Proactive leaders in the design, construction, and operation of high-risk environments, such as healthcare, understand that quality and safety improvement is a continuous part of managing complex and dynamic systems. Historically, industry leaders in high-risk/high-reliability environments, such as aeronautics and energy production have been able to measurably reduce the incidence of system failure and accident rates with the adoption of stringent work stream quality management strategies (Wiegmann & Shappell, 2003). However, even in these hyper-vigilant organizations, the introduction of rigorous behavior based risk reduction systems, human error can paradoxically increase (Hollnagel, 2004). This supports the notion that mere awareness of procedural gaps and the implementation of enterprise-wide procedural standards to improve quality results and stem risk alone are insufficient in guaranteeing reliable workforce engagement and safety outcomes ( Rand, 2000). Evidence suggests that using principles of Human Factors
Engineering as a guiding context to configuring environments and process of care delivery can yield significant safety benefits. Applying these principles and methodologies to environmentally based systems can contribute to integration of improved signal detection that can increase ‘moment in time’ performance resiliency and bi-directional engagement of staff and patients in care (Holden, et.al. 2013). This approach also provides an evidence-based, “person-centered” rather than “process-oriented” method for better understanding and enhancing the performance of individuals, teams, and organizations within certain environments (Farrington, 2012). The focus of this session is to review supporting evidence and discuss how systems oriented and human-centered, approaches like those used in Human Factors Engineering can have meaningful implications for environment of care design and operation. Substantive evidence will be presented and the implication these methods may have for supporting safe, reliable, and resilient systems of care delivery will also be discussed.
1.) Understanding incidences and indicators of environmental design undermining or enhancing human intention
2.) Collaborative and consensus building tools to reduce system based and human error in high risk environments
3.) How the application of Human Factors, Signal Detection, and Cognitive Systems Engineering can meaningfully impact environmental system safety and resilience
4.) Human-centered approaches to designing for High Reliability
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EDAC Course ID:
May 19, 2017