Human Factors In Healthcare Research Articles

Lessons learned from implementing a Human Factors programme into an NHS trust*

The interest in employing Human Factors (HF) in healthcare is increasing. There are very few papers that outline an approach to embedding the practical application of HF in healthcare and the lessons that can be learned. The SCReaM HF and Team Resource Management (TRM) programme is not only aimed at raising the awareness and understanding of the science of HF within healthcare, but also to embed its practical application to support staff improve their safety and wellbeing and that of their patients. The programme is divided into three strands: rolling training, HF Projects and HF Engineering. Each strand of the programme supports the use of HF by teaching and applying systems thinking methodology. The programme has been embedded into an NHS Trust and this paper provides a reflection on the approach used to help guide future attempts to integrate HF into an NHS trust.

A50The SEIPS game: An interprofessional teaching aid to promote understanding of human factors in healthcare

As a human-factors focused simulation centre, we begin all our simulation courses with a human factors workshop introducing participants to the SEIPS model of human factors [1]. This enables them to explore systems-based impacts on clinical practice during post-scenario debriefs. However, we have noticed that some participants struggle to identify and discuss human factor themes which impact on them in their workplace. We aimed to develop an innovative teaching aid which would promote participant understanding and engagement. Previous experience has provided evidence that participants enjoy simulation games. Therefore, we chose to develop a table-top game to play with participants based on the SEIPS work system. We worked with interprofessional colleagues to identify factors that help and hinder processes in the work system and categorized them under SEIPS headings. We made a series of cards based on these factors which participants collect. The winner was the person who collected a helpful card for each SEIPS heading first. We have piloted our SEIPS game with interprofessional faculty, including those with specialist expertise in human factors in healthcare. We surveyed participants to obtain feedback. Survey results so far include data contained in ‘Play’ is a kinaesthetic way of learning and helps embed ideas and thinking. It also can create opportunities for discussion on different headings for human factors and systems thinking. The examples are fun but are also realistic so helps you see how HF is relevant. With the examples of human factors in the game it could be useful for staff with little clinical experience. Liked the competitive element and the examples helped expand on what SEIPS was and how it could be relevant to lots of areas. SEIPS game participant survey results We have developed a SEIPS game to facilitate discussion of human factors in healthcare. This novel approach has received positive initial feedback following our pilot. We are confident we can now move forward to integrate our SEIPS game into our Foundation Doctor’s simulation programme from August 2023. Following this, we intend to continue the process of data collection and analysis, with the intention of incorporating our SEIPS game more widely across simulation courses within various clinical specialties in future. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A40The importance of human factors and the implementation of the ‘Social GRACES’ in simulation training: a 6-month review of foundation simulation training at Guys and St Thomas’ (GSTT) NHS Foundation Trust

Traditionally the focus of simulation has been centred on clinical management. More recently there has been a drive to enhance training on ‘human factors’ [1]. In simulation, human factors can be challenging to replicate, particularly with regards to how individuals interact within a system. At GSTT we introduced a concept known as ‘social GRACES’ into simulation training. Social GRACES, first described by John Burnham in 1992 [2], outline a framework to understand an individual’s personal and social identity. An abundance of research into the development of human factors skills exists in the literature. Our aim was to integrate social GRACES into our simulation programme as a novel approach to engage trainees with human factors. Between October 2022- April 2023, there were 23 full-day simulation training days. The course started with an introduction on human factors and the social GRACES. This was followed by a ‘lost at sea’ activity where trainees worked individually and in teams to prioritize the items they would take if lost at sea. This was followed by 4 clinical scenarios with debriefs related to clinical management, human factors and social GRACES. Pre and post course questionnaires were disseminated, and delegates were consented for data being used for quality improvement. Unique identifiers allowed for paired data analysis. 101 pre-course and 138 post-course feedback forms were received. To allow for paired analysis, only completion of both questionnaires was included, leaving 83 responses. There was a statistically significant increase in the percentage of responders who strongly agreed they felt confident in recognizing (7.2%-35.2%), assessing (15.7%-43.4%), managing (3.6%-20.5%) and escalating care (15.7%-35%), in acutely unwell patients. Additionally, confidence improved in understanding the impact of human factors in delivering care (9.6%-35%) and the performance of healthcare professionals (9.6%-39.8%). We explored confidence with regards to the practical implementation of human factors in healthcare ( 10 questions were devised to assess confidence relating to practical aspects of human factors in healthcare with regards to teamwork, communication, and leadership. Following paired data analysis, we found a statistically significant improvement in confidence in all areas investigated. The results demonstrate that the interplay between managing acute clinical scenarios & human factors can effectively be taught through simulation and enhanced with an understanding of social GRACES. An increased understanding of human factors and simulation training was useful in improving 3 crucial skills; teamwork, communication and leadership, which are instrumental in improving clinician confidence and patient outcomes. Future direction should look to include awareness and implementation of human factors within mainstream simulation to effectively replicate real time clinical scenarios & pressures. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Shifting Perspectives: A proposed framework for analyzing head-mounted eye-tracking data with dynamic areas of interest and dynamic scenes.

