Human Factors Specialists Research Articles

Risk Controls Identified in Action Plans Following Serious Incident Investigations in Secondary Care: A Qualitative Study.

The impact of incident investigations in improving patient safety may be linked to the quality of risk controls recommended in investigation reports. We aimed to identify the range and apparent strength of risk controls generated from investigations into serious incidents, map them against contributory factors identified in investigation reports, and characterize the nature of the risk controls proposed. We undertook a content analysis of 126 action plans of serious incident investigation reports from a multisite and multispeciality UK hospital over a 3-year period to identify the risk controls proposed. We coded each risk control against the contributory factor it aimed to address. Using a hierarchy of risk controls model, we assessed the strength of proposed risk controls. We used thematic analysis to characterize the nature of proposed risk controls. A substantial proportion (15%) of factors identified in investigation reports as contributing to serious incidents were not addressed by identifiable risk controls. Of the 822 proposed risk controls in action plans, most (74%) were assessed as weak, typically focusing on individualized interventions-even when the problems were organizational or systemic in character. The following 6 broad approaches to risk controls could be identified: improving individual or team performance; defining, standardizing, or reinforcing expected practice; improving the working environment; improving communication; process improvements; and disciplinary actions. The identified shortfalls in the quality of risk controls following serious incident investigations-including a 15% mismatch between contributory factors and aligned risk controls and 74% of proposed risk controls centering on weaker interventions-represent significant gaps in translating incident investigations into meaningful systemic improvements. Advancing the quality of risk controls after serious incident investigations will require involvement of human factors specialists in their design, a theory-of-change approach, evaluation, and curation and sharing of learning, all supported by a common framework.

Uncovering patient safety considerations in laparoscopic cholecystectomy using cognitive task analysis.

Educating residents on laparoscopic operations requires direct teaching and deliberate practice. Attending surgeons are often systematic when performing surgery, which creates a challenge when instructing surgery residents. The aim of this study was to use cognitive task analysis to expand laparoscopic cholecystectomy into microsteps reflecting expert surgeon cognition (perceptions, assessments, decisions, etc.) throughout the operation such that these could be better formalized and conveyed to residents in educational materials or assessments and to attending surgeons as teaching scripts. One surgeon, a surgical resident, and a human factors specialist conducted cognitive task analyses with three expert general surgeons and one hepatobiliary surgeon using semi-structured interviews. These interviews expanded an existing task model of laparoscopic cholecystectomy to specifically add patient safety aspects including injury prevention, risk management, and complication detection for each step. Interview analysis resulted in an expanded task diagram. Cognitive task analysis expanded the current laparoscopic cholecystectomy task model from 19 to 97 microsteps. In addition to microsteps, an additional major step was identified, the planning step or step zero. Steps with the greatest number of microsteps included dissection with 15 microsteps and intraoperative cholangiogram with 10 microsteps. Laparoscopic cholecystectomies are complex operations with multiple microsteps. Identification of these steps can lead to explicit strategies that can improve training of surgeons, with an end towards efficacy and safety. The identification of a planning step prior to beginning the operation is a significant finding that should arguably be included in all future cognitive task analyses regardless of operation or procedure, to emphasize to trainees what senior surgeons have learned through experience. These findings inform the development of interventions for surgical training and evaluation of competency.

Meetings and Congresses

Meetings and Congresses

A Competency Framework for Aviation Psychologists and Human Factors Specialists in Aviation

Abstract: Aviation psychology and human factors have made a significant contribution to aviation safety since the beginning of flying. Following the Germanwings tragedy in 2015, the professions have received extra attention from both governmental and aviation industry organizations. This paper reports on the development of a competency framework defining skills, knowledge, and attitudes for the endorsement of aviation psychologists (AVPSY) and aviation human factors specialists (AVHFS) based on input from 47 stakeholders and subject matter experts. The framework covers aviation domain knowledge, knowledge about humans, methodological approaches and tools, application practice areas, and common supporting skills and attitudes. Commonalities and differences between AVPSY and AVHFS are highlighted, and competency levels are discussed. Practical benefits of using the competency-based framework are emphasized for practitioners, employers, and universities or training organizations.

