Contents -- Preface -- 1 Introduction -- 1.1 Background -- 1.2 Medical Error-Related Facts and Figures -- 1.3 Terms and Definitions -- 1.4 Useful Information on Human Reliability and Error in Medicine -- 1.4.1 Books -- 1.4.2 Journals -- 1.4.3 Conference Proceedings -- 1.4.4 Organizations -- 1.5 Scope of the Book -- Problems -- References -- 2 Human Reliability and Error Mathematics -- 2.1 Introduction -- 2.2 Sets and Boolean Algebra Laws -- 2.3 Probability Definition and Properties -- 2.4 Discrete Random Variables and Probability Distributions -- 2.4.1 Binomial Distribution -- 2.4.2 Poisson Distribution -- 2.4.3 Geometric Distribution -- 2.5 Continuous Random Variables and Probability Distributions -- 2.5.1 Exponential Distribution -- 2.5.2 Rayleigh Distribution -- 2.5.3 Weibull Distribution -- 2.5.4 Normal Distribution -- 2.5.5 Gamma Distribution -- 2.6 Laplace Transform Definition and Final Value Theorem -- 2.7 Differential Equation Solution -- Problems -- References -- 3 Human Factors Basics -- 3.1 Introduction -- 3.2 Man-Machine System Types and Comparisons -- 3.3 Human Behaviors -- 3.3.1 Typical Human Behaviors and the Corresponding Design Considerations -- 3.3.2 Behavior Towards Safety for the Different Age Groups -- 3.4 Human Sensory Capacities -- 3.4.1 Sight -- 3.4.2 Noise -- 3.4.3 Touch -- 3.4.4 Vibration -- 3.5 Human Body Measurements -- 3.6 Human Factors-Related Formulas -- 3.6.1 Character Height Estimation Formula I -- 3.6.2 Character Height Estimation Formula II -- 3.6.3 Noise Reduction Estimation Formula -- 3.6.4 Rest Period Estimation Formula -- 3.6.5 Glare Constant Estimation Formula -- 3.7 Human Factors Checklist and Guidelines -- 3.8 Human Factors-Related Data Sources and Useful Publications on Human Factors Data -- 3.8.1 Useful Publications on Human Factors Data -- Problems -- References.

4 Human Reliability and Error Basics -- 4.1 Introduction -- 4.2 Human Performance Characteristics Occupational Stressors General Stress Factors and Human Operator Stress Characteristics -- 4.3 Human Performance Reliability and Correctability Functions -- 4.3.1 Human Performance Reliability Function -- 4.3.2 Human Performance Correctability Function -- 4.4 Human Reliability Analysis Methods -- 4.4.1 The Throughput Ratio Method -- 4.4.2 Pontecorvo Method -- 4.4.3 Personnel Reliability Index Method -- 4.5 Human Error Occurrence Reasons and Its Consequences -- 4.6 Human Error Occurrence Ways and Classification -- 4.7 Human Error Analysis Models -- 4.7.1 Model I -- 4.7.2 Model II -- Problems -- References -- 5 Methods for Performing Human Reliability and Error Analysis in Health Care System -- 5.1 Introduction -- 5.2 Failure Modes and Effect Analysis (FMEA) -- 5.2.1 FMEA Benefits -- 5.3 Root Cause Analysis (RCA) -- 5.3.1 RCA Softwares -- 5.3.2 RCA Benefits and Drawbacks -- 5.4 Fault Tree Analysis (FTA) -- 5.4.1 Fault Tree Symbols and Steps for Performing FTA -- 5.4.2 Probability Evaluation of Fault Trees -- 5.5 Cause and Effect Diagram (CAED) -- 5.6 Hazard Operability Study (HAZOP) -- 5.7 Probability Tree Method -- 5.8 Error-Cause Removal Program (ECRP) -- 5.9 Man-Machine Systems Analysis (MMSA) -- 5.10 Markov Method -- Problems -- References -- 6 Human Error in Medication -- 6.1 Introduction -- 6.2 Medication Error Facts Figures and Examples -- 6.3 Types and Causes of Medication Error and Medication Use Processes -- 6.4 Medication Errors in Hospitals Nursing Factors in Medication Errors and Medication Errors Leading to Manslaughter Charges -- 6.5 Medication Error Reduction -- 6.5.1 Use of Information Technology for Reducing Medication Errors in Hospitals.