Eye-tracking is a valuable research method for understanding human cognition and is readily employed in human factors research, including human factors in healthcare. While wearable mobile eye trackers have become more readily available, there are no existing analysis methods for accurately and efficiently mapping dynamic gaze data on dynamic areas of interest (AOIs), which limits their utility in human factors research. The purpose of this paper was to outline a proposed framework for automating the analysis of dynamic areas of interest by integrating computer vision and machine learning (CVML). The framework is then tested using a use-case of a Central Venous Catheterization trainer with six dynamic AOIs. While the results of the validity trial indicate there is room for improvement in the CVML method proposed, the framework provides direction and guidance for human factors researchers using dynamic AOIs.

Measuring situation awareness in health care providers: a systematic review of measurement properties using COSMIN methodology

BackgroundSituation awareness (SA) is a key factor in accountability and ensuring patient safety in health care. SA is an essential element to research on human factors in healthcare. It is essential to identify valid instruments for measuring this concept and assessing how it is affected by interventions and educational methods.MethodsThis systematic review aimed to assess the measurement properties of situation awareness instruments in health care providers’ (HCPS) using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Four databases (Medline (through PubMed), Embase, Scopus, and Web of Science) were systematically searched. A manual search was also conducted on Google Scholar and the reference list of the included primary studies to supplement the electronic search. Studies aiming to determine the measurement properties of SA instruments or non-technical skills in HCPS were included. The overall results for each measurement property were reported as sufficient, insufficient, inconsistent, or indeterminate, and the quality of evidence was reported as high, moderate, low, or very low.ResultsA total of 25 studies and 15 instruments were included in the study. More than one measurement property was reported in some of the studies, and none of the studies presented all measurement properties. The most common measurement properties were content validity (12/25) and internal consistency (12/25). Cross‐cultural validity and responsiveness were not investigated in any study. Evidence quality for the measurement properties was not high in any of the 15 instruments.ConclusionsNone of the instruments can be recommended as the most suitable instrument, and all instruments were classified as promising instruments in need of further psychometric assessment. This systematic review proves the dire need for the development and psychometric evaluation of instruments to measure SA in HCPs in clinical settings.Systematic review registrationPROSPERO CRD42020147349.

