Pickup Laura, Lang Alexandra, Atkinson Sarah, Sharples Sarah
a NIHR CLAHRC South West Peninsula (PenCLAHRC), Medical School , University of Exeter Medical School , Exeter , UK.
b NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine , University of Nottingham , Nottingham , UK.
Ergonomics. 2018 Jan;61(1):15-25. doi: 10.1080/00140139.2017.1306632. Epub 2017 Mar 24.
There is increasing demand for a systems approach within national healthcare guidelines to provide a systematic and sustainable framework for improvements in patient safety. Supported by this is the growing body of evidence within Human Factors/Ergonomics (HFE) healthcare literature for the inclusion of this approach in health service design, provision and evaluation. This paper considers the current interpretation of this within UK healthcare systems and the dichotomy which exists in the challenge to implement a systems approach. Three case studies, from primary and secondary care, present a systems approach, offering a novel perspective of primary care and blood sampling. These provide practical illustrations of how HFE methods have been used in collaboration with healthcare staff to understand the system for the purpose of professional education, design and safety of clinical activities. The paper concludes with the challenge for implementation and proposes five roles for systems HFE to support patient safety. Practitioner Summary: healthcare is classified as a complex and dynamic system within this paper and as such HFE system methods are presented as desirable to understand the system, to develop HFE tools, to deliver education and integrate HFE within healthcare systems.
国家医疗保健指南对系统方法的需求日益增加，以便为改善患者安全提供一个系统且可持续的框架。在此支持下，人因学/工效学（HFE）医疗保健文献中越来越多的证据表明，应将这种方法纳入卫生服务设计、提供和评估中。本文探讨了英国医疗保健系统中对这一方法的当前解读，以及在实施系统方法的挑战中存在的二分法。来自初级和二级护理的三个案例研究展示了一种系统方法，为初级护理和血液采样提供了新的视角。这些案例实际说明了HFE方法是如何与医护人员合作，以了解该系统，从而实现专业教育、临床活动设计和安全的目的。本文最后提出了实施方面的挑战，并提出了系统HFE支持患者安全的五个作用。从业者总结：本文将医疗保健归类为一个复杂且动态的系统，因此HFE系统方法被认为有助于理解该系统、开发HFE工具、提供教育以及将HFE整合到医疗保健系统中。
