International Classification Systems
The preceding Section HFACS in Health Care Internationally discusses the work of Bill Runciman, M.D., in Australia and the international human factors classification systems in the patient safety endeavors of the World Health Organization (WHO) and the World Alliance for Patient Safety. In the United States, others groups have developed their own human factors classification systems based on the initial James Reason concepts, but without the expertise from the extensive meta-analysis for development of HFACS by Drs. Shappell and Wiegmann.
While Dr. Shappell was a Commander in the United States Navy, reporting to the Admiral of the Atlantic Fleet, he was tasked to reduce an alarming rate of aviation accidents. Working with his associate, Doug Wiegmann, Ph.D., who was then at the Pensacola Air Station, they conducted a meta-analysis of over 16,000 accidents involving U.S. Navy/Marine Corps (1990-98), U.S. Air Force (1991-97), U.S. Army (1992-98). Their collaborative human factors meta-analysis led to what is now the Human Factors Analysis & Classification System (HFACS). Dr. Shappell continues to conduct studies of both civil and military accidents as part of an ongoing project with NASA and the U.S. Navy/Marine Corps. Previously, he served as Chief, Human Factors Branch US Naval Safety Center, then Head, Aeromedical Department US Naval Safety Center Reserve Unit (1999-2004).
Healthcare organizations, without human factors expertise, have developed a variety of unsuccessful systems characterized as patient safety human factors classification systems
and taxonomies. methods have been used to analyze medical malpractice claims data. Despite excellent endeavors to date, these methods have not significantly impacted preventable medical errors and reduced patient harm from those efforts. The most obvious include:
- Joint Commission Patient Safety Event Taxonomy (PSET);
- CRICO (Risk Management Foundation affiliated with Harvard); and
- MedStar Health, National Center for Human Factors in Healthcare.