ally when a caregiver is distracted, sick, or otherwise incapacitated. But as the diversity of tasks and the diversity of people increase, the potential for errors grows.

To bring task demands in line with capabilities, there are five things that can be changed:

  1. the task,

  2. the person providing or receiving care,

  3. the technology being used,

  4. the environment surrounding the task, and

  5. the social system surrounding the task.

Making changes in these five areas implies better procedures, better training, better equipment design, better home environment design, and better social interactions. In this context, “better” means fitting tasks to people, Drury said.

Task Analysis

Task analysis has two parts. First, assessing the demands of a task requires a task description—a detailed and hierarchical breakdown of every step involved in the task. Second, assessing human capabilities draws on the literature on human factors plus contributions from other disciplines, such as psychology and biomechanics, supplemented with professional judgment.

In addition, there are two methods of understanding tasks, and both are needed for error-proof designs. The first is to analyze errors or system failures in existing systems, as was done in the 2000 report on medical errors by the Institute of Medicine, To Err Is Human: Building a Safer Health System, National Academy Press, Washington, DC. The second is to analyze the functioning of a system, starting with its objectives and then focusing on the task elements for existing and proposed systems.

A common pitfall of task analysis is to assume that everyone looks like you, Drury said. Avoiding this false assumption requires that the people performing the task be involved along with someone who can integrate the various tasks being analyzed. As an example, Drury cited the transport of a care recipient, whether from the bed to a chair, from the home to a hospital, or from the hospital to a care facility. Each of these overall tasks requires planning to tie its constituent tasks together. The job is simple if the constituent tasks are lined up in a logical and linear order. “You just go down the checklist and you do them. But lots of them have branches. If it says this, you do this. It may not be that. This may be blocked. You may have to do something else.” Because of this complexity, task analyses generally involve multiple levels of detail.



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