Humans and Technology

Free AccessHumans and TechnologyJulia Behrend and Matthew J. W. ThomasJulia BehrendJulia Behrend, Ecole Normale Supérieure, PSL Research University, Laboratoire de Neurosciences Cognitives, 29 rue d’Ulm, 75005 Paris, Francejournal@eaap.net Ecole Normale Supérieure, PSL Research University, Laboratoire de Neurosciences Cognitives, Paris, France Search for more papers by this author and Matthew J. W. ThomasMatthew J. W. Thomas, Appleton Institute, Central Queensland University, 44 Greenhill Rd, Wayville, SA 5034, Australiajournal@eaap.net Appleton Institute, Central Queensland University, Adelaide, Australia Search for more papers by this authorPublished Online:May 08, 2023https://doi.org/10.1027/2192-0923/a000248PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreThis issue of Aviation Psychology and Applied Human Factors presents a set of papers that reflect two different, yet equally important dimensions of our disciplines, that of technology and the human element.First, several of the articles in this issue focus on new technologies, and their potential role in enhancing aviation safety. Our disciplines of aviation psychology and human factors have from their beginnings focussed on technological innovation, given the rapid evolution of the aviation industry and the enormous technological advances that have occurred along the way. However, one of the most important roles we play is through the evaluation of those technologies, demonstrating their effectiveness from a human perspective, and identifying any unanticipated consequences in implementation.The evaluation of new technologies demands high quality, in the form of sound experimental design, disciplined data collection and appropriate statistical analysis. All of these characteristics are seen in the papers presented in our journal, and our reviewers and editorial team pay significant attention to the scientific rigor applied to the research we publish.While the focus on new technologies, and their scientific evaluation is important, just as important is the attention we pay to the individuals and teams who together create safety and efficiency in operations.Feeling safe at work implies more than the physical aspects, including an individual’s mental and social well-being. Aviation psychologists and human factors specialists play a major role in creating that diverse climate. Their knowledge, skills, and attitudes help to make the sky safer.The term competency is more than ever an area of focus for the aviation industry, looking at the job-related observable behaviors of safety-sensitive personnel. Keeping the balance of analyzing human behavior in a precise way without creating too narrow mindsets is a challenge for future operations. Gestalt psychology emphasizes that the whole is greater than the sum of its parts.The human element and technology are two equally important dimensions of our discipline that should always create a synergy to keep safety the overarching priority.Every time, we receive a new submission, we are amazed by the brilliant research ideas and variety of thought. We would like to thank all authors, reviewers, associate editors, the editorial team and the Hogrefe team for their ongoing support to make the journal a continued success.Julia Behrend Matthew J. W. ThomasEditor-in-Chief EditorAuthor BiographiesJulia Behrend (PhD) is an associate member of the Department of Cognitive Studies at the Ecole Normale Supérieure, PSL Research University in Paris, France, and is Head of Safety Innovation & Human Cooperation at Air France. She aims to apply findings from aviation psychology and cognitive neuroscience to safety to better understand human performance in high-risk industries.Matthew J. W. Thomas (PhD) is an Associate Professor at Appleton Institute at Central Queensland University in Adelaide, Australia, and Director of Westwood Thomas Associates. His research focuses on error management and non-technical skills across high-risk industries.FiguresReferencesRelatedDetails Volume 13Issue 1March 2023ISSN: 2192-0923eISSN: 2192-0931 Published onlineMay 8, 2023 InformationAviation Psychology and Applied Human Factors (2023), 13, pp. 1-1 https://doi.org/10.1027/2192-0923/a000248.© 2023Hogrefe PublishingPDF download

Ethics in Quality Improvement Projects: Experiences of a Human Factors Team.

The Alberta Health Services Human Factors (HF) team completes many quality improvement projects involving human participants and requires a robust and efficient ethics process. The team has developed an ethics process utilizing ARECCI (A pRoject Ethics Community Consensus Initiative), wherein HF specialists review their project for alignment with a reference project. The reference project captures a broad range of work that the HF team may lead or support in some way, and it has a corresponding series of countermeasures that have been created to address ethical risks. While some challenges remain, the process has largely allowed the team to meet its ethics goals.