In-situ simulation: educational tool and a clinical system test

Simulation-based clinical systems testing (SbCST) is a process that allows clinicians and hospital stakeholders to evaluate work carried out in new environments. Unlike work-as-imagined, SbCST takes into account the complex interactions resulting from human performance limitations [1]. These factors can result in errors that may even lead to patient harm [2]. Therefore, we used SbCST to evaluate a newly built children’s emergency department with the aim of identifying latent errors and implementing changes to minimise the risk of their occurrence, whilst also ensuring that the simulation experience was an independently valuable educational opportunity. Scenarios were created according to two criteria. Firstly, that they tested at least one specific environmental issue and secondly, that they focused on topics that the paediatric and Accident and Emergency departments felt would be educationally valuable to the participants. Once created, these scenarios were then carried out as un-announced in-situ simulations during the first 8-weeks of departmental opening. The participants were instructed to treat the scenarios as real, including the manner in which they called for help. Any equipment required came from the department and if single use, it was exchanged for training equipment. The participants then undertook a hot debriefing before feedback was gathered about both the educational value of the scenarios as well as any issues identified within the new department. In total there were 38 multidisciplinary participants including nurses, operating department practitioners, and doctors from 6 different specialties. The feedback from the sessions was positive with an average ranking of >4 out of 5 in 8 out of the 9 measured domains, including; realism, enhancement of knowledge, and usefulness of in-situ simulation in a new environment. We also identified greater than 50 problems spanning all 5 of the categories from the ‘SHEEP’ model [3]. Approximately 60% of issues were resolved within the 8 weeks, whilst the remaining are on the risk register and awaiting review at a stakeholder level. In-situ simulation is an excellent mechanism for carrying out clinical systems testing of new environments due to the fact that it simulates realistic events which are prone to the same errors as the real events, without the risk of patient harm. Once the source of an error is exposed the debriefing can help to identify methods to minimise the risk of future reoccurrences. At the same time, with appropriate planning, the scenarios can also provide an opportunity to deliver multidisciplinary training. 1. Colman N, Doughty C, Arnold J, Stone K, Reid J, Dalpiaz A, Hebbar KB. Simulation-based clinical systems testing for healthcare spaces: from intake through implementation. Advances in Simulation. 2019;4(1):1–9. 2. Reason J. Human error: models and management. Br Med J. 2000;320:768–770. 3. Rosenorn-Lanng D. Human factors in healthcare: level one. Oxford: Oxford university press. 2014.

Preface: Special Issue on Human Factors in Healthcare.

Preface: Special Issue on Human Factors in Healthcare.

The History of Human Factors in Healthcare: From Its Emergence 50 Years Ago to COVID-19

Advances in medical technologies and training have been met by universal challenges in safety, efficiency, and effectiveness. The drastic growth and variegation of Healthcare as a field demands greater optimization of medical resources by Human Factors professionals. This study aimed to qualitatively evaluate the entire field of Medical Human Factors since its inception, comprising 1,251 articles across two discipline-specific conferences through keywords related to Healthcare. We analyzed trends in the Human Factors and Ergonomics Proceedings (HFES) from 1974 to 2020 and in the Proceedings of the International Symposium on Human Factors in Health Care (HCS) from 2013 to 2020. Results were tabulated, analyzed, and graphed based on their authorial affiliations, funding agencies, countries of research, as well as general content areas and more specific domains over time. Our analyses indicated that Healthcare research has grown exponentially in the past five decades, with 75% of relevant proceedings papers produced since 2010. Gaps in Healthcare literature, directions for future research, and emerging issues related to technologies and training are discussed as well.

Catalyzing Pediatric Electronic Health Record Usability and Safety Improvements.

* Abbreviation: EHR — : electronic health record Nearly every office-based pediatrician now uses an electronic health record (EHR).1 There is now evidence that using EHRs can improve guideline adherence, reduce medication errors, and improve other measures of health care quality,2 but the rapid adoption of EHRs has also precipitated unintended and undesired consequences, including the poor usability of EHRs.3 Usability is the extent to which a technology can be used efficiently, effectively, and satisfactorily.4 Poor EHR usability results in clinician frustration, contributes to clinician burnout, and has direct patient safety consequences.5–7 To improve EHR usability, we need rigorous and robust measures of usability to identify specific problem areas, quantify the effect of improvement efforts, and facilitate product comparisons so that consumers can purchase products that meet their needs. In this issue of Pediatrics , Overhage and Johnson8 report on a large-scale analysis of Cerner Millennium EHR use in >20 million pediatric ambulatory encounters by almost 30 000 physicians. Their approach provides a broad assessment of the time spent on tasks in the EHR, and time on task is a usability measure commonly used to … Address correspondence to Raj Ratwani, PhD, National Center for Human Factors in Healthcare, Medstar Health Research Institute, MedStar Health, 3007 Tilden St NW, Suite 6N, Washington, DC 20008. E-mail: raj.m.ratwani{at}medstar.net

