Application of HFACS, fuzzy TOPSIS, and AHP for identifying important human error factors in emergency departments in Taiwan

In previous studies, the frequency of error factors associated with medical adverse events seems to be the only criterion for understanding the distribution of error factors in hospitals. However, the types of error that occur most frequently in hospitals are not necessarily the most important. Therefore, this study integrated human error analysis and fuzzy TOPSIS to reconcile this discrepancy. The purpose of the study is to identity the important human error factors in emergency departments (ED) in Taiwan. Human factors analysis and classification system (HFACS) was used to analyze 35 ED adverse events to define the error factors. Multiple criteria decision making (MCDM) methods such as analytic hierarchy process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were applied to evaluate the importance of error factors. Results showed that decision errors, crew resource management, inadequate supervision, and resource management were the important human error factors related to ED adverse events. This study recommends that MCDM should be applied to further analyze the results based on the criteria.