LEVERAGING VIDEO CONFERENCING TECHNOLOGY TO FACILITATE SOCIAL ENGAGEMENT IN OLDER ADULTS

Abstract Social engagement is critical for maintaining well-being and quality of life in older adults. However, typical age-related changes across bio-psychosocial dimensions as well as age-related conditions such as mild cognitive impairment (MCI), pose many challenges for older adults to remain socially connected. The development of technologies, specifically video conferencing, can be leveraged as a tool to facilitate the delivery of social engagement opportunities, both enhancing access and minimizing social isolation. For successful adoption of these tools, the needs and preferences of older adult users must be considered. We employed an iterative research process for designing and developing a social-engagement intervention using a platform called OneClick.chat. We provide community-dwelling older adults with opportunities to engage in casual conversations and reminisce with others on topics of shared interests (e.g., nature, food, hobbies). Our iterative design process involved an interdisciplinary team of engineers, human factors specialists, gerontologists, and neuropsychologists. We also evaluated the system with eight participants (aged 50-64) who provided their insights pertaining to the content, delivery, perceived ease of use, usefulness, and potential adoption of this video-conferencing platform. Based on the feedback received, we have optimized the intervention in preparation for a randomized controlled trial. Furthermore, we provide key insights related to the implementation of social engagement through video technologies with the aim of facilitating social connectivity. Our learnings can be used to guide future work involving video-technology-based interventions to facilitate social connectivity for older adults with varying cognitive abilities.

Human As Automation Failsafe: Concept, Implications, Guidelines and Innovations

Humans are frequently left to “backstop” automated systems, and Human Factors specialists have argued against this for decades with, at best, partial success. What if we took a different tack… and designed to support it? The participants were involved in a recent effort to review and document cases across multiple domains where operators acted as a “failsafe” for automation, intervening in unanticipated situations to maximize success and minimize damage. We defined a “Human As Failsafe” (HAF) incident and then investigated conditions and practices making HAF success more or less likely. Analyzing these historical incidents, we suggested remediation approaches. The project also examined the legal concept of culpability (i.e., when intervention should have happened but didn’t) and proposed a state-machine-based analytic simulation to identify when HAF interventions are plausible. The panel objective will be to briefly present these concepts, but more generally to discuss designing for inevitable HAF events.

Situational Approach of Teaching Speaking Maritime English in Merchant Marine Polytechnic of North Sulawesi

English communication skills in the areas of speaking, listening, reading, and writing. However, in many students' minds communication means only interaction between the speaker and the listener. Teaching English at maritime universities and nautical colleges involves not only teaching the language and the sea-related terminology but also making the students aware of the cross-cultural issues and problems that they may encounter in their work onboard ships. The best way of teaching is, how the teacher, instructor, and lecturer can choose and use the right teaching method. FAIES is one of the unique and well-known methods in teaching which can adapt to many situations in the classroom and makes the students feel easy to understand and study comfortably during the lesson especially in speaking English. According to Freud in Wollheim (1981), FAIES (First Aid in English System) is the teaching method to emphasize or stress communication, which consists of a directional approach, functional approach, situational approach, and drilling technique. Maritime English is largely restricted to IMO Standard Marine Communication Phrases, which build basic knowledge of English and had been drafted in a simplified version of maritime English. In terms of maritime education, the current simulator-based studies can be divided into two areas: marine engineering and nautical science. In particular, human factor specialists work in these two fields addressing issues concerning the relationship between humans and technology, such as simulators (Lützhöft et al. 2017). A multitude of new methodologies has been explored and discussed in recent years in an attempt to approach the training and testing of the proficiency of maritime English that meets the international standards laid out in STCW.

Observation: Setting the Foundation for Creativity and Innovation.

Observation: Setting the Foundation for Creativity and Innovation.

An interview study to identify circulating nurses’ nontechnical skills

Aim Non-technical skills are component features of human factors whose defects can lead to surgical errors and adverse events. Circulating nurses need to deploy non-technical skills for safe and efficient performance. This study aimed to identify circulating nurses’ non-technical skills. Methods This interview study was conducted on 29 operating room personnel. Semi-structured interviews were used for data collection. The prepared annotated transcripts were analysed using the content analysis method by a human factors specialist under the supervision of two other researchers. The extracted behaviours were grouped based on meaning and similarity. Results Six categories of non-technical skills including leadership, communication, task management, situational awareness, teamwork, and coping were identified as the circulating nurses’ key non-technical skills. The related behaviours were also noted. Conclusion Non-technical skills are incorporated in circulating nurses’ tasks from the onset to the end of surgery. Thus, these nurses should be aware of the necessary non-technical skills and positive behaviours to assure a safe surgery.

