Surveillance and Disaster Planning for Multidimensional Field

Question: Discuss about theSurveillance and Disaster Planning for Multidimensional Field. Answer: Introduction Human factors is a multidimensional field of learning getting significant inputs from engineering, psychology, statistics, operations research. The emphasis of this subject is on elements of cognition, perception, engineering and empiricism. The human factor is the prime tool for understanding best practice management of process design and system since it promotes abilities and competencies of humans in a certain workforce. Human factors are of chief importance in the healthcare domain since the professionals caring for other are susceptible to unmonitored high workloads that are indirectly and directly related to the scope of practice and role of the professional (Gurses et al., 2012). The standpoint taken in this regard for the present paper is that identification of the impact of a human factor on the quality of care delivery and functional performance of healthcare organisations is pivotal for the promotion of better work environment and patient outcomes. The present paper is a critical analysis of literature existing on human factors related to work performance. The aim of the paper is to compare between literatures and highlight the similarities and dissimilarities between different findings. The main content of the paper is divided into two sections; identification and description of human factors related to work performance, and critical analysis of the association between human factors and quality and safety in health care. Identification and description of human factors related to work performance A number of human factors drive the quality of care in a manner that is noteworthy. The report of Australian Institute of Health and Welfare (2016) point out that the quality and safety of care delivered to patients in different healthcare systems in the country has been drawing attention of the public health organisations as better services are expected for meeting the rising demands of the population. As per the report, the key focus is on the service providers who have deviated from delivering the optimal quality care to the patients. The report summarised the information on safety and quality issues pertaining to care services provided. The indicators of hospital safety and quality are healthcare-associated infections, adverse events in hospital, unplanned hospital readmission rates, falls leading to patient harms and patient satisfaction and experience. Depending on the results of the evaluation of these indicators, one can come to the conclusion whether care delivered is safe o r not. The report further states that a direct influence on these indicators is exerted by organisational, environmental and job factors. Individual as well as human characteristics influence behaviour at work and therefore affect health and safety. Some of the noteworthy human factors are leadership style of manager, communication, team leadership, situation awareness, decision making ability, fatigue and stress. Kaufman and McCaughan (2013) also consider good teamwork, effective leadership and a culture of learning and fairness as the human factors related to patient care quality. Cafazzo and St-Cyr (2012) support the idea as they state that role of human factors in healthcare is definitely transformative. The authors reviewed the human factors that contribute to the failure to deliver optimal quality health care. Active errors relate to those made by the users systems, such as administration of wrong medicine. On the contrary, the latent errors relate to those created by the organisation, such as incomplete training, inadequate procedures, and poor labelling choices. Organisational factors and team factors are significant concerns when it comes to quality of care provided. A culture of misunderstanding and blaming the other also contribute to adverse events. The research paper also pointed out some other crucial human factors that play a key role in healthcare. These are fatigue, cognition, consistency, workflow efficiency, visual and audible noise and distractions and interruptions. The underpinning concept is that these human factors promote a rejection of the concept that humans are at fault while making errors in the delivery of care using the socio-technical system. Carayon et al., (2014) point out that a assortment of work system factors contributes to medication errors in health care system. These are mainly human factors, including failure to abide by the medication checking procedures, and issues with verbal or written communication. Fryer (2013) adds to the knowledge on the factors that contribute to poor quality care services. The authors state that healthcare service is complex and underpinning human factors related to the work environment is paramount to care quality. In the explanation put forward by Hookham (2016) on the human factors related to the death of patients in hospitals, it has been mentioned that cognitive function is a key human factor when it comes to making errors. Omission errors arise out of poor skill-based actions as these are accountable for lapses and forgetfulness of completing a task. Lapses and slips in tasks are a result of task overload, distractions and interruptions. Errors in rule-based actions attribute to those that occur due to inability to cope up with the changed circumstances. Humans need to retrieve stored schemas for matching with present circumstances. An error would occur when a wrong schema is retrieved. Knowledge-based actions are common when a person is unable to carry out the task due to limited knowledge. The kinds of errors poined out by Hookham can be linked with the ideas of Henriksen et al., (2008). The authors put the focus on interruptions in the care environment, poor communication, diffusion of responsibility, and management neglect as the core human factors contributing to poor quality care. These are the contributing factors towards the urgent need of bringing reforms in the policies and procedures of the healthcare system. The concepts are consistent with the research of Holden et al., (2013) who state that factors such as poor communication and management neglect are a result of stress and fatigue. The two forms of stress are chronic stress and acute stress. Job-related stress is the adverse reaction individual exhibit against demand placed on them or excessive work pressure. When such stress is high, rates of accidents is more. Patel and Kannampallil (2014) highlight the human factor of ability to utilise technologies as a key element of patient care quality. As per the authors, adaptability to use novice and modern technologies and implement them adequately depending on patient condition is a key competency. Different patient safety tools have been developed that ensures risks of patient harm are identified before-hand. A different concept has been put forward by Sirriyeh et al., (2010) who state that errors due to human factors in a healthcare setting give rise to feelings of guilt, shame, fear, anxiety and depression. In addition, self-doubt and low morale and self-confidence are also crucial factors. On the other hand, Xie and Carayon (2015) have to say that management of patient safety undergoing treatment and diagnosis in a clinical setting needs the understanding of organisational factors along with human factors for reducing iatrogenic injury and other adverse effects. Safety culture is known to reflect professionals attitudes and values in relation to the management of risk and safety. The dimensions of safety culture include