Healthcare is always delivered by people, and those people always work in some sort of organisation. As such, it is unsurprising that human and organisational factors are some of the most important contributors both to safe and effective care – and to unsafe care and safety incidents.
The role of human and organisational factors in safety has long been recognised by other safety-critical industries, such as aviation and nuclear power, but it is only relatively recently that these issues have been recognised in healthcare.
Human and organisational factors encompass such things as organisational culture, leadership and communication, stress, design of the work environment and technologies, decision making and teamwork (see Human Factors in Patient Safety: Review of Topics and Tools). In short, they encompass nearly everything that either supports or distracts from healthcare professionals’ daily work.
Understanding how human and organisational factors impact on patient safety
It is critically important to understand how different forms of human and organisational factors can cause safety incidents. Papers – such as An organisation with a memory and Human error: models and management – have been key in showing how these can be managed in order to ensure that healthcare organisations can move towards being extremely safe, high reliability environments in which the occurrence of errors and mishaps is continually reduced and safety incidents are effectively analysed and learnt from.
One of the most important ideas in this area focuses on ‘systems-thinking’, where individual behaviours are seen as dependent on and shaped by the surrounding organisational, cultural and human systems. Understanding patient safety in terms of systems helps to reveal the underlying sources of risk, and the gaps in safety defences, that can be managed to create high reliability organisations.