WATERSON, P.E., 2008. Taking stock of the systems approach to patient safety. IN: Hignett, S. ... et al (eds). Improving Patient Safety 2008: From Safe Design to Safe Practice, Cambridge, UK, 16th-18th July. Loughborough: The Ergonomics Society.
The application of concepts, theories and methods from systems
ergonomics to the domain of patient safety has proved to be an expanding area
of research and application in the last 15 years. This paper describes a review of
the approach which aimed to identify: the main issues that have been
researched; the types of methods of investigation adopted by researchers; the
extent to which different system levels are covered; and, the types of medical
domain in which work has gone on in the last few years. A total of 360 papers
were selected for a detailed review. Approximately 16% of these focused on
human error, followed by safety/error frameworks (13%), incident reporting
(12%) and perceptions of safety/risk (9%). Most studies have addressed system
concerns at the level of the individual (27%). The most frequent methodology
used within research adopting the approach are case studies (33%). The
findings from the review are discussed within the context of previous
evaluations and criticisms of the systems approach and patient safety.