Critical Analysis: Human Factors, Quality, and Safety in Healthcare

This report critically analyzes the impact of human factors on work performance, quality, and safety within healthcare settings. It begins by identifying key human factors such as workload, safety culture, and communication errors, which influence healthcare worker performance and patient outcomes. The report then explores the relationship between these factors and patient safety, emphasizing the role of technology, human error, and cognitive aspects in healthcare delivery. It highlights how factors like increased workload and communication breakdowns can lead to stress, fatigue, and medical errors, while a strong safety culture can mitigate risks. The report also discusses the importance of addressing human factors to improve healthcare quality and patient safety, referencing studies on medication errors, adverse drug events, and the impact of information technology. The conclusion underscores the need to consider human factors to enhance worker performance and minimize medical errors, ultimately promoting safer and more efficient healthcare practices.

Nursing Leadership

Introduction: Intensifying the Clinical performance with the understanding of aftermaths of the
teamwork, equipment, working space, tasks, workplace culture, and organization on personnel
behavior and skill and applying of that know-how in clinical settings comes under human factors
in health care. In my opinion, healthcare factors are important for the improvement in the quality
of healthcare and patient safety. The report highlights the fact that despite having the modern
equipment, excellent research and continuous research in the healthcare organization over the
developed regions of the globe, still the suffering for high levels of patient safety failures is
prevalent. Health Factors and Ergonomics (HEF) helps in addressing the physical and mental
influence that work and work conditions can be made on the work performance of healthcare
workers. As per the Institute of Medicine (IOM), patient safety has a direct influence on
medication errors, duty hours, fatigue, adverse drug events, and healthcare workers' working
condition. This study is going to throw light on those human factors that affect the work
performance of healthcare workers. A critical analysis of the relationship between human factors
and quality and safety in health care has been demonstrated with the help of this report (Mao, Jia,
& Zhao, 2015).
Human Factors Connected to Work Performance: Identification and then management of the
human factors that affect the performances in healthcare is critical for the reliable and effective
minimization of risks in the health care segment for patient safety. There are various human
factors influencing the work performance such as knowledge, skills, performance appraisal and
utilization, remuneration, benefits, rewards and recognition, staffing and working schedules,
increased workload, safety culture, workspace and environment, commitment and satisfaction,
aspects related to leadership and management styles, organizational mission and goals,
commitment and satisfaction, etc. that affects work performance (Manyisa & Aswegen, 2017).

Increased workload is one such significant factor that affects the performance of the workers.
The increased workload causes stress and fatigue in health care workers. As per Tomic and
Tomic, the employees experience the heavy workload when they are found difficulties in
fulfilling the requirements of the task delegated by the employers resulting in health problems
and burnouts by nurses affecting their performances. Al Momani explained how the long and
odd working hours cause the risk and adversely affects the health and well-being of the nurses
causing stress, fatigue, depression, chronic infections and other problems that affect the
productivity and efficiency of their work. According to Shiron workload had been found as the
major cause of dissatisfaction for the absence of involvement, burnout, and dehumanization of
patients by the health caregivers and supporting staff (Flin, Winter, Sarac, & Raduma , 2009).
Another significant factor is culture and patient safety. According to Kennedy safety culture is
another significant issue faced by health care organizations striving for improving patient safety.
Some research suggests the change in organizational culture is required for making
‘Uncomplicated to do the correct things and hard to do the wrong things'. Kohn stated that health
care organizations should develop a safety culture in such a manner that the workforce and the
design of organizational processes are focused on a specific goal. Hofmann & Mark, Naveh and
Zohar have done studies that show the assessment of safety culture in different organizations of
healthcare and it has been connected to both workers and the safety of the patient (Gurses, 2019).
Kirk has designed MaPSaF Manchester Patient Safety Assessment Framework for team works
for the self-reflection on culture for the pharmacy, primary care and hospital settings for the
assessment of safety culture as it is considered as an important factor that directly or indirectly
affects the working of the health care workers and supporting staff (WHO, 2009).

Katz Navon established that if safety is kept at high managerial priority, the lesser errors are
experienced by hospital units. According to Botwinick, the senior leaders are only responsible
for fostering the culture of work and commitment required for addressing the basic causes of
medical errors and the safety of patients. The safety culture of the health care units can highly
impact the working performance of the medical workers and staff. The more congenial the work
culture is the more convenient it gets for the health care workers to work in the health care units
that can highly affect their efficiency and effectiveness (WHO, 2009).
Another significant factor is human error due to communication, medication errors and adverse
drug events. Safren and Chapanis collected information for the various nurses and had shown the
medication errors done by them. Institute of Medicine has shown the medication error and
adverse drug events as the major cause that affects work performance. According to D.W. Bates
& Petrycki the medication errors hat times lead to adverse effects. The reason for medication
errors as per L.L.Leape occurs due to a lack of patients’ information (Fryer, 2017). According to
Cullen due to the volume of medications prescribed and administered the frequent medication
errors occur due to confusion created in communication in the urgent situations in ICU. The
human errors generally take place because of failure to follow checking procedures, written
miscommunication, transcription errors, prescriptions misfiled and at times calculation errors
done by the healthcare workers. The wrong communication at times hampers the speed of the
healthcare workers. King has explained the cause of death of Josie King is due to a lack of
communication amongst the different health care providers along with the lack of consideration
of the parent's concern of Josie King (Beyond Rewards Inc, 2016).
Patient safety is the global challenge that is being faced by the health care departments that could
be only achieved by any health care organization, pharmacy or practicing unit if the human

