Avoiding a Second Wave of Medical Errors: The Importance of Human Factors in the Context of a Pandemic
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LETTER TO THE EDITOR
Avoiding a Second Wave of Medical Errors: The Importance of Human Factors in the Context of a Pandemic Rodrigo Tejos1 • Alfonso Navia1 • Alvaro Cuadra1 • Oscar F. Fernandez-Diaz2 Juan Enrique Berner3,4
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Received: 29 June 2020 / Accepted: 1 July 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract The COVID-19 pandemic has had an unprecedented impact on the delivery of healthcare services around the globe. This has resulted in important loss of life for our communities, including health professionals that have been exposed to the disease in their workplace. A human factors approach to the recent changes introduced due to the pandemic can help identify how we can minimize the impact of human error in these circumstances. We hereby present a case study illustrating the application of human factors in the difficult times we are going through at present. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Human factors Pandemic COVID-19 Plastic surgery
The COVID-19 pandemic has been a major disruptor for health services worldwide, including plastic surgery [1]. & Juan Enrique Berner [email protected] 1
Section of Plastic and Reconstructive Surgery, Surgery Division, School of Medicine, Pontificia Universidad Cato´lica de Chile, Santiago, Chile
2
St. Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK
3
Plastic Surgery Department, Royal Victoria Infirmary, Victoria Rd, Newcastle upon Tyne, UK
4
Kellogg College, University of Oxford, Oxford, UK
During this period, a series of adaptations have been introduced to maintain the safe delivery of urgent operations. However, the consequences of increased pressure on healthcare staff from a well-being point of view are still unknown. Exhaustion and stress are well documented contributing factors for medical errors. As surgical services go back to pre-pandemic caseload levels, a human factors approach can be particularly useful to mitigate a ‘‘second wave’’ of mistakes related to pre-operative care. A patient that had previously undergone a breast reduction presented to our service with a postoperative infection that required admission for intravenous antibiotics. Surgical debridement and lavage was performed, with tissue samples sent for microbiology cultures. Unfortunately, specimens were mislabeled with the details of a different patient. Two days later, the mistake was identified, and no harm was caused. An investigation identified that a junior nurse, who had recently joined the team, mistakenly used a sticker with a different patient’s details to label the specimen pot. It came to light that this nurse had worked several extra shifts to cover for colleagues quarantined during the pandemic. The correct
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