Human error: models and management

Summary

In this BMJ article, James Reason discusses how the human error problem can be viewed in two ways: the person approach and the system approach. Each has its model of error causation and each model gives rise to quite different philosophies of error management. Understanding these differences has important practical implications for coping with the ever present risk of mishaps in clinical practice.

Content

Key learning points

• Two approaches to the problem of human fallibility exist: the person and the system approaches.

• The person approach focuses on the errors of individuals, blaming them for forgetfulness, inattention, or moral weakness.

• The system approach concentrates on the conditions under which individuals work and tries to build defences to avert errors or mitigate their effects.

• High reliability organisations—which have less than their fair share of accidents—recognise that human variability is a force to harness in averting errors, but they work hard to focus that variability and are constantly preoccupied with the possibility of failure.