82 Surgeons Don’t Just Operate: Improving Junior Surgical Practitioners’ Non-Technical Skills Outside of the Operating Theatre Using High-Fidelity Simulation

The non-technical skills of surgeons play a significant role in patient confidence, experience and safety The aim of the study was to improve non-technical skills and confidence of junior surgical practitioners regarding DNACPR conversations and obtaining operative consent.We have developed a speciality-specific course to address the educational deficit surrounding non-technical skills outside of the operating theatre, focussing on DNACPR and consent, for junior surgical practitioners. It was piloted at Aintree University Hospital with their Orthopaedic Department. We combined lectures and workshops delivered by subject matter specialists with simulated scenarios. The simulated scenarios were debriefed by human factors specialists using the gold standard validated NOTSS tool The pilot course in June was a resounding success; candidate confidence scores increased significantly across both skills and knowledge surrounding capacity, consent and DNACPR. All attending candidates have recommended the course to their peers and suggested integration into the Foundation training curriculum. However, identifying and implementing courses appropriate for all foundation doctors with such a specialized course would be challenging. Most foundation doctors have at least one placement in a surgical specialty. Therefore, it is more realistic to adjust the course to become less specialized, encompassing all the surgical specialities, to target all foundation doctors initially instead of juniors in each speciality. Following the capture of foundation doctors, the second phase of implementation will return to speciality-specific courses to address the learning needs of non-medical practitioners, such as Physician Associates and Advanced Nurse Practitioners, working in surgical departments.

Using Operational Scenarios in a Virtual Reality Enhanced Design Process

Maritime user interfaces for ships’ bridges are highly dependent on the context in which they are used, and rich maritime context is difficult to recreate in the early stages of user-centered design processes. Operations in Arctic waters where crews are faced with extreme environmental conditions, technology limitations and a lack of accurate navigational information further increase this challenge. There is a lack of research supporting the user-centered design of workplaces for hazardous Arctic operations. To meet this challenge, this paper reports on the process of developing virtual reality-reconstructed operational scenarios to connect stakeholders, end-users, designers, and human factors specialists in a joint process. This paper explores how virtual reality-reconstructed operational scenarios can be used as a tool both for concept development and user testing. Three operational scenarios were developed, implemented in a full mission bridge simulator, recreated in virtual reality (VR), and finally tested on navigators (end-users). Qualitative data were captured throughout the design process and user-testing, resulting in a thematic analysis that identified common themes reflecting the experiences gained throughout this process. In conclusion, we argue that operational scenarios, rendered in immersive media such as VR, may be an important and reusable asset when supporting maritime design processes and in maritime training and education.

Thinking about the Future: How Do Young People Deal with Money?

The world population is changing and ageing. And young adults? Are they prepared to be an older adult? How to deal with expectations for life and financial aspects in the long term? These are the questions discussed in this paper, gathering information design, financial literacy, and human factors. A descriptive approach considered a literature review of financial education and literacy, consumer consumption by adolescents and young adults, and how human factors specialists discuss this topic. Based on this information, both qualitative and quantitative research with young adults on their financial literacy was conducted to investigate young adults' perspectives on their future, decision-making about money now, and retiring. Data results pointed out a view, and some solutions are proposed as the next steps.

Optimal Crash Cart Configuration for a Surgical NICU: Utilizing Human Factors Principles.

Neonates admitted to cardiac and surgical neonatal intensive care units (NICUs) are at an increased risk of requiring emergency lifesaving interventions that require the use of both Neonatal Resuscitation Program (NRP) and Pediatric Advanced Life Support (PALS) algorithms. Clinicians working within the surgical NICU must be able to access emergency equipment and medications quickly in order to respond to critical situations. A crash cart that integrates human factors principles and supports both the NRP and PALS algorithms is necessary to promote patient safety for this high-risk population. A multidisciplinary quality improvement project constructed an optimal crash cart configuration that embedded human factors principles and supported clinical workflow by reflecting both the NRP and the PALS algorithms in an NICU that cares for cardiac and surgical patients. A crash cart working group including frontline NICU staff, simulation experts, and a human factors specialist was formed within a surgical NICU. Human factors principles were utilized to align the organization of the cart with the NRP and PALS algorithms to increase the efficiency and intuitiveness of the cart. The new crash cart configuration was usability tested through simulation, revised on the basis of clinical feedback, and then implemented in a clinical setting. Data were collected following implementation of the new crash cart to validate that the new configuration was viewed as a significant improvement. The Plan-Do-Study-Act cycle was used to make improvements and capture outcome indicators. Evaluation data collected both during usability simulation testing and in situ within the NICU clinical environment indicated that the revised crash cart scored higher on Likert scale response questions than the previous crash cart. Human factors science, in combination with frontline user engagement, should be utilized to create intuitive crash cart configurations, which are then tested in a simulation environment and evaluated in situ in the NICU. Further research around crash cart design within NICUs that use multiple lifesaving algorithms would add to the paucity of research around the impact of human factors theory in the utilization of lifesaving equipment and medications within this specific population.

