Proactive Safety Management in Trauma Care: Applying the Human Factors Analysis and Classification System : The Journal for Healthcare Quality (JHQ)

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Original Article

Proactive Safety Management in Trauma Care: Applying the Human Factors Analysis and Classification System

Cohen, Tara N.; Cabrera, Jennifer S.; Litzinger, Tracy L.; Captain, Kevin A.; Fabian, Michael A.; Miles, Steven G.; Reeves, Scott T.; Shappell, Scott A.; Boquet, Albert J.

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Journal for Healthcare Quality 40(2):p 89-96, March/April 2018. | DOI: 10.1097/JHQ.0000000000000094

Abstract

Introduction: 

This article examines the reliability of the Human Factors Analysis and Classification System (HFACS) for classifying observational human factors data collected prospectively in a trauma resuscitation center.

Methods: 

Three trained human factors analysts individually categorized 1,137 workflow disruptions identified in a previously collected data set involving 65 observed trauma care cases using the HFACS framework.

Results: 

Results revealed that the framework was substantially reliable overall (κ = 0.680); agreement increased when only the preconditions for unsafe acts were investigated (κ = 0.757). Findings of the analysis also revealed that the preconditions for unsafe acts category was most highly populated (91.95%), consisting mainly of failures involving communication, coordination, and planning.

Conclusion: 

This study helps validate the use of HFACS as a tool for classifying observational data in a variety of medical domains. By identifying preconditions for unsafe acts, health care professionals may be able to construct a more robust safety management system that may provide a better understanding of the types of threats that can impact patient safety.

© 2017 National Association for Healthcare Quality

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