Human Factors in Healthcare

Research into surgical outcomes has focused primarily on the role of patient risk factors and the skills of the individual surgeon. However, this approach neglects a wide range of factors such as teamwork and effective communication, which have been found to be important in achieving safe, high-quality performance in high-risk environments.

In contrast to the increasing error rate in healthcare, the aviation industry has experienced a significant decrease. This marked improvement in aviation safety has led to the question of whether the safety techniques used in the aviation industry can be applied to healthcare

The History of Crew Resource Management.

In 1979, the National Aeronautic and Space Administration convened workshops to examine the role of human error in airline crashes based on information collected from aviation accidents that occurred during the 1970s. Safety initiatives resulting from this careful analysis included using all available sources (information, equipment, and people) to achieve safe and efficient operations.

The focus of operations was on safety, efficiency, and morale of people working together. This developed into current practices that use Line-Oriented Flight Training. Line-Oriented Flight Training includes working in flight simulators, the use of preflight and postflight debriefings, and measurement of airline crew performance. Examination of these successful techniques led the Institute of Medicine in 2000 to recommend establishing team training programs for personnel in critical care areas using the Crew Resource Management techniques used in aviation.

Human Factors in Healthcare

JCAHO has identified improved communication of accurate patient information as a priority patient safety goal. To achieve this, one of the Joint Commission’s recommendations includes healthcare team training that is part of a comprehensive patient safety plan (www.jcaho.org).

Human reliability and human factors refer to the reliability of humans in fields such as manufacturing, transportation, the military, or medicine. Human performance can be affected by many factors such as circadian rhythms, state of mind, physical health, attitude, emotions, propensity for certain common mistakes, errors, and cognitive biases.

Human reliability is important due to the possible adverse consequences of human errors or oversights, because the human is a crucial part of large socio-technical systems. User-centered design and error-tolerant design are only two of many terms used to describe efforts to make technology better suited for human operation.

Healthcare Human Factors skills are absolutely crucial to healthcare teams in safety-critical environments. When healthcare teams work well together, threats and errors can be recognized, prioritized, and managed before an adverse outcome becomes a reality.


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