6.5.2 Role of Manufacturers and Food and Drug Administration (FDA) in Reducing Medication Errors -- 6.5.3 General Guidelines for Reducing Medication Errors -- 6.6 Medication Error-Related Studies -- Problems -- References -- 7 Human Error in Anesthesia -- 7.1 Introduction -- 7.2 Facts and Figures -- 7.3 Frequent Anesthesia Errors and Their Causes and Modes of Human Error in Anesthesia -- 7.4 Anesthesiologist Decision Making Model -- 7.5 Methods for Preventing or Reducing Anesthetic Mishaps with Respect to Human Error -- 7.5.1 Method I -- 7.5.2 Method II -- 7.5.3 Method III -- 7.6 Anesthesia Error-Related Studies -- Problems -- References -- 8 Human Error in Miscellaneous Health Care Areas and Health Care Human Error Cost -- 8.1 Introduction -- 8.2 Human Error in Intensive Care Units -- 8.3 Human Error in Emergency Medicine -- 8.4 Human Error in Operating Rooms -- 8.5 Human Error in Image Interpretation Laboratory Testing Medical Technology Use and Radiotherapy -- 8.6 General Guidelines for Preventing Medical Errors -- 8.7 Human Error Cost in Medical System -- 8.7.1 Health Care Human Error-Related Cost Studies -- 8.7.2 Health Care Human Error Cost Estimation Models -- Problems -- References -- 9 Human Factors in Medical Devices -- 9.1 Introduction -- 9.2 Facts and Figures -- 9.3 Human Error Causing User-Interface Design Problems Medical Devices with a High Incidence of Human Errors and Medical Device-Associated Operator Errors.

9.4 An Approach to Human Factors in the Development Process of Medical Devices for Reducing Human Errors Areas for Questions in Developing an Effective Medical Device Design and Characteristics of Well-Designed Medical Devices -- 9.5 Rules of Thumb for Device Control/Display Arrangement and Design Installation Software Design and Alarms with Respect to Users -- 9.5.1 Rules of Thumb for Device Control/Display Arrangement and Design to Avoid User Errors -- 9.5.2 Rules of Thumb for Device Installation to Avoid User Errors -- 9.5.3 Rules of Thumb for Device Software Design to Avoid User Errors -- 9.5.4 Rules of Thumb for Device Related Alarms -- 9.6 Evaluating Medical Devices Prior to Purchase and Already-Purchased with Respect to Human Factors and Practical General Guidelines for Alleviating Device- Interface Design Problems -- 9.7 Human Error Analysis Methods for Medical Devices -- 9.7.1 Failure Mode and Effects Analysis (FMEA) -- 9.7.2 Barrier Analysis -- 9.7.3 Fault Tree Analysis (FTA) -- 9.7.4 Force Field Analysis (FFA) -- 9.7.5 Throughput Ratio Method -- 9.7.6 Critical Incident Technique (CIT) -- Problems -- References -- 10 Mathematical Models for Predicting Human Reliability and Error in Medical System -- 10.1 Introduction -- 10.2 Model I: Human Performance Reliability -- 10.3 Model II: Human Correctability Function -- 10.4 Model III: Human Performance Reliability in Alternating Environment -- 10.5 Model IV: Human Performance Reliability with Critical and Non-Critical Errors -- 10.6 Model V: Human Performance Reliability with Critical and Non-Critical Errors and Corrective Action -- 10.7 Model VI: Reliability Analysis of a Medical Redundant System with Human Errors -- Problems -- References -- 11 Health Care Human Error Reporting Systems and Data -- 11.1 Introduction.

11.2 Effective Event-Reporting Systems and Approaches Practiced in Existing Reporting Systems -- 11.3 Review of Current Human Error-Related Health Care Reporting Systems -- 11.4 Lessons from Non-Medical Near Miss Reporting Systems -- 11.5 State Adverse Medical Event Reporting Systems -- 11.6 Human Error Data and Sources -- 11.6.1 Medical Human Error-Related Data -- 11.6.2 Non-Medical Human Error Data -- 11.6.3 Human Error Data Sources -- Problems -- References -- Appendix: Bibliography: Literature on Human Reliability and Error in Health Care -- A.1 Introduction -- A.2 Publications -- Index.