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      Human factors in healthcare: welcome progress, but still scratching the surface

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      BMJ Quality & Safety
      BMJ

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          Safety culture in healthcare: a review of concepts, dimensions, measures and progress.

          A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures. Specific objectives of this literature review include: summarising definitions of safety culture and safety climate, identifying theories, dimensions and measures of safety culture in healthcare, and reviewing progress in improving safety culture. Peer-reviewed, English-language articles published from 1980 to 2009 pertaining to safety culture in healthcare were reviewed. One hundred and thirty-nine studies were included in this review. Results suggest that there is disagreement among researchers as to how safety culture should be defined, as well as whether or not safety culture is intrinsically diverse from the concept of safety climate. This variance extends into the dimensions and measurement of safety culture, and interventions to influence culture change. Most studies utilise quantitative surveys to measure safety culture, and propose improvements in safety by implementing multifaceted interventions targeting several dimensions. Conversely, very few studies made their theoretical underpinnings explicit. Moving forward, a common set of definitions and dimensions will enable researchers to better share information and strategies to improve safety culture in healthcare, building momentum in this rapidly expanding field. Advancing the measurement of safety culture to include both quantitative and qualitative methods should be further explored. Using the expertise of traditional culture experts, anthropologists, more in-depth observational and longitudinal research is needed to move research in this area forward.
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            Sociotechnical principles for system design.

            This paper offers a set of sociotechnical principles to guide system design, and some consideration of the role of principles of this kind. The principles extend earlier formulations by Cherns (1976, Human Relations, 29, 783-792; 1987, Human Relations, 40, 153-162). They are intended to apply to the design of new systems, including those incorporating new information technologies and a range of modern management practices and ways of working. They attempt to provide a more integrated perspective than is apparent in existing formulations. The principles are of three broad types: meta, content and process, though they are highly interrelated. They are for use by system managers, users and designers, and by technologists and social scientists. They offer ideas for debate and provide devices through which detailed design discussions can be elaborated. The principles are most likely to be effective if they are relatively freestanding, but supported by relevant methods and tools. The principles are necessary but not sufficient to make a substantial contribution to design practice.
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              Psychology as a means of promoting human welfare.

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                Author and article information

                Journal
                BMJ Quality & Safety
                BMJ Qual Saf
                BMJ
                2044-5415
                2044-5423
                June 17 2016
                July 18 2016
                : 25
                : 7
                : 480-484
                Article
                10.1136/bmjqs-2015-005074
                a2c3cc9e-20cb-4660-b432-18df5c020133
                © 2016
                History

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