Human factors & ergonomics and quality improvement science: integrating approaches for safety in healthcare

Introduction: In this paper, we will address the important question of how quality improvement science (QIS) and human factors and ergonomics (HFE) can work together to produce safer solutions for healthcare. We suggest that there will be considerable advantages from an integrated approach between the two disciplines and professions which could be achieved in two phases. First, by identifying people trained in HFE and those trained in QIS who understand how to work together and second, by developing opportunities for integrated education and training. To develop this viewpoint we will: Discuss and explore how QIS and HFE could be integrated by building on existing definitions, scope of practice, knowledge, skills, methods, research and expertise in each discipline. Outline opportunities for a longer-term integration through training, and education for healthcare professionals

A study of Foundation Year doctors’ prescribing in patients with kidney disease at a UK renal unit: a comparison with other prescribers regarding the frequency and type of errors

Objectives Errors in the process of prescribing can lead to avoidable harm for patients. Establishing the extent of prescribing errors across medical specialties is critical. This research explores the frequency and types of prescribing errors made by healthcare professionals prescribing in patients with renal disease where prescribing problem-solving and decision-making is complex due to co-existing multimorbidity Methods All prescriptions and errors made by prescribers were captured over a four-month period at a UK renal unit. Data was recorded about the medicine associated with error, the nature and severity of error, alongside the prescriber’s occupational grade. Results There were 10394 items prescribed and 3.54% with associated prescribing errors. Whilst Foundation year one doctors made almost one error every week (n=15.13) and Foundation year two doctors one every two weeks (n=8.00), other prescribers made one error per month (n=3.94, 95%). The medicines most frequently associated with errors for Foundation doctors were paracetamol (6.51%), calcium acetate (5.33%), meropenem (3.55%), alfacalcidol (3.55%) and tazocin (3.55%), whilst for all other prescribers they were meropenem (6.15%), alfacalcidol (4.62%), co-amoxiclav (4.62%) and tacrolimus (4.62%). The most common types of error for both groups were omitting the indication, using the brand name inappropriately, and prescribing inaccurate doses. Conclusions The range of errors made by multi-professional healthcare prescribers confirms complexity of prescribing on a renal unit for patients with kidney disease and multimorbidity. These findings have implications for the types of educational interventions required for reducing avoidable harm and overcoming human factors challenges to improve prescribing behaviour

Human Factors and Ergonomics and Quality Improvement Science: Integrating Approaches for Safety in Healthcare

In this paper, we will address the important question of how quality improvement science (QIS) and human factors and ergonomics (HFE) can work together to produce safer solutions for healthcare. We suggest that there will be considerable advantages from an integrated approach between the two disciplines and professions which could be achieved in two phases. First, by identifying people trained in HFE and those trained in QIS who understand how to work together and second, by developing opportunities for integrated education and training. To develop this viewpoint we will: Discuss and explore how QIS and HFE could be integrated by building on existing definitions, scope of practice, knowledge, skills, methods, research and expertise in each discipline; Outline opportunities for a longer-term integration through training, and education for healthcare professionals