Implementation or continuous design? The contribution of human factors and engineering to healthcare quality and patient safety

Abstract

Implementation of complex healthcare interventions can benefit from methods and principles from the discipline of human factors engineering, such as the Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety. In order to design useful and usable interventions, we need to understand the actual work performed by healthcare workers, patients, and caregivers. This work system analysis is part of the human-centred design process advocated by the human factors engineering discipline. As complex healthcare interventions are implemented in the actual work system, changes will emerge; some may be expected, but others may not be. Therefore, healthcare organizations need mechanisms to understand and assess these emergent changes and engage in a process of continuous work system design; these are the feedback loops in the SEIPS model. The continuous work system design process requires participation of the people who are at the centre of the work system. Methods and principles of human factors engineering (e.g., participatory ergonomics, work system analysis, usability) can make important contributions to healthcare quality and patient safety by fostering continuous improvement of the work systems in which healthcare interventions are implemented.