By Patrice Tremoulet, PhD, Director, Human Factors Engineering, ECRI
Healthcare has yet to realize the benefits of applying human factors engineering (HFE), in part because HFE solutions developed for other high-risk industries have been applied without appreciating the important ways that healthcare differs from those industries.
KEY SIMILARITIES & IMPORTANT DIFFERENCES
Like aviation, ground transportation, and nuclear power, healthcare is:
• High-risk – Errors have profound consequences for patients, staff and organizations.
• Complex and interdependent – Outcomes depend on seamless interaction between people, processes and technologies.
• Decision-intensive – High-stakes choices must be made under time pressure and uncertainty.
However, healthcare also has unique challenges, which must be taken into account when designing safety strategies:
• Every patient is different – No two “inputs” are alike. Standardization is limited by biology and individuality.
• Care plans evolve constantly – Decisions are revisited and adapted several times a day.
• Communication is fragmented – Providers often work asynchronously, connected only through electronic health records.
• Outcomes are subjective – “Health” looks different depending on the patient’s goals and values.
• Motivation drives performance – Healthcare relies on judgment, collaboration and intrinsic commitment so it cannot require or deliver strict controls.
These differences mean healthcare organizations cannot simply copy-paste HFE solutions developed for other high-risk industries. Instead, healthcare systems must apply proven HFE principles to develop solutions tailored for their specific system.
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APPLYING HFE SYSTEMS THINKING
The most effective way to improve healthcare safety is to redesign health system environments, tools and workflows to support people to do their best work, even under stress. This is the only way to manage healthcare complexity and prevent inevitable human slips from causing significant harm.
CULTURE COUNTS
Realizing profound safety improvements requires not only designing systems that make safe care the path of least resistance but also fostering and sustaining environments where staff are empowered to speak up without fear of blame. In other words, great system design and great safety culture are both required to enable healthcare systems to continuously learn from failures and near-misses.
CONCLUSION
By embracing HFE and applying systems thinking, healthcare systems can become not only safer, but also more compassionate, adaptive and sustainable, leading to better patient outcomes, healthier providers, lower costs, greater efficiency and stronger public trust.
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