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Work design and patient safety

This paper describes the linkages between work design and patient safety. The focus is on nursing work; however, many of the concepts and methods are equally applicable to other healthcare professions. Work design relies on a large body of knowledge, including ergonomics, job stress and job/organizational design. First, a general framework of work design and patient safety is proposed. The proposed framework assumes that when designing or redesigning work one needs to examine different elements of a work system, i.e. the individual, the tasks, tools and technologies, the physical environment and organizational conditions. The second part of the report discusses the work design process, i.e. what it consists of, the ‘toolbox’ of tools and methods used to evaluate the work system and design and implement solutions, and principles for successful work (re)design projects. Finally, a number of recommendations to healthcare decision makers are proposed. §An extended version of this paper was written for the US Institute of Medicine Committee on the Work Environment for Nurses and Patient Safety (Carayon et al . 2003b). It was used by the Institute of Medicine for its report on Keeping Patients Safe – Transforming the Work Environment of Nurses (Institute of Medicine 2004).