Challenges and opportunities for improving patient safety through human factors and systems engineering

Pascale Carayon, Abigail Wooldridge, Bat Zion Hose, Megan Salwei, James Benneyan

Research output: Contribution to journalArticlepeer-review


Despite progress on patient safety since the publication of the Institute of Medicine’s 1999 report, To Err Is Human, significant problems remain. Human factors and systems engineering (HF/SE) has been increasingly recognized and advocated for its value in understanding, improving, and redesigning processes for safer care, especially for complex interacting sociotechnical systems. However, broad awareness of HF/SE and its adoption into safety improvement work have been frustratingly slow. We provide an overview of HF/SE, its demonstrated value to a wide range of patient safety problems (in particular, medication safety), and challenges to its broader implementation across health care. We make a variety of recommendations to maximize the spread of HF/SE, including formal and informal education programs, greater adoption of HF/SE by health care organizations, expanded funding to foster more clinician-engineer partnerships, and coordinated national efforts to design and operationalize a system for spreading HF/SE into health care nationally.

Original languageEnglish (US)
Pages (from-to)1862-1869
Number of pages8
JournalHealth Affairs
Issue number11
StatePublished - Nov 2018

ASJC Scopus subject areas

  • Health Policy


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