P14 Reducing medication errors using prescribing nudges: intravenous aciclovir on paediatric intensive care

AimThis Quality Improvement project is the second phase of a long term project to improve the quality of prescribing on the paediatric intensive care unit (PICU). Small adjustments are made to the electronic prescribing (EP) system, known as ‘nudges’, with the aim of improving the quality of prescribing in terms of error rate or user experience.1 2Intravenous aciclovir is prescribed to most patients admitted to the PICU with suspected meningitis/encephalitis. There is a complicated dosing schedule where the prescriber must decide whether to use body surface area (BSA) or weight to calculate the required dose. Underdosing risks subtherapeutic treatment of a viral encephalitis and overdosing risks acute kidney injury. Within our EP system, dosing by weight can be automated, but dosing by BSA cannot.A project in 2018 used a ‘nudge’ to alter the order of prescribing options in the drop down menu on the EP system. This reduced the error rate from 26% to 17% by reducing the likelihood of picking the wrong indication for acyclovir.3 However, a re-audit in October to December 2018 found the error rate had crept back up to 32%. Prescribing on the EP system is a multi-step process. Prescribers had to pick ‘aciclovir’ to choose the weight based dose or ‘aciclovir injection 3 month-11 yr‘ to choose the BSA based dosing. When ‘aciclovir’ was picked, this removed the body surface area dosing option from the prescriber’s screen and led them in the direction of an incorrect dose.MethodThe intervention for this project was to amalgamate all weight and BSA dosing options for acyclovir within the EP system, and then order them by age so that the prescriber could see all options simultaneously. This change was designed and implemented by our electronic prescribing support pharmacist in April 2019. Pre and post change prescriptions were audited by pharmacy undergraduate students for accuracy using data downloaded from the EP system.ResultsThe error rate post change was 8% (pre change 32%). The remaining errors reflect transcribing of an incorrect dose initiated outside of the PICU from a referring ward or hospital.ConclusionThis project shows that small, ‘smart’ changes within EP configuration can improve the quality of prescribing.Future work involves working with the software company to incorporate the ability to automatically calculate the dose based on BSA, further reducing the need for manual calculations. This project would not have been possible without the skills and knowledge of our electronic prescribing support pharmacy team.ReferencesPatel MS, et al. Nudge units to improve the delivery of health care. NEJM 2018; 378: 214–216Cafazzo JA, et al. From discovery to design: the evolution of human factors in healthcare. healthcare quarterly 2012; 15: 24–29Gunning C, Gray J. Audit of acyclovir prescribing to assess whether changing the order of drop down box options in an electronic prescribing system can reduce prescribing errors. Archives of Disease in Childhood 2019; 104:7

P15 Using prescribing nudges to reduce medication errors: paracetamol on paediatric intensive care

