Sunday, September 22, 2013

Problems of psychology and engineering, not of medicine

There is a superb (and open access!!) article in BMJ Quality and Safety about how human factors engineering can help reduce medical errors.  Well worth reading.  I like, in particular, its summary of fact and fiction.  Here are excerpts:

Human error in medicine, and the adverse events that may follow, are problems of psychology and engineering, not of medicine.

Medicine is devoted to human health and healing, but the science behind why errors occur, and how to reduce the likelihood of preventable harm to individuals, are well described in human factors literature. Human factors—a science at the intersection of psychology and engineering—is dedicated to designing all aspects of a work system to support human performance and safety. The goals of human factors in healthcare are twofold: (1) support the cognitive and physical work of healthcare professionals and (2) promote high quality, safe care for patients.

Fact #1: Human factors is about designing systems that are resilient to unanticipated events.
Fiction: Human factors is about eliminating human error

Fact #2: Human factors addresses problems by modifying the design of the system to better aid people.
Fiction: Human factors addresses problems by teaching people to modify their behaviour

Fact #3: Human factors work ranges from the individual to the organisational level.
Fiction: Human factors is focused only on individuals

Fact #4: Human factors is a scientific discipline that requires years of training; most human factors professionals hold relevant graduate degrees.
Fiction: Human factors consists of a limited set of principles that can be learnt during brief training

Fact #5: Human factors professionals are bound together by the common goal of improving design for human use, but represent different specialty areas and methodological skills sets.
Fiction: Human factors scientists and engineers all have the same expertise


Human factors is an established body of science that is positioned to assist with the challenge of improving healthcare delivery and safety for patients. Human factors and healthcare professionals can work together to identify problems and solutions that may not be apparent by traditional means. While human factors does not promise instant solutions for healthcare improvement, it can provide a wealth of scientific resources for sustainable progress.

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