Proactive Safety Management in Trauma Care: Applying the Human Factors Analysis and Classification System

• Published in: Journal for healthcare quality Vol. 40; no. 2; p. 89
• Main Authors: Cohen, Tara N, Cabrera, Jennifer S, Litzinger, Tracy L, Captain, Kevin A, Fabian, Michael A, Miles, Steven G, Reeves, Scott T, Shappell, Scott A, Boquet, Albert J
• Format: Journal Article
• Language: English
• Published: United States 01.03.2018
• Subjects: Adult; Critical Care - standards; Critical Care - statistics & numerical data; Factor Analysis, Statistical; Female; Humans; Male; Medical Errors - classification; Medical Errors - statistics & numerical data; Middle Aged; Patient Safety - standards; Patient Safety - statistics & numerical data; Reproducibility of Results; Safety Management - standards; Safety Management - statistics & numerical data; Trauma Centers - standards; Trauma Centers - statistics & numerical data
• ISSN: 1945-1474
• DOI: 10.1097/JHQ.0000000000000094

This article examines the reliability of the Human Factors Analysis and Classification System (HFACS) for classifying observational human factors data collected prospectively in a trauma resuscitation center. Three trained human factors analysts individually categorized 1,137 workflow disruptions identified in a previously collected data set involving 65 observed trauma care cases using the HFACS framework. Results revealed that the framework was substantially reliable overall (κ = 0.680); agreement increased when only the preconditions for unsafe acts were investigated (κ = 0.757). Findings of the analysis also revealed that the preconditions for unsafe acts category was most highly populated (91.95%), consisting mainly of failures involving communication, coordination, and planning. This study helps validate the use of HFACS as a tool for classifying observational data in a variety of medical domains. By identifying preconditions for unsafe acts, health care professionals may be able to construct a more robust safety management system that may provide a better understanding of the types of threats that can impact patient safety.