A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety

Abstract

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 identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of 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.

Abstract

Practitioner Summary: Existing evidence shows that HFE-based healthcare system redesign has the potential to improve quality of care and patient safety. Healthcare organisations need to recognise the importance of HFE-based healthcare system redesign to quality of care and patient safety, and invest resources to integrate HFE in healthcare improvement activities.

Keywords::

• human factors and ergonomics
• healthcare system redesign
• quality of care
• patient safety
• systematic review
• SEIPS model

Acknowledgements

The authors would like to thank Betty Chewning, Michael J. Smith, Tosha Wetterneck and Douglas Wiegmann for their comments and feedback.

Notes

^1. The projects' and studies' numbers in this section refer to the list in Table 3.

^2. Blinding is a procedure that prevents participants, caregivers or outcome assessors from knowing which intervention was received. It seeks to prevent performance and ascertainment bias and protect the sequence after allocation.

Additional information

Funding

This study was supported by the Clinical and Translational Science Award (CTSA) programme, previously through the National Center for Research Resources (NCRR) grant [number 1UL1RR025011] and now by the National Center for Advancing Translational Sciences (NCATS) grant [number 9U54TR000021].