Ergonomics
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Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. ⋯ We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.
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Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. ⋯ We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.
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The development of physiologic monitors has contributed to the decline in morbidity and mortality in patients undergoing anaesthesia. Diverse factors (physiologic, technical, historical and medico-legal) create challenges for monitor alarm designers. Indeed, a growing body of literature suggests that alarms function sub-optimally in supporting the human operator. Despite existing technology that could allow more appropriate design, most anaesthesia alarms still operate on simple, pre-set thresholds. Arguing that more alarms do not necessarily make for safer alarms is difficult in a litigious medico-legal environment and a competitive marketplace. The resultant commitment to the status quo exposes the risks that a lack of an evidence-based theoretical framework for anaesthesia alarm design presents. In this review, two specific theoretical foundations with relevance to anaesthesia alarms are summarised. The potential significance that signal detection theory and cognitive systems engineering could have in improving anaesthesia alarm design is outlined and future research directions are suggested. ⋯ The development of physiologic monitors has increased safety for patients undergoing anaesthesia. Evidence suggests that the full potential of the alarms embedded within those monitors is not being realised. In this review article, the authors propose a theoretical framework that could lead to the development of more ergonomic anaesthesia alarms.
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Review
The Work Compatibility Improvement Framework: an integrated perspective of the human-at-work system.
The industrial revolution demonstrated the limitations of a pure mechanistic approach towards work design. Human work is now seen as a complex entity that involves different scientific branches and blurs the line between mental and physical activities. Job design has been a traditional concern of applied psychology, which has provided insight into the interaction between the individual and the work environment. ⋯ A joint approach to organizational and job design will not only result in decreased prevalence of health risks, but in enhanced organizational effectiveness as well. The implementation of the WCM, that is, the Work Compatibility Improvement Framework, provides the basis for integrating different elements of the work environment into a single reliable construct. An improvement framework is essential to ensure that the measures of the WCM result in a system that is adaptive and self-regulated.
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Friction has been widely used as a measure of slipperiness. However, controversies around friction measurements remain. ⋯ It is concluded that static friction measurement, by the traditional use of a drag-type device, is only suitable for dry and clean surfaces, and dynamic and transition friction methods are needed to properly estimate the potential risk on contaminated surfaces. Furthermore, at least some of the conditions at the shoe/floor interface during actual slip accidents should be replicated as test conditions for friction measurements, such as sliding speed, contact pressure and normal force build-up rate.