AimParacetamol is widely available and its safety profile is relatively good. However, the risk associated with a paracetamol overdose is much greater in a neonate than that associated with an adult.In 2018, 8% of paediatric medication errors related to the use of paracetamol, including three 10x overdoses. These irregular but serious risks are difficult to manage over time due to degradation of heightened awareness. The aim of this project was to improve the prescribing quality of IV paracetamol on PICU and prevent recurrence of a 10-fold overdose by the implementation of multi-level changes.MethodElectronic prescribing (EP) has been in use on our unit since 2016. Small changes (prescribing nudges) in the configuration of the EP system can be used to improve prescribing quality. Forced functions, automation and standardisation have been found to be more effective in this than more traditional education and training methods.1 2The changes implemented in January 2019 were as follows:Forced function: All paracetamol prescriptions for patients under 1 year of age were capped at 180 mg (change from 1000 mg). The prescriber could not enter a number greater than 180 mg.Automation: All oral paracetamol prescriptions were changed to automatically prescribe 15 mg/kg 6 hourly regardless of age (previously 2 different options requiring the prescriber to input dose and frequency according to formulary directions).Standardisation/simplification: All oral paracetamol prescriptions were rationalised to a single option with automatic dose and frequency as above (previously 2 different options unnecessarily).Reminder/rule: A rule of ‘Consultant Approval’ was added to all intravenous paracetamol prescriptions. The intention of this was for a review of the prescription before use to ensure appropriate use and dose/frequency. This could not be forced, so an education package was launched across the unit by the quality improvement group.Prescription details were downloaded from the EP system for 3 month periods pre and post changes. he data was audited by pharmacy undergraduate students for prescribing accuracy.ResultsThe forced function, automation and standardisation options were implemented with 100% compliance. The ‘consultant approval’ rule was followed in 23% of cases. Consultant review led to a 58.6% reduction of IV paracetamol prescriptions on the unit and zero prescriptions for the first 2 months post implementation. The usage of oral paracetamol increased accordingly. This change corresponded to an overall reduction rate of 41.7% for intravenous paracetamol prescriptions.ConclusionsThis project demonstrates how changes that increase automation within prescribing can reduce error and that implementation is more successful than education. A limitation of our data analysis was that we did not measure the effect on pain relief or pain scores in the patients who did not receive IV paracetamol compared to those who did.ReferencesCafazzo JA, et al. From discovery to design: the evolution of human factors in healthcare. Healthcare Quarterly 2012; 15: 24–29.Patel Ms, et al. Nudge units to improve the delivery of healthcare NEJM 2018; 378: 214–216.

An interview analysis of coordination behaviours in Out–of–Hours secondary care

This paper seeks to elicit and structure the factors that shape the execution and, in particular, the coordination of work in Out of Hours care. Evenings and weekends in UK hospitals are managed by specific Out of Hours (OoH) care arrangements, and associated technology. Managing care within the constraints of staff availability and demands is a key concern for both patient care and staff wellbeing, yet has received little attention from healthcare human factors. A study of sixteen clinical staff used Critical Decision Method to understand how work is coordinated and the constraints and criteria that are applied by the roles managing OoH care. The analysis identified ten types of coordination decision that, in turn, underpinned three types of adaptive behaviour – pre-emption, information augmentation and self-organisation – that were crucial for the effective performance in OoH care. These behaviours explain how OoH staff manage the task demands placed on them, individually and as a team.

Uncovering the invisible patient work system through a case study of breast cancer self-management

As patients transition from passive recipients to actors in their health management, there is an opportunity to enhance theoretical frameworks describing the patient work system. Previous macroergonomic frameworks depict how patients manage health outside the institutional healthcare system, though none formally integrate the concept of invisible work – self-management practices undervalued or unseen by healthcare providers. This article overlays invisible work onto the patient work system through a case study of breast cancer self-management. Thirty breast cancer survivors were interviewed about positive and negative experiences post-diagnosis. Invisible and visible components of participants’ work systems were explicated through qualitative content analysis. The results demonstrate that all participants had invisible work system components, and based on these findings, this article theorises the existence of an 'invisible patient work system.' Future research and design to support self-management practices should explicitly address the invisible characteristics of the work systems in which patients are embedded.Practitioner Summary: This article seeks to enhance the healthcare human factors literature by integrating the concept of invisible work into preexisting patient work system models. Through a secondary analysis of an interview study with 30 breast cancer survivors, we found that all participants recalled invisible components of their respective work systems.AbbreviationsCHITConsumer Health Information TechnologySEIPSSystems Engineering Initiative for Patient SafetyIRBInstitutional Review BoardSESSocioeconomic StatusmHealthMobile HealthPHRPatient Health RecordICANInstrument for Patient Capacity AssessmentHIPAAHealth Insurance Portability and Accoutability Act

