title: An Evaluation of the Effects of Human Factors and Ergonomics on Health Care and Patient Safety Practices: A Systematic Review.
abstract: BACKGROUND
  From the viewpoint of human factors and ergonomics (HFE), errors often occur because of the mismatch between the system, technique and characteristics of the human body. HFE is a scientific discipline concerned with understanding interactions between human behavior, system design and safety.
  
  
  OBJECTIVE
  To evaluate the effectiveness of HFE interventions in improving health care workers' outcomes and patient safety and to assess the quality of the available evidence.
  
  
  METHODS
  We searched databases, including MEDLINE, EMBASE, BIOSIS Previews and the CBM (Chinese BioMedical Literature Database), for articles published from 1996 to Mar.2015. The quality assessment tool was based on the risk of bias criteria developed by the Cochrane Effective Practice and Organization of Care (EPOC) Group. The interventions of the included studies were categorized into four relevant domains, as defined by the International Ergonomics Association.
  
  
  RESULTS
  For this descriptive study, we identified 8, 949 studies based on our initial search. Finally, 28 studies with 3,227 participants were included. Among the 28 included studies, 20 studies were controlled studies, two of which were randomized controlled trials. The other eight studies were before/after surveys, without controls. Most of the studies were of moderate or low quality. Five broad categories of outcomes were identified in this study: 1) medical errors or patient safety, 2) health care workers' quality of working life (e.g. reduced fatigue, discomfort, workload, pain and injury), 3) user performance (e.g., efficiency or accuracy), 4) health care workers' attitudes towards the interventions(e.g., satisfaction and preference), and 5) economic evaluations.
  
  
  CONCLUSIONS
  The results showed that the interventions positively affected the outcomes of health care workers. Few studies considered the financial merits of these interventions. Most of the included studies were of moderate quality. This review highlights the need for scientific and standardized guidelines regarding how HFE should be implemented in health care.
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
authors.forename: Xuanyue
authors.initials: X
authors.lastname: Mao
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
authors.forename: Pengli
authors.initials: P
authors.lastname: Jia
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
authors.forename: Longhao
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
authors.forename: Pujing
authors.initials: P
authors.lastname: Zhao
authors.affiliation: School of Foreign Languages, Sichuan University, Chengdu, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, P.R. China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D006804:Ergonomics; D006801:Humans; D061214:Patient Safety; D011787:Quality of Health Care