Document

Author
Matthew Woodward, Rounaq Nayak & Peter McCulloch
Abstract
Irradiation of the wrong patient or wrong site is a reportable adverse event for hospital radiology departments. This study applied a systems human factors/ergonomics (HFE) approach in an NHS trust to develop interventions across work system levels. Changes were implemented to address interruptions in radiography control rooms, to standardise identification checks and to run workshops to raise awareness of a systems approach for near miss reporting.