Human Factors, Workplace Performance and Quality and Safety in Healthcare Relationships
Introduction
Healthcare systems need to provide efficient, effective, and safe care that meets the several needs of patients. However, these patients’ multiple needs are not met as a result of human factors and errors that hinder workplace performance and provide efficient, effective, and safe care to patients. This paper aims to investigate the correlation between human factors, workplace performance, and quality and safety in healthcare settings. The impacts of human factors in the healthcare system continue to evolve and, in turn, continue to gain considerable attention from researchers, educators, patient safety leaders, practitioners, as well as healthcare leaders. Humans have an intrinsic tendency to make mistakes. Therefore, understanding human factors that contribute to medical errors is a significant step towards the pursuit of making fewer errors in the medical set-up. Human factors information can help healthcare practitioners and professionals in identifying areas where mistakes are likely to occur. This information is used to maximize work systems designs, tools, environment, as well as tasks to minimize the likelihood of medical errors. Understanding the connection between human factors, work performance, and patient safety and quality in healthcare and tackling such factors, promotes a safe and healthy work principle.
Human Factors Related to Work Performance
Several human factors impact the performance of human beings in different situations and environments. According to the Institute of Medicine (2005), human factors examine all the elements that ensure it is easier to perform a particular work in the right manner. Human factors study the correlation between humans, the equipment and tools they utilize in their workplaces, and the environments where they work. Human factors are some of the major causes of medical errors in healthcare systems. For instance, a study was conducted in 1960 to investigate the effects of human factors on the safety of medication (Carayon et al., 2012). Consequently, the results revealed different types of medication errors due to human factors including; the administration of medication to wrong patients, administration of the wrong dosage, administration of unordered medication, failure to administer medication, incorrect timing of medication, administration of wrong medicines, as well as wrong means of administering drugs. Some of the human factors in the healthcare setting include cognitive functions, sensory, behavioral, organizational factors, and others.
Cognitive functions factor is one of the human factors in the healthcare system that impacts work performance. However, cognitive skills and interpersonal skills can be assessed as non-technical skills (NOTECHS), and refer to all the behavioral and attitude factors that are not related to the operation and system management processes (Bleetman et al., 2012). Subsequently, these NOTECH skills have four classes of expertise according to the two major categories; leadership, decision-making, situation awareness, and cooperation. Leadership and cooperation skills are interpersonal skills, whereas decision-making and situation awareness are cognitive skills. Nonetheless, communication is also a vital skill, but it is not considered a separate class since it is inherent in all the elements. According to Flin and others (2003), NOTECH skills evaluate the individual abilities of the practitioners rather than the capabilities of entire teams as a single entity. They can be used to assess the NOTECHS before and after on-job training.
These non-technical skills have different significant roles in healthcare service delivery by the entire healthcare professionals and stakeholders. First, leadership skills help healthcare professionals direct the operations of groups towards a common goal (Carayon et al., 2012). Therefore, effective leadership helps to lead and drive change at all levels of the healthcare system to actualize the goals of the continuing reforms in the healthcare system. Second, cooperation skills are special skills that enhance healthcare system performance and well as individual work performance. In other words, cooperation is the ability of individuals to work together, negotiate agreements, and manage conflicts by understanding and valuing each other as colleagues. Third, decision-making is vital in all aspects of an organizational setting. In the healthcare system, decision-making skills are crucial in guiding healthcare professionals in choosing the best clinical options, reflecting patients’ preferences and all the healthcare stakeholders. Lastly, situation awareness is an aspect concerned with knowing where people and resources are at any given time.
Organizational factors represent other human factors that impact work performance in the healthcare systems. According to Reason (2000), the organizational environment can lie dormant sometimes, although when linked with other factors, it can obstruct the system’s defenses and result in errors. The organizational factors can be grouped into five groups, namely; job aids, supervisor support, workplace incentive, performance feedback, local organizational practices, authority gradient, morale, group norms, and organizational climate. In her examination, Vaughan (1996) realized an array of small erosions to healthcare quality and safety that became the norm over time. Vaughn referred to this organizational situation as normalization of deviance. This aspect aimed at reducing any uneasy feelings and doubt concerning the mission status and preserved the initial certainty that the systems were considered safe.
Organizational factors that majorly impact work performance in the healthcare settings include employee morale, supervisor support, workplace incentive, performance feedback, authority gradient, group norms, as well as organizational climate. First, employee morale can be affected either positively or negatively by the environment of healthcare. Consequently, boosting the morale of healthcare providers plays a critical role in their work productivity and performance (Vincente, 2004). Second, supervisor support is another crucial factor in the performance and productivity of healthcare frontline workers. Healthcare workers have great professional reputations due to their splendid work ethics, compassion, and commitment (Henriksen et al., 2009). Therefore, supervisor support is essential to help in their problem-solving abilities, resourcefulness, and competence. Third, organizational climate is another vital factor in work performance and productivity. For instance, failures in processes in the healthcare setting like malfunctioning equipment, unavailable personnel, incomplete information, and missing supplies have adverse effects on the productivity and work performance in the healthcare systems (Roth, 2008). In an empirical study, Tucker and Edmonds (2003) established that failures in the systems caused quick fixes and workaround by about 93% of the time, and reports of the failure to an individual who may be capable of doing something about it 7% of the time. Healthcare system performance and employees’ work performance should be focused on the infrastructure of the system and the personnel’s motivation.
