Abstract

Patient safety and accidental harm or iatrogenic errors are increasingly important healthcare issues resulting in high costs and mortality. The way clinical workflow and actions are communicated can impact patient safety. Although much work has been done to identify the individual human factors and recommendations are made to control and reduce human factor errors, little work has been done to provide a structured methodology to analyse and control human factor influencing patient safety outcomes. In this paper, we build on the previous work on automatic development of clinical pathways, semiotic approach to modelling norm-base clinical pathways and propose a Human Factor Failure Modes and Effects Analysis (HFMA) which offers a systematic approach to define, design and incorporation of human factors into formal design of clinical pathways. Organisational semiotics methods specifically NAM and SAM are applied to identify and analyse controls to reduce the adverse impact of human factors in healthcare settings. This is achieved through modelling and integration of human factors into clinical pathways. This will result in more rigorous control the care process ensuring completeness, consistency and patient safety by enabling the mapping of formal and informal/safety controls into clinical pathways.

Highlights

  • The challenge of achieving significant improvements in patient safety is one of the key tasks facing healthcare at the start of the 21st century

  • This paper presented a background to the current application of clinical pathways in hospitals and presented a case for the need to consider human factors if significant improvement in patient safety outcomes are intended

  • It is argued that integration of human factors in clinical pathways design will have a significant role in improving patient safety

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Summary

Introduction

The challenge of achieving significant improvements in patient safety is one of the key tasks facing healthcare at the start of the 21st century. The proposed methodology provides a robust mechanism to analyse human factor failure points and to identify and model the controls in to formal process models e.g. CPs. Norm Analysis Method (NAM) is adopted to analyse patterns of behavior and decision-making models of clinicians and the condition under which the behavior will occur. Norm Analysis Method (NAM) is adopted to analyse patterns of behavior and decision-making models of clinicians and the condition under which the behavior will occur This mechanism is crucial for conceptualizing and developing personalized clinical pathways which describes the conditions and temporality of human factor failure modes

Norm Based Approach for Incorporating Human Factors into Clinical Pathways
Human Failure
Human Factors
Failure Mode and Effects Analysis
Controls
Predictive Controls
Personal Controls
Culturally Driven Controls
Risk Alleviation Norms to Improve Patient Safety Outcomes
Extension of Clinical Pathways with Risk Alleviating Norms
Findings
Conclusion
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