ABSTRACT
It is widely recognized that human factors play a crucial role in safety in modern workplaces, partic ularly in safety-critical domains such as aviation, ship handling, and operations in nuclear power plants. Thus, human errors and human factorsrelated failures lie behind the majority of accidents in aviation (e.g., Amalberti, 1998), at sea (e.g., Bryant, 1991) and in other high-tech industries (e.g., Hollnagel, 1998). By contrast, it is only fairly recently that it has become generally realized that health care shares many of the characteristics of both high-tech and low-tech human-machine sys tem operations found in industry and that it is equally vulnerable to human failures (Kohn, Corrigan, & Donaldson, 1999). For example, a number of health care activities are performed by teams that are vulnerable to the same error mecha nisms that may jeopardize the performance of cockpit crews or control room teams in process industry. Safe and efficient teamwork require that communication, coordination, and task allocation be conducted so that shared situation awareness may be maintained both in traditional humanmachine systems (e.g., Glendon & McKenna, 1995) and in health care (e.g., Helmreich, 2000b). Finally, human error has now been recognized as the most important cause of adverse events in health care (Kohn et al., 1999). Therefore, appears useful to
adapt-and not necessarily copy-some of the modes of analysis and survey and assessment meth ods that have been developed for the mainly hightech human-machine system domains to investigate human factors aspects of patient safety in the med ical domain (Helmreich, 2000b). This is not to sug gest that health care is just like production industry or the transport sector. Health care differs from other safety critical domains, as it has been observed in the U.S. Institute of Medicine report (Kohn et al, 1999), “ ... mostly because of huge variability in patients and circumstances, the need to adapt processes quickly, and the rapidly changing knowl edge base . . However, methods and techniques to coordinate team performance in high-hazard human-machine environments, such as air traffic control, process industry, aircraft carrier operations, may be successfully adapted to health care. Indeed, anesthesiology has long been leading other health care fields in adapting human performance manage ment techniques, such as the crew resource manage ment approach pioneered by the aviation industry (Gaba, Howard, Fish, Smith, & Sowb, 2001).