The relationship between human factors and quality and safety in healthcare
There is a considerable correlation between human factors and quality and safety in the healthcare system. The examination of human factors has conventionally concentrated on humans, and how they interact with their environment, workspace, procedures, processes, devices, and products they encounter at work daily (Sanders & McCormick, 1993). Consequently, most people meet pieces of equipment, products, work environments that hinder their optimal performance. Hence, if humans’ limitations and strengths are not considered in the design process, devices can be inefficient, unsafe, difficult to use, and confusing. Henriksen and colleagues (2009) assert that work environments can result in excessive fatigue, stress, and be disruptive. The information about human factors helps to bridge this gap in the healthcare system through the application of the information about machines, designs of tools, human abilities, limitations as well as
Behaviors.
Human factors research uses knowledge about the strengths and limitations of humans to design interactive systems of people, environments, and equipment to ensure their ease of use, safety, and effectiveness. Henriksen (2006) underscores that tasks that healthcare workers undertake, the technology they utilize, the environment of the work in which they function, as well as the organizational policies that direct their activities may impact their strengths and limitations. Consequently, when such factors of the systems and the cognitive, behavioral, and sensory factors are not well-matched, insufficient results commonly occur concerning the expended efforts, care quality, patients’ safety, as well as job satisfaction.
Most healthcare work processes have evolved due to personal preferences or local organizational practices rather than through systemic approaches of designing systems that result in greater efficiency and fewer errors. According to Henriksen and colleagues (2009), healthcare practitioners frequently fall into the trap of the status quo of doing things because they have continually been performed that way. On the other hand, the practitioners of human factors consider human strengths and limitations in the designing of the systems by emphasizing the significance of evading memory reliance, follow-up, and vigilance in areas where human performance is less steadfast. Primary processes can be harmonized and simplified to result in fewer errors, efficiency gains, and less confusion (Gluyas et al., 2016). Consequently, Flin and others (2003) assert that when the processes of care are harmonized and simplifies, healthcare practitioners get more time to attend to the specialized needs of individual patients. Therefore, when new technology and medical equipment are designed with user consideration, detection of errors, ease of use, and preventability are probable, contrary to most contemporary “opaque” devices that are controlled by computers that inhibit the users from understanding their full functionalities.
The field of human factors focuses on human performance besides technology and equipment. This field of human factors developed during the Second World War due to equipment controls and displays that were not well-suited to the machinists’ cognitive and visual abilities. Additionally, each successive epoch of human factors work, and application has seen an improvement of the human performance factors that are regarded as worthy of exploration. According to Carayon and Smith (2000), several investigators of human factors with interest in healthcare safety and quality suggested adopting a more inclusive range of socio-technical system factors, including work environment, socioeconomics, management factors, and organizational factors, microsystems in the institutions. Therefore, considerable improvements can be achieved through the correction of the misalignments in the systems approach. Managing the interdependence of the healthcare system is a primary challenge that providers and other human factors practitioners face in the care system.
The management of interdependence in the healthcare system to help in problem-solving meets the immediate needs of patients. Hensiksen (2006) posits that it is irrational to concentrate only on the first-order problems and not do something about the second-order problems. As a result, concentrating only on the first-order problems and not the second-order problems leads to the reoccurrences of the problems of successive shifts as the healthcare workers reprise the cycles of attempting to keep up with the days’ emergencies. Therefore, it is vital for healthcare leaders and managers to value some new qualities in a bid to shape the organizational climate to change this short-termism (Nacioglu, 2016). It is vital to appreciate the workers who step out of the status quo to solve second-order problems. Human factors are crucial aspects in the healthcare system, and encouraging the understanding of their application contributes to the delivery of safer, higher quality, and more patient-centered care.
Conclusion
There is a correlation between human factors, work performance, and patient safety and quality in healthcare, and understanding their connection and tackling such factors, promotes a safe and healthy work principle. The primary purpose of the healthcare system is to provide efficient, effective, and reliable care that meets the several specialized needs of individual patients. Nonetheless, these patients’ needs are not met due to human factors and errors that obstruct workplace performance and the provision of efficient, effective, and safe care to patients. The human factors such as non-technical skills and organizational factors are some of the human factors that undermine work performance. The non-technical skills include cognitive and interpersonal factors, while organizational factors include supervisor support, local corporate practices, morale, group norms, and regulatory climate. Understanding the link between human factors, work performance, and patient safety and quality in healthcare systems helps promote a safe and healthy work principle.
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