Implications of Trust on Patient Generated Health Data

Propelled by a focus on patient-centered care, technology development is moving in a direction of providing the patient formal avenues of contributing health information. Specifically, patient generated health data (PGHD), ranging from biometric to health status interpretation is an emerging topic in health informatics (Hull, 2015). Further, tools are in development to allow for the electronic delivery of PGHD from the patient to the provider in the electronic health record (EHR). At its core, human factors is concerned with representing information in a way that supports safe and efficient decision making. PGHD is a topic area that requires a human factors perspective for multiple reasons including the need to identify user needs and requirements of data capture on the patient side, data use on the provider side, and supporting technology design to support these users effectively. Much research in health informatics and healthcare human factors is concerned with the EHR, as the system has not reached intended design, forcing clinicians to search through a broad and deep information space to make decisions (Sittig, Wright, Ash, & Singh, 2016). As an emerging concept in health informatics, PGHD will serve as an additional informational category within the EHR for providers to consider in medical decision making. Therefore, one construct that needs to be examined is trust. The topic of trust has considerable relevance as reflected by prolific research efforts in domains in which automated technology and artificial intelligence dominate. Understanding and consideration of trust factors has been integral in complex domains where technological systems carry out functions ranging from representing and delivering information, providing decision support, to carrying out complex tasks. Trust is defined by Mayer, David, & Schoorman as a “willingness to be vulnerable to the actions of another party based on the expectation that the other will perform a particular action important to the trustor, irrespective of the ability to monitor or control that other party” (Mayer, David & Schoorman, 1995, pg 5). In healthcare, examination of trust factors has been limited to trust in technology, from both provider and patient perspectives, and trust in the provider from the patient perspective (interpersonal trust) (Montague, 2010; Montague, Winchester, & Kleiner, 2010). Albeit limited, evidence does suggest that trust plays a role in healthcare outcomes. For instance, higher trust in one’s primary care physician can increase proactive health behaviors such as following up with recommended colorectal cancer screenings (Gupta, Brenner, Ratanawangsa, & Inadomi, 2014). However, as of yet, no literature exists examining trust factors associated with the patient from the provider’s perspective either in face-to-face interactions or technology mediated. Therefore, there is a need to examine and consider trust to inform the design and implementation of electronic PGHD systems addressing the needs of both providers and patients in the capture and delivery of relevant content that may be useful and usable to the provider. Leveraging the knowledge from the trust in automation literature (Parasuraman, Sheridan, & Wickens, 2000), we can begin to examine issues of reliance and trust of PGHD.

Dentists are humans too - education in human factors within dental care.

The role of human factors in healthcare has become increasingly well recognised, particularly following the Francis inquiry into the failings in care at the Mid Staffordshire NHS Foundation Trust and Berwick Reports. The recognition of human factors in dentistry, particularly in primary care, is less well developed. This paper aims to explore the relevance of human factors in dentistry and highlight the importance of considering their role in any adverse patient outcomes and, importantly for the future, the continued recognition and integration of teaching about human factors in healthcare in both undergraduate and postgraduate education.

A Linguistic Approach for Facilitating the Interpretation of the Human Factors and Ergonomics Society Symposium Proceedings: An Efficient Method for Real-Time Literature Review

The Human Factors and Ergonomics Society (HFES) has for some time been a leader in facilitating the discussion of human factors in health care. We hoped to capture essences of these discussions through reviewing and analyzing the last ten years of health care-related HFES Annual Meetings Proceedings and the last six years of the HFES Health-Care Symposium Proceedings. Because of the large number of papers, we utilized semi-automated means to process the Proceedings abstracts. These semi-automated means included methods in natural language processing (NLP), computational linguistics (CL), and corpus linguistics. We provide example approaches for visualizing linguistic themes within this body of text that may contribute to efforts in prospective risk awareness within health care. We also suggest an initial framework that is amenable for longitudinal, living, and interactive visualizations into this important and growing body of work.

