The Influence Of Human Factors On Health Care: A Study On Leadership For Quality Effectiveness And Safety Management

Introduction to Human Factors in Health Care

Question:

Discuss about the Human Factors And Its Influence On A Health Care Setting.

The current assignment focuses on the concept of human factors and its influence on a health care setting.  The human factors could be described as a comprehensive view of the design of systems which could be used by the humans for their own benefits and welfare.  The human factors take into consideration most aspect of human capacity which is taken into consideration for the designing of the effective strategies and systems. The current assignment takes into consideration the different human attributes such as cognition, workflow efficiency, consistency, ergonomics, interruptions and distractions. Some of these factors might contribute to inadvertent errors within a health care system and process and may duly affect the patient health.

The current assignment focuses on the concept of leadership for quality effectiveness and safety management in health care. The study has been broken down into two main components such as identification of human factors related to work performance.  It has been further evaluated with the help of measurement of the human factors on the performance of the staff and patient safety. Similarly, relationships between human factors and quality and safety management in health care have also been evaluated over here.

Understanding the influence of human factors on work performed within a hospital setting and its influence on patient health and safety.

The aim of the assignment is to comprehend the relationship between human factors and its adverse effect on the work performance which directly or indirectly affects patient health and safety.

The human factors consist of a multidisciplinary field with contributions from a number of a number of areas such as psychology, engineering, anthropology, statistics, industrial design and operations research. It covers the social environment within which the human operates and the effect of the social determinants on further governing the actions of the humans. The human factors could be divided into separate classes as per the working ergonomics. In this respect, some of the governing human factors are cognitive abilities possessed by a person along with the interpersonal skills possessed by an individual.  Thus, the potential of decisions making under time pressure and along with team coordination and organizational culture are some of the determining factors.

In this respect, the human factors could be related to the ergonomics which dictates the process of workflow and work efficiency within a health care setup. In the present context, a number of human factors and their plausible effects on the collective work performance need to be discussed. The two contributing factors which have been chosen over here are the surrounding environment and the collective forces including the ergonomics which impacts upon individual performance. The other factor is the interpersonal skills possessed by an individual which affects the success of the overall workforce. 

Relationship Between Human Factors and Quality and Safety Management

The factors could be further fragmented down to evaluate individual effects on the collective work process.  As commented by Carayon et al. (2014), a positive and supportive work culture helps in enhancing individual performance within a group. This further helps in improvement of the services and standards by maintaining a steady organization culture. The different components of the workplace environment are provision of sufficient information and collective feedback to the employees. As commented by Holden et al. (2013), the propagation of standardized and required information to the employees help in the avoiding human errors. The information should be complete and true to the best of knowledge and belief based on which further care planning and decision making are done within a healthcare setup. 

There is a need for sufficient engagement and support from the management in the form of provision of constant feedbacks to the employees which would help in enhancing the performance of the staff.  The feedbacks also help in the identification of the loopholes within the care services and processes. Additionally, the systems processes, workload policies and the cultural resources further affect the working potential of the staff. In this respect, the policies and procedures of the work environment further affect the professional well being and the performance of the staffs. As argued by Wilson (2014), long working hours, lack of comfortable and flexible timings often impact upon the staff performance within a healthcare environment.  Thus, the nurses looking after the patients have to work longer hours and perform night shifts which leave them with little time to rest. Therefore, they need to be provided with better working ergonomics such as well ventilated resting areas, 24*7 clean drinking water, proper changing areas. As mentioned by Weaver et al. (2014), overtired and exhausted nurses have often been seen to administer wrong doses of medication to the patients.

