Zusammenfassung
Human-Factor-Modelle analysieren Bedingungen menschlichen Leistungsverhaltens, die im Akteur selbst, in der jeweiligen Arbeitsaufgabe, im Umfeld oder in der Organisation liegen können und die ursächlich für Arbeitsqualität oder Fehler wirksam werden. Aufgrund der hohen Bedeutung dieser Faktoren für Hochrisikoorganisationen entwickelte sich in den 1980er Jahren die Human-Reliability-Forschung. Das SHELL-Modell gliedert Human Factors in die Bereiche Software (Regelwerke), Hardware (Geräte), Environment (Umfeld) und Liveware (Team/Individuum). Grenzen menschlichen Leistungsvermögens können z. B. bei Übermüdung, Informationsüberfluss oder Stress auftreten. Mensch-Maschine-Interaktionen werden ebenso besprochen wie ein hoher Automatisierungsgrad, der neue Risiken birgt (z. B. Complacency). Der Ansatz des Threat-and-error-Managements beschreibt Strategien, durch die Gefahren und Fehler im Arbeitsalltag rechtzeitig identifiziert und durch Gegenmaßnahmen neutralisiert werden können.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. (2004) The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ 170 (11): 1678–86
Balkin EA (2013) How surgical robotics transform the development of expertise in modern operating rooms: An ethnographic study. Proceedings of the Human Factors and Ergonomics Society Annual Meeting 57: 693–697
Barger LK, Ayas NT, Cade BE, Cronin JW, Rosner B, Speizer FE, Czeisler CA (2006) Impact of extended duration shifts on medical errors, adverse events, and attentional failures. PLOS Medicine 3 (12): 2440–2448
Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA (2005) Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 352: 125–134
Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley JE, Milanovich S, et al. (2004) Eliminating catheter-related bloodstream infections in the intensive care unit. CriticalCare Medicine 32 (10): 2014–2020
Brennan TA, Localio AR, Leape LL, Laird NM, Peterson L, Hiatt HH, et al. (1990) Identification of adverse events occurring during hospitalization. A cross-sectional study of litigation, quality assurance and medical records of two teaching hospitals. Annals of Internal Medicine 112 (3): 221–6
Carayon P, Xie A, Kianfar S (2014) Human factors and ergonomics as a patient safety practice. BMJ Qual Saf 23: 196–205
Comittee on the Role of Human Factors in Home Health Care (2011) Consumer health information technologies in the home: A guide for human factors design considerations. National Research Council, National Academies Press, Washington/DC
Dawson D, Reid K (1997) Fatigue, alcohol and performance impairment. Nature 388 (6639): 235
Diller T, Helmrich G, Dunning S, Cox S, Buchanan A, Shappell S (2014). The Human Factors Analysis Classification System (HFACS) applied to health care. Am J Med Qual 29 (3):181–90
Edwards E (1972) Man and machine: systems for safety. In: Proceedings of the BALPA Technical Symposium. London
Elmenhorst EM, Hörmann HJ, Oeltze K, Pennig S, Rolny V, Vejvoda M, Staubach M, Schießl C (2013) Validierung eines Fitness-for-Duty Tests zur Steigerung der Sicherheit in Luftfahrt und Verkehr. Abschlussbericht zum FIT-Projekt. DLR, Köln
Euteneier A (2014) Risikomanagement – Umgang mit Regelverstößen. Deutsches Ärzteblatt 111 (37): 1504–1506
Flin R, Winter J, Sarac C, Raduma M (2009) Human factors in patient safety: Review of topics and tools. Report for Methods and Measures Working Group of WHO Patient Safety. Geneva: World Health Organization. April 2009
Gurses AP, Winters BD, Pennathur PR, Carayon P, Pronovost PJ (2012) Human factors and ergonomics in intensive care units. In: Carayon P (ed) Handbook of human factors and ergonomics in health care and patient safety, 2nd ed, pp 693–707. CRC Press, Boca Raton
Hawkins FH (1987) Human Factors in Flight. Technical Press, Aldershot, Gower
Health and Safety Executive (1999) Reducing error and influencing behavior, 2nd ed. HSG48. HSE Books, London
Helmreich RL (2001) Culture, threat, and error: Assessing system safety (Report No.166). University of Texas at Austin Human Factors Research Project, Texas
Helmreich RL, Merritt AL (1998) Culture at work in aviation and medicine. Aldershot, Ashgate
Hoffmann B, Rohe J (2010) Patientensicherheit und Fehlermanagement. Deutsches Ärzteblatt 107 (6): 92–99
Holden RJ, Carayon P, Gurses AP, Hoonakker P, Schoofs Hundt A, Ozok A, Rivera-Rodriguez AJ (2013) SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics 56 (11): 1669–1686
International Civil Aviation Organization (ICAO) (2003) Human factors training manual (Doc 9683, AN/950, 3rd edn). Montreal, Canada: International Civil Aviation Organization
Israelski EW, Muto WH (2012) Human factors risk management for medical products. In: Carayon P (ed) Handbook of human factors and ergonomics in health care and patient safety, 2nd ed, pp 475–505. CRC Press, Boca Raton
Hudson P (2007) Implementing a safety culture in a major multi-national. Safety Science 45: 697–722
Kohn LT, Corrigan JM, Donaldson MS (eds) (2000) To err is human: Building a safer health care system. Committee on Quality of Health Care in America, Institute of Medicine (IOM). National Academy Press, Washington, D.C
Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick F, Latz JT, Lilly CM et al. (2004) Effect of reducing interns’ work hours on serious medical errors in intensive care units. New England Journal of Medicine 351 (18): 1838–1848
Laughery KR, Wogalter MS (2006) Designing effective warnings. Reviews of Human Factors and Ergonomics 2: 241–271
Lawton R, McEachan RR, Giles SJ, Sirriyeh R, Watt IS, Wright J (2012) Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review. British Medical Journal Quality and Safety 21: 369–80
Leape L L (1994). Error in medicine. Journal of the American Medical Association 272 (23):1851–7
Leape L L (2000). Institute of Medicine medical error figures are not exaggerated. Journal of the American Medical Association 284 (1):95–7
Lim J, Dinges DF (2010). A meta-analysis of the impact or short-term sleep deprivation on cognitive variables. Psychological Bulletin 136 (3): 375–389
Maguire R (2006) Safety cases and safety reports. Aldershot, Ashgate
Manser T, Foster S, Flin R, Patey R (2013) Team communication during patient handover from the operating room: More than facts and figures. Human Factors 55 (1): 138–155
Miller G A, Galanter E, Pribram K A (1960). Plans and the structure of behavior. Holt, Rhinehart, & Winston, New York
Morrow D, North R, Wickens CD (2005) Reducing and Mitigating Human Error in Medicine. Reviews of Human Factors and Ergonomics 1: 254–296
Parasuraman R, Manzey D (2010) Complacency and bias in human use of automation: An attentional integration. Human Factors 52: 381–410
Philibert I (2005) Sleep loss and performance in residents and nonphysicians: A meta-analytic examination. Sleep 28 (11): 1392–1402
Pronovost PJ, Needham D, Berenholtz SM, Sinopoli D, Chu H, Cosgrove S, Sexton B et al. (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355 (26):2725–2732
Reason J (1997) Managing the risk of organizational accidents. Ashgate Publishing, Hants/UK
Reason J (2005) Directions in safety research: Reviewing the past, guessing the future. Paper presented at the 1st Meeting on the Global Research Program for Patient Safety. Waschington/DC: WHO World Alliance for Patient Safety in Collaboration with AHRQ
Rosen MA, Salas E, Tannenbaum SI, Pronovost PJ, King HB (2012) Simulation-based training for teams in health care: Designing scenarios, measuring performance and providing feedback. In: Carayon P (ed) Handbook of human factors and ergonomics in health care and patient safety, 2nd ed, pp 573–594. CRC Press, Boca Raton
Shappell SA, Wiegmann DA (1997) A human error approach to accident investigation: The taxonomy of unsafe operations. The International Journal of Aviation Psychology 7: 269–91
Shortliffe EH, Cimino JJ (2005) Biomedical informatics: Computer applications in health care and biomedicine, 3rd ed. Springer, New York
Smith MJ, Carayon-Sainfort P (1989) A balance theory of job design for stress reduction. International Journal of Industrial Ergonomics 4: 67–79
Swain AD, Guttmann HE (1983) Handbook of human reliability analysis with emphasis on nuclear power plant applications. Sandia Laboratories, Washington D.C., NUREG/CR–1278
Ulmer C, Miller-Wolman D, Johns MME (eds) (2009) Resident duty hours: Enhancing sleep, supervision and safety. Institute of Medicine. National Academy of Sciences, Washington, D.C.
Vincent C, Neale G, Woloshynowych M (2001) Adverse events in British hospitals: preliminary retrospective record review. British Medical Journal 322 (7285): 517–519
Weinger MB (2012) Human factors in anesthesiology. In: Carayon P (ed) Handbook of human factors and ergonomics in health care and patient safety, 2nd ed, pp 803–823. CRC Press, Boca Raton
Whalen T, Walsh W (2011) New standards addressing fiteness for duty, alertness management, and fatigue mitigation, In Philibert I, Amis S The ACGME 2011 duty hour standards: Enhancing quality of care, supervision, and resident professional development (pp 61–67). Accreditation Council for Graduate Medical Education, Chicago/IL
Williamson AM, Feyer AM (2000) Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med 57: 649–655
Windrum B (2013) It’s time to account for medical error in „top ten causes of death“ charts. Journal of Participatory Medicine, Commentary Vol. 5
Yue RYK, Trbovich P, Easty T (2012) A healthcare failure mode and effect analysis on the safety of secondary infusions. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting 56: 877–881
Zegers M, de Bruijne M C, Wagner C, Hoonhout L H, Waaijman R, Smits M, et al. (2009) Adverse events and potentially preventable deaths in Dutch hospitals: Results of a retrospective patient record review study. Quality and Safety in Health Care 18 (4): 297–302
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Hörmann, HJ. (2015). Human Factor. In: Euteneier, A. (eds) Handbuch Klinisches Risikomanagement. Erfolgskonzepte Praxis- & Krankenhaus-Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45150-2_12
Download citation
DOI: https://doi.org/10.1007/978-3-662-45150-2_12
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-45149-6
Online ISBN: 978-3-662-45150-2
eBook Packages: Medicine (German Language)