More holes than cheese. What prevents the delivery of effective, high quality and safe health care in England?

Hignett, S., Lang, A., Pickup, L., Ives, C., Fray, M., McKeown, C., Tapley, S., Woodward, M. and Bowie, P. (2018) More holes than cheese. What prevents the delivery of effective, high quality and safe health care in England? Ergonomics, 61(1), pp. 5-14. (doi: 10.1080/00140139.2016.1245446) (PMID:27712281)

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Abstract

What prevents the delivery of effective, high quality and safe health care in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 years (staff shortages, finance and patient complexity) but other challenges raise questions about the commitment of the NHS to patient and staff safety. For example, Organisational Culture leading to ‘stifling bureaucracy’, ‘odds stacked against smooth […] working’ and Workload resulting in ‘firefighting daily’ and ‘perpetual crisis mode’. The role of Human Factors/Ergonomics professional input (engagement with safety scientists) is discussed in the context of success stories and examples of Human Factors Integration from other safety critical industries (Defence, Nuclear and Rail). Practitioner Summary: 760 challenges to the quality, effectiveness and safety of health care were identified at Human Factors/Ergonomics taster workshops in England. These are used to challenge health care providers to think about a Human Factors Integration (HFI systems) approach for safety, well-being and performance for all people involved in providing and receiving health care.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bowie, Dr Paul
Authors: Hignett, S., Lang, A., Pickup, L., Ives, C., Fray, M., McKeown, C., Tapley, S., Woodward, M., and Bowie, P.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
Journal Name:Ergonomics
Publisher:Taylor & Francis
ISSN:0014-0139
ISSN (Online):1366-5847
Published Online:20 October 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Ergonomics 61(1): 5-14
Publisher Policy:Reproduced under a Creative Commons License

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