In this context, a relevant case study can be highlighted such as the human factors leading to the death of a child in a hospital bed. The child JP was admitted to the hospital for management of the symptoms of gastroenteritis. JP was diagnosed at birth with epilepsy and spastic quadriplegia and was dependent on his mother for most of his needs. The child was admitted to the hospital for the control of the potentially infectious condition. The nurses reported that the child was provided with intravenous fluids and bed bumpers. However, later it was reported that these were not placed correctly which could have aggravated the condition of the patient towards the worst. Additionally, there was a shift change two hours before the death of the child where a nurse was just finishing her 12 hours shift and was replaced by another nurse. This was followed by a hurried and scanty exchange on information between the staffs which resulted in the misinterpretation of information. Additionally, provision of awards and incentives can act as motivating factors in improving the quality of patient care and in achieving better dedication from the nursing professionals (Karsh et al. 2014).

Effect of Human Factors on Work Performance and Patient Health and Safety

The patient safety and quality management in health care are pivotal to maintaining the overall organizational culture and balance. The safety of the patients is further dependent upon a number of factors such as maintenance of standardized health treatments and protocol. In order to ensure the patient safety, a number of factors need to be taken into consideration such as skills, knowledge and attitudes possessed by the person, the internal and external motives possessed by the care professional. The patient safety is further dependent upon the organizational culture which is a complex mix of different elements. These further influences the way things are performed within an organizational setup. It takes into consideration a number of factors such as symbols, rituals and languages within an organization. As commented by Onnasch et al. (2014), culture is affected by attitudes beliefs and values possessed by an individual. The culture practised within an organization forms an effective lens through which an organization is viewed and analysed (Kennedy et al. 2014). In this context, the rituals performed within an organization further govern the rate of success achieved within the organization.

Therefore practising effective cultural norms such as ward rounds patient handovers record keeping and drug administration rounds are some of the effective measures which could prevent the rate of mishaps or accidents within an organizational setup. As commented by Zohar (2014) engagement in the rituals by the health care professional helps in maintaining safety and quality. Additionally, good record keeping and appropriate communication practices are essential in assuring safety culture within the organization.  Moreover, values professed by the workforce are crucial in determining the safety of the patients within a care set up.

The human factors and their impact on health care could be described further with the help of safety and risk management protocols.  As commented by Liden et al. (2014), a human is prone to commit errors or mistakes which can further affect the patient quality and safety within a hospital setup. In this context, unsafe or less efficient devices along with stressful work environment can lead to errors within the normal processes of health delivery. Thus, on the poor matching of the systems factors with sensory, behavioural and cognitive characteristics of the health care providers disruption of the safety culture and practices of the organization are often noted. Additionally, work fatigue, inefficiency in the handling and management of machinery, poor record keeping has often affected the quality of safety management in health care (Sacks et al. 2015). As mentioned by Cafazzo & St-Cyr (2012), standardization of the care processes reduces the chances of errors and provides sufficient time to the care providers to cater to the needs of individual patients.

Factors Affecting Professional Well Being and Performance of Staff

The human factors play a crucial role in maintaining the quality of patient safety in care and hospital setups. In this regard, constant efforts need to be taken by the hospital staff for improvement of the patient health in an acute hospital setting. Some of the efforts include the provision of health-related information on an open public platform. This helps in educating the community as a whole regarding the accepted standards of health behaviour.

The Australia’s National Health Performance Framework (NHPF) potentially describes safety as reducing the levels of potential harm to the patient within an acute hospital set up or making the environment more patient-friendly. In this respect, the guidelines provided by the Australian community on safety and quality can be described over here such as:

• Provision of suitable strategies or advises to health ministers for improving the standards and practices in an acute health setup
• Development and supporting national clinical care standards
• Development of quality related indicators for maintaining health  safety care standards
• Establishment of common practice methods and reducing variations
• Coordination of national actions for addressing incidents of infections and antimicrobial resistance

The National Safety and Quality Health Service (NSQHS) provide the statement highlighting the level of care patients can expect from the health care services. As commented by Gurses et al.(2012), most of the public and private hospitals in Australia need to be accredited against these standards through an accreditation scheme employed by the commission. The commission is responsible for the implementation of the standards for maintaining the patient safety and quality risk management within a hospital set up. The NHSQS standards mention that regular reports on safety quality indicators and quality performance data are monitored by important healthcare organisation leaders.

