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!Be"er!knowledge!for!safer!care!!HumanFactorsinPa!entSafetyReviewofTopicsandToolsReportforMethodsandMeasuresWorkingGroupofWHOPa!entSafetyApril2009©WorldHealthOrganization(WHO),2009WHO/IER/PSP/2009.052©WorldHealthOrganization(WHO),2009WHO/IER/PSP/2009.053CONTENTSEXECUTIVESUMMARY3INTRODUCTION4FRAMEWORK8REVIEWOFTOPICSandTOOLS101.OrganizationalSafetyCulture102.Managers’Leadership123.Communication154.Team(structuresandprocesses)185.TeamLeadership(supervisors)256.SituationAwareness277.DecisionMaking318.Stress339.Fatigue3510.WorkEnvironment37CONCLUSION40REFERENCES41©WorldHealthOrganization(WHO),2009WHO/IER/PSP/2009.054EXECUTIVESUMMARYThisreportwaspreparedforWHOPatientSafety’sMethodsandMeasuresforPatientSafetyWorkingGroup.Itprovidesabasicdescriptionofmajortopicareasrelatingtohumanfactorsrelevanttopatientsafety,withsomeindicationofpossibletoolsthatcanbeusedinahealthcareworkplaceformeasurementortrainingofthesetopics.Firstanexplanationofthehumanfactorsapproachisprovided.Anorganisingframeworkispresentedtoprovideastructureforthediscussionofthetopics,bycategorisingthemasfollows:i)Organizational/Managerial,ii)Team,iii)Individual,iv)Workenvironment.Widersocialfactorsandthecentralroleofthepatientarealsoacknowledgedbuttheseaspectsofthehealthcaresystemarenotexplicitlycovered.Tentopicareaswithinthesefourcategoriesaredescribed:organizationalculture,managerialleadership,communication,teamwork,teamleadership,situationawareness,decisionmaking,stress,fatigue,workenvironment.Aselectionoftoolsforeducation,measurementortrainingthesehumanfactorstopicsisdescribed.Someofthesemaybesuitableforapplicationindeveloping,aswellasdeveloped,countries.Acknowledgements:Wewouldliketothankthefollowingforhelpfulcommentsondraftsofthisreport:LucyMitchell.,Simon-Paterson-Brown,TomReader,BillRunciman,SarahParker,GeorgeYoungson©WorldHealthOrganization(WHO),2009WHO/IER/PSP/2009.055HumanFactorsinPatientSafety:ReviewofTopicsandToolsINTRODUCTIONThisdocumentpresentsabasicdescriptionoftentopicareasrelatingtoorganizationalandhumanfactorsinfluencingpatientsafety.Italsoidentifiesaselectionoftoolsforthemeasurementortrainingofthesefactorswhichmaybesuitableforapplicationindeveloping,aswellasdeveloped,countries.Itwascommissionedin2008byDrItziarLarizgoitia,WHO,followingtheinitialmeetingsoftheWHOPatientSafetyMethodsandMeasuresGroup.TheWHOPatientSafetyMethodsandMeasuresWorkingGroupcompletedaseriesofreportsonmethodstomeasurepatientsafetyinacute(Jeffsetal,2009)andprimary(Doveyetal,2009)healthcare,aswellaspositionpapersonepistemologyandontologyofpatientsafetyresearch(Brownetal,2008;Runcimanetalunderreview).Anumberofimportantlinesofinvestigationemergedfromtheseoverviewreports,mostnotablytheneedtounderstandnotonlyorganizationalculturebutalsoarangeofhumanfactors,suchasmanagerial,teamandindividualcharacteristicsthatinfluencethebehaviourofhealthcarestaffinrelationtosafepatientcare.InrelationtothenewWHOconceptualframeworkforpatientsafety,theorganizationalandhumanfactorscoveredherewouldbeclassedascontributingormitigatingfactors(seeShermanetal,2009).Thisreviewgivessomedetailsofhowahumanfactorsapproachhasbeenadoptedinindustryandthenprovidesabriefexplanationofanumberofthesefactors,indicatingtheirrelevancetopatientsafety.Itconcludeswithsuggestionsforthewideradoptionofhumanfactorsinpatientsafetypractices.Sowhatarehumanfactors?WhatareHumanFacto...