Human factors in anaesthesia: a narrative review

Area of Science:

• Human factors science
• Anaesthesiology
• Patient safety

Background:

• Healthcare often relies on the 'human as the hero' concept, which is unreliable in high-pressure situations.
• Safety-critical industries successfully use human factors principles to enhance safety and reduce dependency on exceptional performance.
• Anaesthesia can benefit from integrating human factors to improve safety and reliability.

Purpose of the Study:

• To review the current understanding of human factors in anaesthesia.
• To explore the potential of human factors to enhance safety and reduce errors in anaesthetic practice.
• To highlight strategies for designing out errors and mitigating adverse events.

Main Methods:

• Narrative review of existing literature on human factors in anaesthesia.
• Analysis of human factors principles applicable to safety-critical environments.
• Examination of non-technical skills as barriers and mitigation strategies.

Main Results:

• Human factors strategies aim to 'design out' errors and implement barriers/mitigations for adverse events.
• Non-technical skills, including situation awareness, decision-making, task management, and teamwork, are crucial.
• Effective implementation may require initial investment but offers long-term cost savings.

Conclusions:

• Human factors principles offer a robust framework for improving safety in anaesthesia.
• Integrating human factors can reduce reliance on individual performance and enhance system reliability.
• Further investment and application of human factors science are recommended for anaesthesia practice.