Integrating human factors is essential for the future of healthcare safety and sustainability, but many systems are working against the system instead of toward it, an op-ed piece in Science Direct written by five physicians said.
The authors proposed a new framework called safety II that views human creativity as an essential safety safeguard rather than the root cause of errors.
"Humans are often seen as the root cause: a problem to be fixed and a source of liability and hazard to be protected against," the authors wrote. "This approach inadvertently sends clinicians the message that they are not to be trusted — that they are the broken ones. … When systems are not designed with human capacity in mind, the result can be a paradoxical increase in safety hazards, higher rates of burnout, and, ultimately, an exodus of health care workers that puts the entire system at risk."
The safety II framework makes the following shifts:
- Adopt a mindset that clinicians are essential to system safeguards and that their time and talent need to be protected from tasks that create a burden without adding value to patient care.
- Invest in standardization of predictable work to reduce cognitive load and decision fatigue.
- Collaborate with stakeholders to design reasonable safeguards that protect humans from unnecessary errors.
- Create ways for clinicians to provide feedback so decision-makers have data to affect patient care.
"Safety will be achieved by systems that are designed to reduce the non-value-added work, to allow more time for relationship building, and to facilitate customization of care to the unique needs of individual patients and their circumstances," the authors wrote.