Medical errors are most often human errors. But these are usually prompted by flawed systems that can predispose people to fail. The landmark IOM report of 1999 has rightly recognized the role systems and procedures of the healthcare workplace play in increasing the likelihood of medical error. In fact the IOM report’s main focus was on systems errors. The common workplace constraints that are likely to induce human error are:

• Scarcity of human resources in terms of time, energy and manpower • Scarcity of financial resources • Poor communication structure • Feeling of helplessness among healthcare professionals to challenge their superiors. • Equipment design flaws • Inadequate or inappropriate labeling • Inadequate or inappropriate instructions The modern healthcare workplace, because of innate complexity, involves a host of interrelated factors and conditions which may negatively impact human performance.

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One of the most important of these factors is an abstract thing called workplace culture, which can to a considerable extent influence the values and beliefs, and as a consequence behaviors, of individual members that are part of the work culture. This is not to say that individuals do not have their own values, or that individuals cannot influence workplace values in their turn, but generally there is a marked tendency for individuals to imbibe workplace ethics, standards and culture, for better or for worse.