title: Good people who try their best can have problems: recognition of human factors and how to minimise error.
abstract: Human error is as old as humanity itself and is an appreciable cause of mistakes by both organisations and people. Much of the work related to human factors in causing error has originated from aviation where mistakes can be catastrophic not only for those who contribute to the error, but for passengers as well. The role of human error in medical and surgical incidents, which are often multifactorial, is becoming better understood, and includes both organisational issues (by the employer) and potential human factors (at a personal level). Mistakes as a result of individual human factors and surgical teams should be better recognised and emphasised. Attitudes and acceptance of preoperative briefing has improved since the introduction of the World Health Organization (WHO) surgical checklist. However, this does not address limitations or other safety concerns that are related to performance, such as stress and fatigue, emotional state, hunger, awareness of what is going on situational awareness, and other factors that could potentially lead to error. Here we attempt to raise awareness of these human factors, and highlight how they can lead to error, and how they can be minimised in our day-to-day practice. Can hospitals move from being "high risk industries" to "high reliability organisations"?
authors.affiliation: Maxillofacial Unit, Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY, UK. Electronic address: Peter.brennan@porthosp.nhs.uk.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
authors.affiliation: Maxillofacial Unit, Bradford Teaching Hospitals NHS Foundation Trust, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Mitchell
authors.affiliation: Medical Director, Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Holmes
authors.affiliation: Postgraduate Medical Dean, Health Education Wessex, Southern House, Otterbourne, Winchester, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Plint
authors.affiliation: Department of Anatomy, Guy's Campus, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Parry
mesh_terms: D057189:Checklist; D004644:Emotions; D005221:Fatigue; D006801:Humans; D019300:Medical Errors; D015203:Reproducibility of Results
keywords: Error; Fatigue; Human factors; Performance; Situational awareness.; Stress; Surgery; Team working