Understanding adverse events: human factors.
(1/24)
(1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with forgetting. States of mind contributing to error are thus extremely difficult to manage; they can happen to the best of people at any time. (7) People do not act in isolation. Their behaviour is shaped by circumstances. The same is true for errors and violations. The likelihood of an unsafe act being committed is heavily influenced by the nature of the task and by the local workplace conditions. These, in turn, are the product of "upstream" organisational factors. Great gains in safety can ve achieved through relatively small modifications of equipment and workplaces. (8) Automation and increasing advanced equipment do not cure human factors problems, they merely relocate them. In contrast, training people to work effectively in teams costs little, but has achieved significant enhancements of human performance in aviation. (9) Effective risk management depends critically on a confidential and preferable anonymous incident monitoring system that records the individual, task, situational, and organisational factors associated with incidents and near misses. (10) Effective risk management means the simultaneous and targeted deployment of limited remedial resources at different levels of the system: the individual or team, the task, the situation, and the organisation as a whole. (+info)
Occupational health psychology: an emerging discipline.
(2/24)
There is growing concern that rapidly changing patterns of work organization and employment pose risk for occupational illness and injury. In the present article, we assert that these changes create new needs and opportunities for research and practice by psychologists in the area of work organization and health. We begin with an historical overview of the contribution of psychologists to the occupational safety and health field, and to the study of work organization and health. We then describe new initiatives by the American Psychological Association and national health organizations in the United States and Europe to frame a new field of study--called "occupational health psychology"--that focuses on the topic of work organization and health. We conclude with a discussion of emerging research needs and trends within this field. (+info)
People and work: some contemporary issues.
(3/24)
In advanced industrial societies social, economic, and technological changes are accompanied by changing values and attitudes to work, symptomatic of what some see as the transition to a post-industrial era. As a result existing job definitions and traditional forms of organization are being challenged and attempts made to restructure work so that it becomes meaningful and rewarding in the fullest sense, to the individual, to the enterprise, and to society. These range from programmes of job enlargement and job enrichment, within the framework of existing technologies, to experiments in the design of organizations as a whole in which fewer constraints are accepted as given. They entail and require a multidisciplinary approach as well as awareness of and commitment to the underlying values. The possibilities and benefits of restructuring work in these various ways have been demonstrated sufficiently to encourage interest at governmental level as well as by employers and trade unions. There are, however, no simple prescriptions or principles of universal application. Knowledge is still tentative and partial but there is consensus that the search for new ways of dealing with the organization of work and the allocation of resources is of fundamental importance. (+info)
Psychological approaches to OSH research--an evaluation of 20 years of psychological research on industrial safety and health in Germany.
(4/24)
During the past 20 years of research in occupational safety and health (OSH), major contributions have been made by psychology in general, foremost German work and organizational psychology. This is the result of an empirical study with 216 scientific projects that were analyzed by content, and 32 interviews on OSH with experts on science, as well as in professional occupations and federations. Its sound methodological and theoretical approach has helped work and organizational psychology to embody itself as a driving force of OSH. The research focuses on the development of tools for job analysis, striving for the valid diagnosis of occupational hazards and mental load. Consequently, work and organizational psychology provides a solid foundation for deriving human and personality ameliorating organizational measures. Among the predominant means of intervention are training in coping with stress, behavioral training and modeling, health circles, and the arrangement of environments sensitive to occupational load. Major deficits in the field of research show up within evaluation and transfer as well as within quality control of the developed diagnostic and devices regarding intervention. Future scientific effort by means of application-orientated methods is vital to detect and overcome effectively a mounting mental load in the occupational world. (+info)
Psychosocial factors at work and self reported health: comparative results of cross sectional and prospective analyses of the French GAZEL cohort.
(5/24)
BACKGROUND: Psychosocial factors at work have been found to be significant contributors to health, especially cardiovascular health. AIMS: To explore the relation between psychosocial factors at work and self reported health, using cross sectional and prospective analyses for a large occupational cohort of men and women. METHODS: Psychosocial factors at work were evaluated using the Karasek questionnaire, designed to measure psychological demands, decision latitude, social support, and physical demands. Self reported health was used as health outcome. Covariates included chronic diseases, and sociodemographic, occupational, and behavioural factors. The cross sectional and prospective analyses concerned respectively 11 447 and 7664 workers. Men and women were analysed separately. RESULTS: Cross sectional analysis revealed significant associations between psychological demands, decision latitude, social support, and physical demands, and self reported health for both men and women. Prospective analysis showed that high psychological demands for both genders, low decision authority for men, and low social support and high physical demands for women were predictive of poor self reported health. These results were independent of potential confounding variables. CONCLUSIONS: Results highlight the predictive effects of psychosocial factors at work on self reported health in a one year follow up study. They also underline the need for longitudinal study design and separate analyses for men and women in the field of psychosocial factors at work. (+info)
The impact of participatory ergonomics on working conditions, quality, and productivity.
(6/24)
A participatory ergonomics model was designed for improving working conditions, quality, and productivity in a medium-sized manufacturing enterprise by making use of a Supportive Expert Team (SET). In order to implement the model, a team-based structure consisting of a Steering Committee (SC) and 2 Action Groups (AGs) was designed and a 5-phase methodology followed. To validate the model, a similar factory was selected as control. Performance of the model was successful throughout the project. AGs under the supervision of the SC and the support of the SET designed and implemented several ergonomics solutions using local resources. Our findings showed that, in comparison with the control factory, application of such a model could be considered as a provider of a more humanized work environment as well as a more efficient and cost-effective approach. (+info)
The role of error in organizing behaviour. 1990.
(7/24)
During recent years the significance of the concept of human error has changed considerably. The reason for this has partly been an increasing interest of psychological research in the analysis of complex real life phenomena, and partly the changes of modern work conditions caused by advanced information technology. Consequently, the topic of the present contribution is not a definition of the concept or a proper taxonomy. Instead, a review is given of two professional contexts for which the concept of error is important. Three cases of analysis of human-system interaction are reviewed: (1). traditional task analysis and human reliability estimation; (2). causal analysis of accidents after the fact, and (3). design of reliable work conditions in modern sociotechnical systems. It is concluded that "errors" cannot be studied as a separate category of behaviour fragments; the object of study should be cognitive control of behaviour in complex environments. (+info)
Reducing social disparities in tobacco use: a social-contextual model for reducing tobacco use among blue-collar workers.
(8/24)
In the United States in 1997, the smoking prevalence among blue-collar workers was nearly double that among white-collar workers, underscoring the need for new approaches to reduce social disparities in tobacco use. These inequalities reflect larger structural forces that shape the social context of workers' lives. Drawing from a range of social and behavioral theories and lessons from social epidemiology, we articulate a social-contextual model for understanding ways in which socioeconomic position, particularly occupation, influences smoking patterns. We present applications of this model to worksite-based smoking cessation interventions among blue-collar workers and provide empirical support for this model. We also propose avenues for future research guided by this model. (+info)