Overview
Definitions of Error
Basic Tenets of Human Error
Human Factors Engineering
Human Performance
Vocabulary
Types of Errors
Systems to Reduce Errors
Stroop Test
Swiss Cheese Model
Toxic Cascades
Lessons from Other Industries
Basic Safety Principles
Summary

Definitions of Error

The dictionary gives many definitions of error. These include:

  • Something incorrectly done through ignorance
  • A transgression of law or duty; a mistake in conduct; a moral fault

Dr. James Reason, a Professor of Psychology who has published extensively on the nature of human error, describes error as circumstances in which planned actions fail to achieve the desired outcome.

Click here for more expanded definitions.

“Human error” is a social label which implies that the individual should have acted differently, and thus is responsible for the consequence of that conduct. This is the basis of the “shame and blame” culture that has been so common in healthcare. (See module: Culture of Safety for more details.)

There are many examples of human error in our everyday life: picking up a tube of ointment when we wanted toothpaste, clicking “send” on an e-mail before we meant to, or missing a stop sign at an intersection. In healthcare settings similar types of errors have even greater potential for harmful consequences.

Providing healthcare will always involve humans in the decision-making and care delivery -- we hope! Each of us wants to provide the best patient care possible. Nonetheless, as humans we will make errors. It is important to acknowledge that fact when designing patient care processes. Systems must be created to prevent and/or catch the inevitable human errors before they result in harm.

 

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