Judging the safety design of a patient care system from the angles of humanistic factors and cognitive theories / 中华医院管理杂志

ABSTRACT

The paper first offers a comprehensive analysis of the existing social understanding of medical errors and then discusses from the angles of humanistic factors and cognitive theories the concepts of operational errors, decisional errors and latent errors, error occurrence mechanisms, system related error occurrence, and ways of designing a safety system that can prevent error occurrence. The paper sets forth 8 aspects that ought to be stressed in the safety design of a patient care system ①attaching great importance to medical safety; ②discovering errors in a timely manner; ③reducing reliance on memories; ④using force and restraint; ⑤avoiding over reliance on human vigilance; ⑥simplifying and standardizing key procedures; ⑦designing system buffer and recovery functions; ⑧establishing non punitive reporting systems.