Human Factors Analysis of Naval Transport Aircraft Maintenance and Flight Line Related Incidents

The article of record as published may be found at https://www.jstor.org/stable/44729462To study maintainer error, the Naval Safety Center’s Human Factors Accident Classification System (HFACS) was adapted for Maintenance Related Mishaps (MRMs). The HFACS Maintenance Extension (ME) successfully profiled the errors present Naval Aviation Class A MRMs. In order to assess its suitability for studying major and minor airline accidents, a post hoc analysis was conducted on 124 Naval Fleet Logistics Support (VR) Wing maintenance related mishap, hazard, and injury reports. Two judges separately coded the 124 VR Wing incidents; a Cohen’s kappa of .78 was achieved, indicating an “excellent” level of agreement. Generally, HFACS-ME was able to profile maintainer errors found in more minor incidents and the factors that contribute to them. Common factors observed include errors attributed to third party maintenance, inadequate supervision, failed communications, skill-based errors, and procedural violations

Effectiveness of a Multidisciplinary Intervention to Improve Hypertension Control in an Urban Underserved Practice

Patient-centered, multidisciplinary interventions offer one of the most promising strategies to improve blood pressure (BP) control, yet effectiveness trials in underserved real-world settings are limited. We used a multidisciplinary strategy to improve hypertension control in an underserved urban practice. We collected 1007 surveys to monitor medication adherence and used weighted generalized estimating equations to examine trends in BP control. We examined 13,404 visits from patients with hypertension between August 2010 and February 2014. Overall, BP control rates increased from 51.0% to 67.4% (adjusted odds ratio, 1.58; 95% confidence interval, 1.44-1.74) by the end of the intervention phase and were maintained during the postintervention phase (adjusted odds ratio, 1.60; 95% confidence interval, 1.41-1.82). Medication adherence scores increased across the intervention (5.9-6.6; P \u3c .001), but were not sustained at the conclusion of the study (5.9-6.2; P = .16). A multidisciplinary team approach involving registered nurses, pharmacists, and physicians resulted in substantial improvements in hypertension control in a real-world underserved setting