare. In P. Carayon (Ed.) Handbook of Human Factors and Ergonomics in Patient Safety (pp. 393-410). Mahwah, NJ: Lawrence Erlbaum, 2007.
19. Karsh, B., Holden, R.J., Alper, S.J., & Or, C.K.L. A human factors engineering paradigm for patient safety: Designing to support the performance of the healthcare professional. Quality & Safety in Health Care, 15(Suppl I), i59-i65, 2006.
20. Karsh, B., Escoto, K.H., Beasley, J.W., & Holden, R.J. Toward a theoretical approach to medical error reporting system research and design. Applied Ergonomics, 37, 283-295, 2006.

Recent Presentations

1. Holden, R.J., Scanlon, M.C., Brown, R.L., & Karsh, B. What is IT? New conceptualizations and measures of pediatric nurses’ acceptance of bar-coded medication administration information technology. 52nd Annual Meeting of the Human Factors and Ergonomics Society, New York City, USA, Sept. 2008.
2. Holden, R.J., Alper, S.J., Scanlon, M.C., Murkowski, K., Rivera, A.J., & Karsh, B. Challenges and problem-solving strategies during medication management: A study of a pediatric hospital before and after bar-coding. 2nd Healthcare Systems Ergonomics and Patient Safety International Conference, Strasbourg, France, June 2008.
3. Holden, R.J., Scanlon, M.C., Alper, S.J., Shalaby, T., Hung, S-Y. & Karsh, B. Pediatric pharmacy workload: Good, bad, and … complicated! 2nd Healthcare Systems Ergonomics and Patient Safety International Conference, Strausburg, France, June 2008.
4. Alper, S.J., Holden, R.J., Scanlon, M.C., Patel, N., Murkowski, K., Shalaby, T.M., & Karsh, B. Violation prevalence after introduction of a bar coded medication administration system. 2nd Healthcare Systems Ergonomics and Patient Safety International Conference, Strasbourg, France, June 2008.
5. Holden, R.J., Alper, S.J., Rivera, A.J., Or, C.K.L., & Karsh, B. Macroergonomic field research reframed: What can be (and has been) learned by field researchers from change management theory. In L. Sznelwar, F. Mascia, & U. Montedo (Eds.) Proceeding of the 9th International Symposium on Human Factors in Organizational Design and Management. São Palo, Brazil, March 2008.