Villa Nicholas, Baskey Michael, LeBlanc Constance
Class of 2025, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
CJEM. 2025 Feb;27(2):129-133. doi: 10.1007/s43678-024-00837-7. Epub 2025 Jan 3.
This initiative assessed the integration of the Human Factors Analysis and Classification System, adapted from aviation, into emergency medicine morbidity and mortality rounds. The objective was to determine whether incorporating the Human Factors Analysis and Classification System could lead to a perceived increase in the overall quality of morbidity and mortality presentations through the standardization of classifying cause factors of medical errors.
This study involved eight emergency medicine residents who applied the adapted Human Factors Analysis and Classification System framework to their morbidity and mortality case presentations over 6 months. Data were collected through surveys completed by presenters and morbidity and mortality audience members. These assessed four main outcomes: relevance, feasibility, quality, and acceptability of the Human Factors Analysis and Classification System framework.
The integration of the Human Factors Analysis and Classification System was positively perceived across all outcome measures. Presenters and audience members rated cause factor identification as important (100%), indicating the relevance of Human Factors Analysis and Classification System in morbidity and mortality rounds. Feasibility assessments showed a mean score of 4.25 out of 5, indicating favorable ease of use. The quality assessment mean score was 3.97 out of 5, indicating perceived improvement in cause factor identification. Presenters (62.5% Strongly Agree, 37.5% Agree) and audience members (73% Yes, 21.62% Undecided, 5.4% No) expressed acceptability and support for continued Human Factors Analysis and Classification System use.
Integrating the Human Factors Analysis and Classification System into morbidity and mortality rounds in the Department of Emergency Medicine was well-received and led to a perceived increase in the quality of cause factor identification. Both presenters and audience members endorsed the use of the Human Factors Analysis and Classification System, suggesting its desirability for sustained integration. The results of this study pave the way for future quality improvement initiatives, including the adaptability of the Human Factors Analysis and Classification System across various medical departments and its potential to enhance cause factor classification in morbidity and mortality rounds.
本项目评估了源自航空领域的人为因素分析与分类系统（HFACS）在急诊医学发病率和死亡率病例讨论中的整合情况。目的是确定纳入HFACS是否能通过对医疗差错原因因素分类的标准化，使发病率和死亡率病例讨论的整体质量得到明显提高。
本研究涉及8名急诊医学住院医师，他们在6个月的时间里将改编后的HFACS框架应用于发病率和死亡率病例汇报中。数据通过汇报者以及发病率和死亡率病例讨论听众完成的调查问卷收集。这些问卷评估了四个主要结果：HFACS框架的相关性、可行性、质量和可接受性。
在所有结果指标方面，HFACS的整合都得到了积极评价。汇报者和听众成员将原因因素识别评为重要（100%），表明HFACS在发病率和死亡率病例讨论中的相关性。可行性评估显示，平均得分为4.25（满分5分），表明使用起来较为便利。质量评估平均得分为3.97（满分5分），表明在原因因素识别方面有明显改善。汇报者（62.5%强烈同意，37.5%同意）和听众成员（73%是，21.62%不确定，5.4%否）对继续使用HFACS表示接受和支持。
将HFACS整合到急诊医学科的发病率和死亡率病例讨论中受到了广泛好评，并使原因因素识别质量得到了明显提高。汇报者和听众成员都认可使用HFACS，表明持续整合是可取的。本研究结果为未来的质量改进举措铺平了道路，包括HFACS在各个医学科室的适应性及其在提高发病率和死亡率病例讨论中原因因素分类方面的潜力。
