Slicing Through the Layers of Pediatric Unintentional Injury With the Swiss Cheese Model: A Topical Review.

This article focuses on applying the Swiss Cheese Model (SCM), an error modeling and accident investigation tool from the human factors field, to enhance understanding and prevention of pediatric unintentional injury. Pediatric unintentional injury remains a leading cause of death and significant financial burden in the U.S., with complex etiology involving human fallibility, context, and barriers. The SCM conceptualizes injury as resulting from the alignment of multiple latent and active failures across system layers, such as individual actions, environmental conditions, supervision, and organizational policies. Through illustrative scenarios—including a child falling from a window, a cyclist struck by a vehicle, and an adolescent driver losing control—the article demonstrates how integrating human error modeling with injury research can identify multilevel causal factors and inform comprehensive prevention strategies. The authors suggest that this systems-level, interdisciplinary approach may improve prediction of injury outcomes and support more effective, equitable injury prevention efforts.