For the process of improvement of the organization’s systems and processes, a number of model health care intervention strategies could be implemented such as the systems engineering initiative for patient safety (SEIPS). The same is based upon the macro ergonomic work system model developed by Smith and Carayon. The model emphasizes upon the structure-process-outcome for achieving sufficient quality in health care. The model helps in the description of the work system and its various interacting elements. It also accommodates the patient outcomes and organizational outcomes which are taken into consideration for further quality improvement.

Conclusion

The current study takes into consideration quality effectiveness and safety in health care. The assignment focuses on the presence of human errors and its impact upon patient safety and health quality maintenance within an acute hospital set up. In this respect, the errors may be attributed to both human factors and the working ergonomics of the healthcare set up. Thus, some of the factors such as fatigue, dissatisfaction from work and lack of sufficient training or knowledge can affect the process of care delivery within an acute care set up.

Case Study: Human Factors Leading to the Death of a Child

Therefore, implementation of some of the policies such as NHPF and NHSQS can also help in improvement of the working standards and ergonomics.  Additionally, the SEIPS model helps in achieving the technical skills required by the health care providers which help in maintaining the efficient flow of the work process.

References

Cafazzo, J.A., & St-Cyr, O. (2012). From discovery to design: The evolution of human factors in health care. Healthcare Quarterly, 15(Special Issue), 24-29.

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), 14-25.

Carayon, P., Xie, A., & Kianfar, S. (2014). Human factors and ergonomics as a patient safety practice. BMJ Qual Saf, 23(3), 196-205.

Caruso, C. C. (2014). Negative impacts of shiftwork and long work hours. Rehabilitation Nursing, 39(1), 16-25.

 Fryer, L. A. (2013). Human factors in nursing: The time is now. Australian Journal of Advanced Nursing (Online), 30(2), 56-65

Gurses, A. P., Ozok, A. A., &Pronovost, P. J. (2012). Time to accelerate integration of human factors and ergonomics in patient safety. BMJ Quality & Safety, 21(4), 347

Hignett, S., Carayon, P., Buckle, P., & Catchpole, K. (2013). State of science: human factors and ergonomics in healthcare. Ergonomics, 56(10), 1491-1503.

Holden, R. J., Carayon, P., Gurses, A. P., Hoonakker, P., Hundt, A. S., Ozok, A. A., & Rivera-Rodriguez, A. J. (2013). SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics, 56(11), 1669-1686.

Karsh, B. T., Waterson, P., & Holden, R. J. (2014). Crossing levels in systems ergonomics: a framework to support ‘mesoergonomic’inquiry. Applied ergonomics, 45(1), 45-54.

Kennedy, G. D., Tevis, S. E., & Kent, K. C. (2014). Is there a relationship between patient satisfaction and favorable outcomes?. Annals of surgery, 260(4), 592.

Liden, R. C., Wayne, S. J., Liao, C., & Meuser, J. D. (2014). Servant leadership and serving culture: Influence on individual and unit performance. Academy of Management Journal, 57(5), 1434-1452.

Onnasch, L., Wickens, C. D., Li, H., & Manzey, D. (2014). Human performance consequences of stages and levels of automation: An integrated meta-analysis. Human Factors, 56(3), 476-488.

Sacks, G. D., Shannon, E. M., Dawes, A. J., Rollo, J. C., Nguyen, D. K., Russell, M. M., … & Maggard-Gibbons, M. A. (2015). Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture. BMJ Qual Saf, 24(7), 458-467.

Weaver, S. J., Dy, S. M., & Rosen, M. A. (2014). Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf, 23(5), 359-372.

Wilson, J. R. (2014). Fundamentals of systems ergonomics/human factors. Applied ergonomics, 45(1), 5-13.

Zohar, D. (2014). Safety climate: Conceptualization, measurement, and improvement. The Oxford handbook of organizational climate and culture, 317-334.