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      Is Open Access

      Human factors and ergonomics as a patient safety practice

      review-article
      , ,
      BMJ Quality & Safety
      BMJ Publishing Group
      Human factors, Patient safety, Human error

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          Abstract

          Background

          Human factors and ergonomics (HFE) approaches to patient safety have addressed five different domains: usability of technology; human error and its role in patient safety; the role of healthcare worker performance in patient safety; system resilience; and HFE systems approaches to patient safety.

          Methods

          A review of various HFE approaches to patient safety and studies on HFE interventions was conducted.

          Results

          This paper describes specific examples of HFE-based interventions for patient safety. Studies show that HFE can be used in a variety of domains.

          Conclusions

          HFE is a core element of patient safety improvement. Therefore, every effort should be made to support HFE applications in patient safety.

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          Most cited references62

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          Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee.

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            Systems analysis of adverse drug events. ADE Prevention Study Group.

            To identify and evaluate the systems failures that underlie errors causing adverse drug events (ADEs) and potential ADEs. Systems analysis of events from a prospective cohort study. All admissions to 11 medical and surgical units in two tertiary care hospitals over a 6-month period. Errors, proximal causes, and systems failures. Errors were detected by interviews of those involved. Errors were classified according to proximal cause and underlying systems failure by multidisciplinary teams of physicians, nurses, pharmacists, and systems analysts. During this period, 334 errors were detected as the causes of 264 preventable ADEs and potential ADEs. Sixteen major systems failures were identified as the underlying causes of the errors. The most common systems failure was in the dissemination of drug knowledge, particularly to physicians, accounting for 29% of the 334 errors. Inadequate availability of patient information, such as the results of laboratory tests, was associated with 18% of errors. Seven systems failures accounted for 78% of the errors; all could be improved by better information systems. Hospital personnel willingly participated in the detection and investigation of drug use errors and were able to identify underlying systems failures. The most common defects were in systems to disseminate knowledge about drugs and to make drug and patient information readily accessible at the time it is needed. Systems changes to improve dissemination and display of drug and patient data should make errors in the use of drugs less likely.
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              The Principles of Sociotechnical Design

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                Author and article information

                Journal
                BMJ Qual Saf
                BMJ Qual Saf
                qhc
                bmjqs
                BMJ Quality & Safety
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-5415
                2044-5423
                March 2014
                28 June 2013
                : 23
                : 3
                : 196-205
                Affiliations
                Department of Industrial and Systems Engineering, Center for Quality and Productivity Improvement, University of Wisconsin-Madison , Madison, Wisconsin, USA
                Author notes
                [Correspondence to ] Dr Pascale Carayon, Department of Industrial and Systems Engineering, Center for Quality and Productivity Improvement, University of Wisconsin-Madison, 3126 Engineering Centers Building, 1550 Engineering Drive, Madison, WI 53705, USA; carayon@ 123456engr.wisc.edu
                Article
                bmjqs-2013-001812
                10.1136/bmjqs-2013-001812
                3932984
                23813211
                71f47e41-2eb0-4874-9e6e-3506946d5d13
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                : 9 January 2013
                : 25 March 2013
                : 5 June 2013
                Categories
                1506
                Systematic Review
                Custom metadata
                unlocked

                Public health
                human factors,patient safety,human error
                Public health
                human factors, patient safety, human error

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