The science of Patient Safety is complex and difficult to achieve without careful planning. Unfortunately, the theories and methods of Patient Safety are not part of the core skills of those who plan and run healthcare facilities – and this is not their own fault, writes Dr. Peter Lachman.
Patient Safety is a new science in healthcare and we are still learning what we need to do. Recently, I spent a week broadening my horizons at the International Ergonomics Society IEA Conference in Florence. This was an experience that has positively changed some of my views on patient safety and on the management of healthcare.
I had thought that human factors are one of the theories for patient safety and now I see it as having many of the answers as we move to designing for safety rather than reacting to events. The key is the translation of the theory into practice. We often think about human factors as being a part of the approach to patient safety and ergonomics about designing for safety in the first place.
On their website https://www.iea.cc/whats/ the IEA defines Ergonomics or human factors as:
“the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design to optimize human well-being and overall system performance.”
Many industries have learnt from the science behind it all and use ergonomics and human factors for design. At the conference experts from a host of industries attended, allowing cross pollination of ideas and concepts across sectors such as aerospace, aviation, agriculture, the military, education and health. Over 1,000 papers were submitted and presented and there was much to be learned. The application of theories of Human Factors is often difficult.
Design of hospitals, processes and the way we interact are not thought through on scientific grounds.
Currently in healthcare human factors are not seen as an essential part of our work, and it is an elite pastime where a few experts are around, usually as consultants from aviation. Healthcare organisations do not employ human factor specialists to assist in the design of the services. Design of hospitals, processes and the way we interact are not thought through on scientific grounds. This needs to change. Yet often the theory has not been translated into practical interventions.
The opening speaker, Pascale Carayon stated there is a way forward and progress has been made. The Systems Engineering Initiative for Patient Safety (SEIPS) model that she pioneered is one way one can translate theory into action and make it accessible for frontline managers and clinical staff. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464868/pdf/i50.pdf
Using the construct of Donabedian of Structures + Processes = Outcomes, the model provides a construct to examine at the interplay of the organisational culture, the environment of the workplace, the tasks that need to be done, the tools and technology available and the people i.e. patients and providers to develop processes that are safe and effective.
Perhaps all managers in Ireland should undertake human factors training so that there is a theoretical construct for the decisions that affect safety. The SEIPS model is a good place to start.