Serious Hazards of Transfusion, SHOT: Improving Transfusion Safety by Applying Human Factors Principles in the UK
Serious Hazards of Transfusion (SHOT), the UK’s professionally led haemovigilance scheme, analyses around 4,000 serious events annually from over two million blood components transfused. Education, toolkits and resources were developed to support understanding and application of human factors and ergonomics (HFE) and enable UK-wide transfusion staff to implement HFE into local practices. A bespoke tool in the reporting portal prompts reporters to examine HFE elements, complemented by a distance-learning package. A variety of platforms for learning and continuous feedback increase the knowledge and skills needed to embed HFE in local practice and contribute to the ongoing aim to improve transfusion safety.
The reach and spread of this project was incredible and represented a sustained and iterative approach to quality improvement, with a real motivation to spread the project further, said our judges.
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HSJ Patient Safety Awards 2022: Harnessing a Human Factors Approach to Improve Patient Safety