SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients

Abstract

Healthcare practitioners, patient safety leaders, educators and researchers increasingly recognise the value of human factors/ergonomics and make use of the discipline's person-centred models of sociotechnical systems. This paper first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, ‘SEIPS 2.0’. SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement and adaptation. The concept of configuration highlights the dynamic, hierarchical and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at ‘a moment in time’. Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed.

Abstract

Practitioner Summary: SEIPS 2.0 is a new human factors/ergonomics framework for studying and improving health and healthcare. It describes how sociotechnical systems shape health-related work done by professionals and non-professionals, independently and collaboratively. Work processes, in turn, shape patient, professional and organisational outcomes. Work systems and processes undergo planned and unplanned adaptations.

Keywords::

• healthcare
• work system
• patient-centred care
• patient and family engagement
• SEIPS model

Acknowledgements

We thank Russ Beebe for his support in developing the figures and the anonymous reviewers for their feedback. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Notes

^1. Email: [email protected]

^2. Email: [email protected]

^3. Email: [email protected]

^4. Email: [email protected]

^5. Email: [email protected]

^6. Email: [email protected]

^7. We note here that (1) while patients or caregivers can have professions, they are ‘non-professionals’ to the extent that their involvement in care is not a function of those professions and (2) the term ‘family caregiver’ here refers to individuals providing informal care but does not imply that only family members provide informal care or that family members' health-related roles are confined to caregiving.

^8. In the original formulation, the ‘person’ could be either a healthcare professional or a patient (Carayon et al. 2006).

^9. Another analogy is of different atomic elements combining through strong or weak bonds to form different molecules. The varying strength of bonds could be depicted in the model by changing the line colour or thickness between the elements.

Additional information

Funding

Funding

This study was partially supported by the Clinical and Translational Science Award (CTSA) programme, previously through the National Institutes of Health (NIH) National Center for Research Resources (NCRR) [grant number 1UL1RR025011] and now by the National Center for Advancing Translational Sciences (NCATS) [grant number 9U54TR000021]. Dr Holden was supported by NCATS [grant number 2KL2TR000446] through the Vanderbilt CTSA. Dr Gurses was supported in part by an Agency for Healthcare Research and Quality K01 [grant number HS018762] for her work on this paper.