Human reliability analysis in healthcare: A review of techniques

Whilst Human Reliability Analysis (HRA) has been well-accepted and integrated into the safety management process in other industries, the application of such error analysis techniques to the problem of complication and reaction to treatment and the associated risks in healthcare is rare. Though the scarcity of HRA techniques in health-care is likely to be due in some part to the safety culture, much is likely to be due to a lack of awareness of the usefulness of the techniques and their applicability to the problem of human error in the clinical context. This review attempts to look at the popular HRA techniques used in high-reliability industries, such as petro-chemical, nuclear and aviation, and consider their feasibility for use in healthcare. Techniques vary in their scope and have been grouped into those that focus on: data collection, task description, task simulation, human error identification and analysis, and human error quantification. Techniques may cover one or more of these aspects, for example, THERP, HEART and SHERPA include both human error identification and analysis, and human error quantification tools. While some areas of healthcare have used certain HRA techniques, there is considerable scope to use others and to apply techniques to other aspects of healthcare not yet explored.