An Evaluation of the Effects of Human Factors and Ergonomics on Health Care and Patient Safety Practices: A Systematic Review

Abstract

BackgroundFrom the viewpoint of human factors and ergonomics (HFE), errors often occur because of the mismatch between the system, technique and characteristics of the human body. HFE is a scientific discipline concerned with understanding interactions between human behavior, system design and safety.ObjectiveTo evaluate the effectiveness of HFE interventions in improving health care workers’ outcomes and patient safety and to assess the quality of the available evidence.MethodsWe searched databases, including MEDLINE, EMBASE, BIOSIS Previews and the CBM (Chinese BioMedical Literature Database), for articles published from 1996 to Mar.2015. The quality assessment tool was based on the risk of bias criteria developed by the Cochrane Effective Practice and Organization of Care (EPOC) Group. The interventions of the included studies were categorized into four relevant domains, as defined by the International Ergonomics Association.ResultsFor this descriptive study, we identified 8, 949 studies based on our initial search. Finally, 28 studies with 3,227 participants were included. Among the 28 included studies, 20 studies were controlled studies, two of which were randomized controlled trials. The other eight studies were before/after surveys, without controls. Most of the studies were of moderate or low quality. Five broad categories of outcomes were identified in this study: 1) medical errors or patient safety, 2) health care workers’ quality of working life (e.g. reduced fatigue, discomfort, workload, pain and injury), 3) user performance (e.g., efficiency or accuracy), 4) health care workers’ attitudes towards the interventions(e.g., satisfaction and preference), and 5) economic evaluations.ConclusionThe results showed that the interventions positively affected the outcomes of health care workers. Few studies considered the financial merits of these interventions. Most of the included studies were of moderate quality. This review highlights the need for scientific and standardized guidelines regarding how HFE should be implemented in health care.

Translational simulation: from description to action

“…HFE approaches are especially useful because they are design-driven, take a systems approach, and focus on optimising both system performance and human wellbeing [ 55 ]. Unfortunately, capacity and expertise for HFE approaches have been underdeveloped in healthcare [ 56 , 57 ] despite evidence of their effectiveness [ 58 , 59 ].…”

Incorporating Human Factors in Perioperative Nursing to Reduce Errors

“…The goal of adapting human factors–based thinking is to create a system (ie, equipment, environment, and tasks) that fits people rather than forcing people to fit into rigid systems. When leaders design systems to complement people, there is a reduction in inefficiencies, dissatisfaction, ineffectiveness, and errors 6 . An individual’s ability to perform a job safely and to his or her full potential depends on the interactions that the individual has with other users of the system (eg, patients, families, coworkers) as well as the equipment, tasks, environments, and organization (Figure 1).…”

“…Leaders can foster error prevention when they standardize and simplify work processes. A key aspect of human factors involves making it as easy as possible for the end user to complete a task 6 . Perioperative work processes that include time pressures and high‐level multitasking require nurses to prioritize and complete many individual tasks (eg, retrieving time‐critical resources; performing safety‐related activities, such as surgical counts and patient hand overs; providing direct patient care).…”

Neonatal healthcare workers' perceptions of the impact of the COVID‐19 pandemic

“…Sub‐optimal communication is a root cause in patient‐safety incidents and complaints. COVID‐19 increased the risks of these, by exacerbating causative factors including stress, workload, fatigue and inconsistent instruction 3 . Mitigating these challenges were accelerated adoption of live and recorded video services for remote team working, teaching and family communication.…”