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      Unreliable numbers: error and harm induced by bad design can be reduced by better design

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          Abstract

          Number entry is a ubiquitous activity and is often performed in safety- and mission-critical procedures, such as healthcare, science, finance, aviation and in many other areas. We show that Monte Carlo methods can quickly and easily compare the reliability of different number entry systems. A surprising finding is that many common, widely used systems are defective, and induce unnecessary human error. We show that Monte Carlo methods enable designers to explore the implications of normal and unexpected operator behaviour, and to design systems to be more resilient to use error. We demonstrate novel designs with improved resilience, implying that the common problems identified and the errors they induce are avoidable.

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          Most cited references7

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          Human error: models and management.

          J. Reason (2000)
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            Medical error: the second victim. The doctor who makes the mistake needs help too.

            Albert Wu (2000)
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              Liability claims and costs before and after implementation of a medical error disclosure program.

              Since 2001, the University of Michigan Health System (UMHS) has fully disclosed and offered compensation to patients for medical errors. To compare liability claims and costs before and after implementation of the UMHS disclosure-with-offer program. Retrospective before-after analysis from 1995 to 2007. Public academic medical center and health system. Inpatients and outpatients involved in claims made to UMHS. Number of new claims for compensation, number of claims compensated, time to claim resolution, and claims-related costs. After full implementation of a disclosure-with-offer program, the average monthly rate of new claims decreased from 7.03 to 4.52 per 100,000 patient encounters (rate ratio [RR], 0.64 [95% CI, 0.44 to 0.95]). The average monthly rate of lawsuits decreased from 2.13 to 0.75 per 100,000 patient encounters (RR, 0.35 [CI, 0.22 to 0.58]). Median time from claim reporting to resolution decreased from 1.36 to 0.95 years. Average monthly cost rates decreased for total liability (RR, 0.41 [CI, 0.26 to 0.66]), patient compensation (RR, 0.41 [CI, 0.26 to 0.67]), and non-compensation-related legal costs (RR, 0.39 [CI, 0.22 to 0.67]). The study design cannot establish causality. Malpractice claims generally declined in Michigan during the latter part of the study period. The findings might not apply to other health systems, given that UMHS has a closed staff model covered by a captive insurance company and often assumes legal responsibility. The UMHS implemented a program of full disclosure of medical errors with offers of compensation without increasing its total claims and liability costs. Blue Cross Blue Shield of Michigan Foundation.
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                Author and article information

                Journal
                J R Soc Interface
                J R Soc Interface
                RSIF
                royinterface
                Journal of the Royal Society Interface
                The Royal Society
                1742-5689
                1742-5662
                6 September 2015
                6 September 2015
                : 12
                : 110
                : 20150685
                Affiliations
                [1 ]College of Science, Swansea University , Swansea SA2 8PP, UK
                [2 ]Department of Computer Science, University of York , York YO10 5DD, UK
                Author notes
                Article
                rsif20150685
                10.1098/rsif.2015.0685
                4614478
                26354830
                b5370595-3a36-4242-a966-47d7e51dc8bd
                © 2015 The Authors.

                Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.

                History
                : 31 July 2015
                : 17 August 2015
                Funding
                Funded by: Engineering and Physical Sciences Research Council http://dx.doi.org/10.13039/501100000266
                Award ID: EP/G059063
                Award ID: EP/L019272
                Categories
                1004
                124
                Research Articles
                Custom metadata
                September 6, 2015

                Life sciences
                number entry,human error,dependable systems,evaluating user interfaces
                Life sciences
                number entry, human error, dependable systems, evaluating user interfaces

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