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A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional
  1. B-T Karsh1,
  2. R J Holden1,2,
  3. S J Alper1,
  4. C K L Or1
  1. 1Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA
  2. 2Psychology, University of Wisconsin-Madison, Madison, WI, USA
  1. Correspondence to:
 Assistant Professor B-T Karsh
 Industrial and Systems Engineering, University of Wisconsin-Madison, 1513 University Avenue, Room 387, Madison, WI, USA; bkarsh{at}


The goal of improving patient safety has led to a number of paradigms for directing improvement efforts. The main paradigms to date have focused on reducing injuries, reducing errors, or improving evidence based practice. In this paper a human factors engineering paradigm is proposed that focuses on designing systems to improve the performance of healthcare professionals and to reduce hazards. Both goals are necessary, but neither is sufficient to improve safety. We suggest that the road to patient and employee safety runs through the healthcare professional who delivers care. To that end, several arguments are provided to show that designing healthcare delivery systems to support healthcare professional performance and hazard reduction should yield significant patient safety benefits. The concepts of human performance and hazard reduction are explained.

  • patient safety
  • medical error
  • performance
  • design
  • hazard
  • human factors engineering

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  • This work was supported in part by a grant from the Agency for Healthcare Research and Quality (1 R01 HS013610).

  • Competing interests: none.