Application of HFACS, fuzzy TOPSIS, and AHP for identifying important human error factors in emergency departments in Taiwan

• Published in: International journal of industrial ergonomics Vol. 67; pp. 171 - 179
• Main Authors: Hsieh, Min-chih, Wang, Eric Min-yang, Lee, Wui-chiang, Li, Lun-wen, Hsieh, Chin-yi, Tsai, Weide, Wang, Chih-ping, Huang, Ju-li, Liu, Te-chu
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-09-2018; Elsevier BV
• Subjects: AHP; Analytic hierarchy process; Crew resources management; Decision analysis; Decision making; Emergency medical care; Emergency medical services; Error analysis; Fuzzy logic; HFACS; Hospitals; Human error; Human errors analysis; Human factors; Multiple criterion; Patient safety; Resource management; Risk factors; TOPSIS; Taiwan; Patient safety; Human errors analysis; AHP; HFACS; TOPSIS
• ISSN: 0169-8141; 1872-8219
• DOI: 10.1016/j.ergon.2018.05.004

In previous studies, the frequency of error factors associated with medical adverse events seems to be the only criterion for understanding the distribution of error factors in hospitals. However, the types of error that occur most frequently in hospitals are not necessarily the most important. Therefore, this study integrated human error analysis and fuzzy TOPSIS to reconcile this discrepancy. The purpose of the study is to identity the important human error factors in emergency departments (ED) in Taiwan. Human factors analysis and classification system (HFACS) was used to analyze 35 ED adverse events to define the error factors. Multiple criteria decision making (MCDM) methods such as analytic hierarchy process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were applied to evaluate the importance of error factors. Results showed that decision errors, crew resource management, inadequate supervision, and resource management were the important human error factors related to ED adverse events. This study recommends that MCDM should be applied to further analyze the results based on the criteria.
•The systematic method of human errors analysis and MCDM was used in this research.•HFACS was applied to analyze medical adverse events in ED.•TOPSIS and AHP were used to assess the important human error factors in ED.•Sensitivity analysis was used to inspect the robustness of the results of TOPSIS.•This is the first study to integrate human errors analysis and MCDM method in ED.