Comparing apples with apples: Hierarchical task analysis as a simple systems framework to improve patient safety

Changing healthcare culture to improve patient safety is the goal of healthcare systems across the world. However the proliferation of Human Factors/Ergonomics (HFE) systems methods may be limiting the embedding of improvements as well-established methods from other safety critical industries are modified. This paper explores how the basic HFE method of Hierarchical Task Analysis (HTA) could be used to compare ‘apples with apples’ by looking at national guidance and local hospital guidance for the care of women and their babies during labour and child birth. It is concluded that HTA could offer a simple framework to visualize operational systems as shared mental models which are accessible within and between multi-disciplinary teams, as part of process improvement projects (including Plan-Do-Study-Act; PDSA) and as the foundation for HFE in healthcare education to ensure the consistency of messages throughout the patient journey.