Errors, violations and workarounds

Most definitions of errors and violations differentiate the two based on whether the action was a conscious decision. For example, the Human Factors Analysis and Classification System (HFACS) defines errors as unintentional behaviours that fail to achieve the intended outcome. By comparison, a violation is an action that deliberately disregards rules and regulations. 1A common misconception is that violations are malicious or negligent, however, this is not always the case.Indeed, many violations are workaround behaviours which may differ from organisationally prescribed or intended procedures. However, the motivation underlying the workaround is to circumvent or temporarily ‘fix’ an evident or perceived workflow hindrance in order to meet a goal or to achieve it more easily.2 Indeed, workarounds are used by healthcare workers every day to circumvent real or perceived barriers to achieve the goal of delivering care. That is, workers use workarounds that violate prescribed procedures to get the job done.