Background:From the viewpoint of human factors and ergonomics (HFE), errors often occur because of the mismatch between the system, technique and characteristics of the human body. HFE is a scientific discipline concerned with understanding interactions between human behaviour, system design and safety.
Objectives:To evaluate the effectiveness of HFE interventions in improving healthcare workers’ outcomes and patient safety, and to assess the quality of the available evidence.
Methods:We searched databases, including MEDLINE, EMBASE, BIOSIS Previews and the CBM (Chinese BioMedical Literature Database), for articles published from 1996 to March 2015. The quality assessment tool was based on the risk-of-bias criteria developed by the Cochrane Effective Practice and Organization of Care (EPOC) Group. The interventions of the included studies were categorised into 4 relevant domains, as defined by the International Ergonomics Association.
Results: For this descriptive study, we identified 8949 studies based on our initial search. Finally, 28 studies with 3227 participants were included. Among the 28 included studies, 20 studies were controlled studies, two of which were randomised-controlled trials. The other 8 studies were before/after surveys, without controls. Most of the studies were of moderate or low quality. Five broad categories of outcomes were identified in this study: 1) medical errors or patient safety; 2) healthcare workers’ quality of working life (e.g. reduced fatigue, discomfort, workload, pain and injury); 3) user performance (e.g. efficiency or accuracy); 4) healthcare workers’ attitudes towards the interventions (e.g. satisfaction and preference); and, 5) economic evaluations.
Conclusions:The results showed that the interventions positively affected the outcomes of healthcare workers. Few studies considered the financial merits of these interventions. Most of the included studies were of moderate quality. This review highlights the need for scientific and standardised guidelines regarding how HFE should be implemented in healthcare.