BackgroundHuman factors and ergonomics (HFE) approaches to patient safety have addressed five different domains: usability of technology; human error and its role in patient safety; the role of healthcare worker performance in patient safety; system resilience; and HFE systems approaches to patient safety.MethodsA review of various HFE approaches to patient safety and studies on HFE interventions was conducted.ResultsThis paper describes specific examples of HFE-based interventions for patient safety. Studies show that HFE can be used in a variety of domains.ConclusionsHFE is a core element of patient safety improvement. Therefore, every effort should be made to support HFE applications in patient safety.

This systematic literature review provides information on the use of mixed methods research in human factors and ergonomics (HFE) research in health care. Using the PRISMA methodology, we searched four databases (PubMed, PsycInfo, Web of Science, and Engineering Village) for studies that met the following inclusion criteria: (1) field study in health care, (2) mixing of qualitative and quantitative data, (3) HFE issues, and (4) empirical evidence. Using an iterative and collaborative process supported by a structured data collection form, the six authors identified a total of 58 studies that primarily address HFE issues in health information technology (e.g., usability) and in the work of healthcare workers. About two-thirds of the mixed methods studies used the convergent parallel study design where quantitative and qualitative data were collected simultaneously. A variety of methods were used for collecting data, including interview, survey and observation. The most frequent combination involved interview for qualitative data and survey for quantitative data. The use of mixed methods in healthcare HFE research has increased over time. However, increasing attention should be paid to the formal literature on mixed methods research to enhance the depth and breadth of this research.

Objectives The aim of this study is to assess the contributions of care management as perceived by care managers themselves. Study Design Focus groups and interviews with care managers who coordinate care for chronic obstructive pulmonary disease and congestive heart failure patients, as well as patients undergoing major surgery. Methods We collected data in focus groups and interviews with 12 care managers working in the Keystone Beacon Community project, including 5 care managers working in hospitals, 2 employed in outpatient clinics and 4 telephoning discharged patients from a Transitions of Care (TOC) call center. Results Inpatient care managers believe that (1) ensuring primary care provider follow-up, (2) coordinating appropriate services, (3) providing patient education, and (4) ensuring accurate medication reconciliation have the greatest impact on patient clinical outcomes. In contrast, outpatient and TOC care managers believe that (1) teaching patients the signs and symptoms of acute exacerbations and (2) building effective relationships with patients improve patient outcomes most. Some care management activities were perceived to have greater impact on patients with certain conditions (e.g., outpatient and TOC care managers saw effective relationships as having more impact on patients with COPD). All care managers believed that relationships with patients have the greatest impact on patient satisfaction, while the support they provide clinicians has the greatest impact on clinician satisfaction. Conclusions These findings may improve best practice for care managers by focusing interventions on the most effective activities for patients with specific medical conditions.

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Care coordination is important for chronically ill patients who need assistance from a variety of care professionals, and often transition through different care settings. This paper provides an overview of coordination and its implications for the care of chronically ill patients. Using 12 interviews of different healthcare professionals involved in coordinating care of chronically ill patients, we provide examples of care coordination situations (e.g., patient discharged home with home health services) and identify coordination activities (e.g., communication for arranging resources, building relationships to facilitate information exchange, monitoring patients to plan follow up care) performed by different healthcare professionals.

n.d.), human factors and ergonomics are two names for the same discipline aimed at "understanding the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data and methods to design in order to optimize human well-being and overall system performance" (Definition section, para. 1). In this chapter, we use HFE as a shortcut for human factors and ergonomics. 2 We use both the terms organizational and sociotechnical to describe the broader context of work. In our macroergonomics approach, we consider the terms to be synonymous, as they emphasize the importance of the broader organizational design as well as the principles of sociotechnical systems theory (Pasmore, 1988;Trist & Bamforth, 1951).

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