work practices relating to safety, adherence to safety rules, management commitment to safety, risk management, relative prioritisation of safety, and reporting of errors and incidents. Critical analysis of the relationship between human factors and quality and safety in health care The relationship between human factors and quality and safety in healthcare is of utmost importance in healthcare research. Cafazzo and St-Cyr (2012) highlight that working healthcare professionals are not to assume that since they are facing challenges and difficulties at a task, involving technology or not involving it, they would lead to an error. They are also not to assume that the individuals who design the systems of healthcare technology are aware of the complexity of the environment in which professionals work. Professionals deter from multitasking, leading to incompletion of tasks and missing of deadlines at certain points. In addition, frequent interruption while performing tasks also leads to errors. The influence of the work system on care process is noteworthy. Carayon et al., (2014) had highlighted that nurses make medication errors that are preventable in the first place. These include wrong patient; unordered or extra medication; an incorrect dose of medication; incorrect drug; medication not administered; the incorrect route of administration and improper timing of administration of medication. The authors opined that these issues regarding medication safety relate to work system issues. The research undertaken by the authors point out that lean thinking can be regarded as a change in the organisation leading to negative and positive changes in the work system design. This, in turn, affects the healthcare quality and the organisational outcomes. A care process is the array of tasks performed by the professionals with the help of different technologies and tools in a particular environment. The context of care is representative of transitions between more than one individual s and the task done by them. In cases where coordination and collaboration between these individuals are there, the care is not appropriate. The human nature to not acknowledge own faults is elementary. Fryer (2013) argues that humans have a predisposition to blame others for their failure and this takes a toll on the quality of care delivered. In contrast to acknowledging the errors made, they run away from the situation and deter from taking up the accountability of the mistakes made. The areas where such instances are more prominent are a patient handover, medication safety, hand washing and medical emergency situations. The research paper put forward by the authors elaborates the impact of poor communication on patient safety. Communication in a healthcare system provides knowledge of relationships and behavioural patterns of healthcare professionals. Failures in communication are a prime cause of preventable patient harm. A large number of studies conducted have pointed out poor communication to be the root cause of poor quality care delivery. Communication between different professionals playing different roles is i mportant when comprehensive care is to be provided. When the communication between professionals is not effective, the issues that arise relate to patient handover; information recorded in case notes, patient files and incident reports; speaking up of junior staff and transfer of information between large organisations. The effect of teamwork on patient care is noteworthy. Gurses et al., (2011) have given insights into how the human factor of teamwork influences patient safety. Good teamwork fosters the exchange of ideas that are crucial for addressing heath concerns of a patient in any situations. In addition, it can promote the wellbeing and morale of the team members along with team viability. Healthcare settings have fluid teams instead of fixed one. This means that the contribution of each member is crucial if the set objectives are to be achieved. When the manger acknowledges the team dynamics, the goals can be easily accomplished. Henriksen et al., (2008) on the other hand puts the blame on the managers for contributing to poor quality care. As per the researchers, it is the responsibility of the manager to demonstrate suitable leadership and act as the vehicle for driving positive changes in the care setting. A manager, and more precisely a leader needs to concentrate both on the contributio ns of each team member and assimilation of the efforts put forward. When a leader does not assess the extent to which the members can perform a task and demonstrate suitable competency skills, the work they do is not aligned with the organisational objectives. Coaching and delegation are what is needed when a manager gives instructions promoting healthcare. Holden et al., (2013) stated that inadequate time-off, issues regarding workload and emotional aversion deters a professional from putting in best efforts in care delivery. Kaufman and McCaughan (2013) explained that leadership is important in care delivery as the absence of this skill puts a professional in a place wherein he is not able to showcase critical thinking skills. Leadership is all about advocating for the patient and raising a voice against any unethical or unjustified concerns in the setting. When a healthcare professional does not have the required leadership skills, he is not able to report any undesirable incident in the workplace, increasing the chances of reoccurrence of the incidents that hamper patient safety. Conclusion Drawing insights from the above critical analysis of literature, it can be concluded that humans are imperfect and they inherit the predisposition to make errors or mistakes. In a healthcare setting, there exist fast-paced, dynamic and complex human factors. As a result, error-provoking attributes can never be eliminated successfully. Though progress towards improvement of patient safety has been witnessed in the past few decades, it is still slow and not up-to-the-mark. A rationale for this undesirable slow speed is the insufficient incorporation of human factors in these efforts. Patient safety issues are complex and are a result of the multi-component system. Latent as well as prominent conditions arising due to diverse human factors allow for inappropriate situations. Understanding the factors that lead to the increased likelihood of error is the best strategy for preventing such errors. Different measured for reducing chances of errors would be invented in future, as believed by different scholars. Health care would certainly benefit at large from human factors evaluations as a systematic process would be initiated to identify the issues, prioritise them and develop practical solutions. Ongoing support and education would potentially decrease the burden of human factors on care delivery process in the near future. References Australian Institute of Health and Welfare 2016. (2016). Australias health 2016.Australias health series no. 15. Cat. no. AUS 199. Canberra: AIHW. Retrieved from https://www.aihw.gov.au/getmedia/3876a585-9a48-4553-8939-59711f1aa573/ah16-6-14-safety-quality-australian-hospitals.pdf.aspx Cafazzo, J.A., St-Cyr, O. (2012). From discovery to design: The evolution of human factors in health care. Healthcare Quarterly, 15(Special Issue), 24-29.doi:10.12927/hcq.2012.22845. Accessed via: https://www.ncbi.nlm.nih.gov/pubmed/20543237 Carayon, P., Tosha, B. Wetterneck, A., Rivera-Rodriguez J., SchoofsHundt, A., Hoonakkera, P., Holden, R., Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 1425, doi:10.1016/j.apergo.2013.04.023. 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