factors are considered. The human factors, directly and indirectly, had a great effect on the work
performance of the health care providers and their supporting staff. The avoidance or human
factors in the system of health care if neglected can create a huge impact on patient safety. These
are the few factors that every health care provider should consider so the performance of the
workers of the healthcare system can be enhanced with improved efficiency and effectiveness
(Russ & Fairbanks, 2019).
Critical Analysis of Relationship between Human Factors and Quality and Safety in Health
Care: Human factors and ergonomics (HFE) approach to patients’ safety has been addressed
with the help of different domains such as human error and its part in safety of patients, usage of
technology, the healthcare workers performance role in the safety of patients’, resilience of
system, etc. (Awases, Bezuidenhout, & Roos, 2013)
Information technologies related to healthcare and the general questions and the advantage of the
electronic records and its execution impact on patients, staff and clinical outcomes required extra
longitudinal studies have been explained by Karsh. Doolan and Bates demonstrated that the
lower-cost alternative medicine and the reduction in the test order redundancy can offset the
increasing cost of investment. Bates further outlined how healthcare information technologies
can reduce the frequentness and after-effects of medical error (Eastern Kentucky University,
2019). Kilbridge presented the E-Prescription for the usage of computerized data entry system
for the generation of prescriptions. Doolan and Bates argued that the Computerized Physician
Order Entry may or may not have electronic health records (EHR) and decision support tools.
Bell has demonstrated the ability of timesaving with electronic prescription usage by determining
the doctors' current workflow. Benedict and Duffy have supported the adoption of the e-

prescription system in healthcare, whereas, Ash and Bates have highlighted the factors which
could affect the HER system adoption. Bell has developed the simulation models that include the
safety aspects, which primarily motivate the adoption of such systems (Aswegen, 2017).
The cognitive aspects and human-computer interaction is another aspect that requires
consideration. Groopman's book How Doctors Think describes the examples describing the
decisions taken by doctors is mostly based on satisfying rather than optimizing. Wickens
considered this as common from the human decision-maker's point of view. Groopman
highlighted the prospective biases that offer opportunities for future research in the cognitive
terms of the delivery of healthcare. For example, he showed that the e-prescription will change
the prescription information as it is going to change from the format in a written manner to
computer input. Jun has shown that the willingness of doctors' to adopt tablet PCs. AHFE has
shown that the various researchers have given their additional considerations on these issues at
the Second Internal Conference which was on Applied Human Factors and Ergonomics (Duffy,
2011).
Leonard has explained the failure in communication as the major reason for unknowing patient
harm. Joint Commission for Hospital Accreditation in the USA revealed a failure in
communication as the fundamental cause of patient safety. The reader found communication as
the primary cause of the reported incidents in ICU. For the safety purpose and delivery of
healthcare services in an effective manner, communication amongst individuals with varied
roles, experiences, and training must be effective. The transition of information in and between
the large organizations regarding the patients requires proper communication. Any
miscommunication can lead to medical errors (WHO, 2009).

Safren and Chapanis highlighted the medical errors due to written miscommunication, failure to
follow procedure, wrong transcript etc. resulting in 178 medication errors in the last 7 seven
months from the data collected from nurses resulting in drug to wrong patient, wrong drugs to
patient, drugs overdose, wrong administration time and omitted drug leading to medical errors.
King has explained the cause of 18 months of Josie King's cause of death as an absence of
communication amongst the providers of healthcare and parents' consideration was not taken
(Carayon & Wood, 2011).
Rotschild has thrown light on the fact that 20% of patients had faced adverse effects due to
medical errors in ICU out of which 45%adverse events could be prevented. The most obvious
errors that contributed to adverse events that could be prevented were medication errors,
elimination, and symptomatic errors and nosocomial infections that could be prevented. Kohn
has explained that “to err is human”; constructing safer health systems with the contribution in
the methodologies to reduce the medical error should be made. Poon (2004) has estimated that
medical errors can be minimized by 55% with the usage of healthcare IT such as CPOE.
Wienger has emphasized on building research on human errors and the reduction of incidents on
anesthesia accidents. Carayon has shown his contribution in his book on Human Factors and
Ergonomics in Healthcare and Patient Safety. Wickens (2004) has shown in his research the
study done by him on human factors and the tools needed to be developed for facilitating the
reduction of errors, enhancing safety and comfort and increasing productivity (Duffy, 2011).
The various challenges had been caused by the human factors in health care systems safety and
quality had been described by the various researches done by the researchers. The different
researchers presented their views on the human factors and helped in determining the

relationship between the human factors that affect the quality and safety of patients in the health
care system, which is the global challenge around the world (Xie & Kianfar, 2013).
Conclusion: This report aimed at highlighting the factors that are made by humans that affect
work performance in the health care system. The various factors such as improper
communication, increased workload for the healthcare workers and their staff resulting in stress,
fatigue, depression and other chronic ailments like diabetes, cardiovascular diseases and other
health-related factors affects the performance of the health care workers. Improper
communication can result in several medical and human errors that influence the services
provided at the healthcare system. The safety of the organization is one such human factor that
creates a significant effect on the performance. The human factors in the healthcare system can
create medical errors that can pose a threat to the patients, which is the cause of concern
worldwide in the health sector. The various authors have revealed in their studies and research
the impact of human factors on health cares' safety and quality. Thus, patient safety is of utmost
importance in the health care segment and human factors and ergonomics should be kept on top
priority for the minimization of the medical errors to give better facilities and services to the
patients who form the foundation of the health care system. Thus, it is rightly said that by
understanding the causes of errors, patient safety can be kept at the forefront at everything that is
done. The human factor in the health care domain looks the human work within and identifies
the potential errors and tries to mitigate the risks by redesigning the system.

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