Errors and adverse events in dentistry – a review

As dental professionals we must change the way we think about error. By adopting a more positive, constructive approach, centred around analysing why errors happen, we can then accept our vulnerability and design systems and protocols to prevent errors from occurring. Errors are inextricably linked to human behaviour. Human factors in healthcare are concerned with ensuring patient safety through promoting efficiency, safety and effectiveness by improving the design of technologies, processes and work systems. Essentially, this embraces standardization and involves examining and designing out error. Health Education England has highlighted education in ‘human factors’ as a priority workstream, however, there are many impediments to progress as system changes are slow and difficult to implement. This effectively means that, at present, it is up to individual practitioners to introduce the concept of human factors into their practices. A number of factors have been identified that are critical to reducing error, namely teamwork, communication, leadership and fatigue. Furthermore, a number of strategies have been implemented in secondary care to help reduce the risk of error, including effective leadership, specific policy and procedure, and monitoring and measuring compliance. The majority of the causes of error are related to human factors rather than technical ability or inadequate knowledge. This has major implications for primary care practice, as currently we are concentrating our professional development on the use of technology and our intellectual capabilities, rather than implementing education within, and the development of, human factors. It is our recommendation that human factors form part of our undergraduate teaching and core CPD (Continued Professional Development). CPD/Clinical Relevance: There needs to be a paradigm shift from a culture of blame to a just culture, where it is accepted that, despite our experience, character and talents, we are going to commit errors.

Human Factors Analysis of Infection Prevention Practices in the Anesthesia Work Environment

The department of anesthesia for a Washington, D.C. hospital engaged the MedStar National Center for Human Factors in Healthcare to identify opportunities for improving the anesthesia work environment with aims to mitigate the risk of pathogen transmission during operating room procedures. The human factors approach included operating room visits for observation and thematic analysis to identify emerging themes. Process inconsistencies in hand hygiene and cleaning practices were indicative of system vulnerabilities, including organizational influences and the design of the physical environment. Work-space design recommendations as well as strategies to improve infection control processes and safety culture are presented.

Human Factors in Healthcare: A Field Guide to Continuous Improvement

Abstract Have you ever experienced the burden of an adverse event or a near-miss in healthcare and wished there was a way to mitigate it? This book walks you through a classic adverse event as a case study and shows you how. It is a practical guide to continuously improving your healthcare environment, processes, tools, and ultimate outcomes, through the discipline of human factors. Using this book, you as a healthcare professional can improve patient safety and quality of care. Adverse events are a major concern in healthcare today. As the complexity of healthcare increases-with technological advances and information overload-the field of human factors offers practical approaches to understand the situation, mitigate risk, and improve outcomes. The first part of this book presents a human factors conceptual framework, and the second part offers a systematic, pragmatic approach. Both the framework and the approach are employed to analyze and understand healthcare situations, both proactively-for constant ...

Human Factors in the Wild

The Institute of Medicine (2005) identified Human Factors (HF) engineering as an approach to promote better healthcare system design. The use of HF in healthcare has evidently delivered improvement in safety, quality, and productivity. Although existing literature shows the application of HF in practice, there is limited discussion of the integration of HF into healthcare operations, and the science of HF and its mechanism to deliver improved outcomes. This gap makes it difficult for healthcare professionals and management to see how HF can benefit their organization. Even if the potential benefits of integrating HF into healthcare organizations are understood, there is a lack of guidance on how to best deploy full-time HF practitioners. Despite the vast number of hospitals and healthcare systems around the world, only a few have actively and successfully engaged HF practitioners as part of their internal operations. This panel invites four healthcare HF practitioners, with diverse backgrounds and sub-specialties (Micro-, Physical-, and Macro-Ergonomics) to share their roles and contributions to their organization, and discuss their pathway to becoming integrated into their healthcare organization. This panel will provide guidance on how healthcare organizations can deploy and achieve the full benefit of their full-time HF practitioner (e.g., which unit/functional department to position HF and proper expectations of HF). Additionally, the panel will discuss insights for educators and budding HF practitioners on what it takes to advance their career in this challenging, yet literally life-saving industry.