A System Ergonomic Analysis Approach for Potential Critical Incidents in Medical Treatment Processes

The necessity for safe treatment processes in clinical work systems is obvious. In recent years an increasing number of “Clinical Incident Reporting Systems” (CIRS) has been established in hospitals worldwide in order to monitor and report critical incidents and to improve the underlying treatment processes. However, CIRS are always restricted to the identification of critical incidents, which have lately occurred, whereas only a systematic analysis of clinical workflows can identify also potential critical incidents of the future. For this reason we have developed a system ergonomic analysis approach for potential critical incidents in medical treatment processes based on a realistic simulation of clinical work processes in combination with their video documentation and expert interviews. The set-up of the simulation is performed directly with the help of the involved medical staff and within their very own clinical environment. The video documentation of the simulated clinical work processes then guarantees a systematic foundation for the later process analysis and optimization based on structured interviews of all system experts involved (physicians, nurses, technicians etc.) and a system ergonomic MTO concept aiming at a well balanced design of all system elements (Men, Technology & Organization). Using this system ergonomic approach in cooperation with the Department of Anaesthesia and Intensive Care at the Klinikum Ernst von Bergmann in Potsdam (Germany) for the analysis of the inner clinical transfer of ICU patients resulted not only in a significant amount of critical incidents, which have lately occurred, but also a wide variety of potential critical incidents likely to happen in the future.