Health care for deep space explorers.

There is a growing desire amongst space-faring nations to venture beyond the Van Allen radiation belts to a variety of intriguing locations in our inner solar system. Mars is the ultimate destinati...

Building Bridges

Free AccessBuilding BridgesMichaela Schwarz and Melanie ToddMichaela Schwarz European Association for Aviation Psychology (EAAP), Vienna, Austria Search for more papers by this author and Melanie Todd Australian Aviation Psychology Association (AAvPA), Melbourne, Australia Search for more papers by this authorPublished Online:April 02, 2020https://doi.org/10.1027/2192-0923/a000187PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreSince 1956 the European Association for Aviation Psychology (EAAP) has been promoting the study of psychology and the scientific pursuit of applied psychology and human factors in the field of Aviation. In 1992 the Australian Aviation Psychology Association (AAvPA) was founded to join forces to raise awareness of aviation psychology and human factors in Australia and the Asia-Pacific region. Dr Melanie Todd, at the time AAvPA Secretary and I had the pleasure to serve on the AAvPA Board from 2008 to 2010. Together with the rest of the AAvPA executive, we worked hard to bring Aviation Psychology and Human Factors down under closer to Europe and vice versa. Our main levers back then were promoting each other’s bi-annual conferences/symposia, training courses and facilitating a close network between EAAP and AAvPA members.Today AAvPA members enjoy the same benefits as EAAP members and EAAP members are welcome to participate at the AAvPA Symposium at special AAvPA rates. Together with our members we have achieved several milestones. The foundation of the new journal Aviation Psychology and Applied Human Factors (APAHF) as the official journal for EAAP and AAvPA in 2011 in cooperation with Hogrefe Publishing was certainly a high point.We are proud that since the first issue in January 2011 and with combined efforts of the editorial board, associate editors, authors, members, and our colleagues from Hogrefe Publishing, two issues could be published timely each year. The journal is an indispensable means to promoting scientific research, applied practices, book reviews, news and events in aviation psychology and human factors. We are happy to see the number of manuscript submissions and the quality of original (scientific) articles is increasing each year. At the same time we are pleased to see science applied in practice sometimes in close cooperation with industry partners. Further, it has always been a goal of both EAAP and AAvPA to support students in the field of aviation psychology and human factors. This journal, in addition to the symposia, also provides a mechanism for student papers to be published and emerging research to be highlighted.In our view it is important to understand the needs of our industry stakeholders when it comes to human performance and people issues. We would like to see the journal further develop as a medium to inform researchers and academics about industry news and help identify possible research areas, questions and problems. In return, academia can inform industry partners by addressing questions and problem areas through scientific studies delivering sound empirical evidence.In this spirit, we encourage both academia and industry partners in aviation to continue to build bridges to increase aviation safety between Europe, Australia, and beyond. We hope that our readers will see the great potential our scientific journal can bring to their daily operations and look forward to more submissions addressing current industry developments and trends.Michaela Schwarz and Melanie ToddEAAP and AAvPA Presidentspresident@eaap.net; president@aavpa.orgMichaela Schwarz is an aviation psychologist and human factors expert working towards improving human performance in aviation and rail. She received her doctoral degree in psychology from the University of Graz, Austria in 2016. Her main research focus and specialities are the assessment and improvement of safety – just culture and safety-relevant behaviour, the integration of human performance elements in safety management systems and the development and delivery of human factors training programs. Michaela has been a member of the EAAP Board for 10 years and EAAP President for 2 years.Melanie Todd is a Human Factors specialist, working across various high reliability industries. She received her doctoral degree in psychology in 2014, with a focus on pilot performance and licensing. Melanie has worked in both regulatory and investigative roles as a specialist in human factors, primarily in aviation with experience in rail and maritime investigations. Her specialist interest areas include accident and incident investigation, human error analysis, fatigue risk management, and training. Melanie has been a member of the AAvPA Executive Committee for over 15 years and AAvPA President for over 6 years.Michaela Schwarz, EAAP, Vienna, Austria, E-mail president@eaap.netFiguresReferencesRelatedDetails Volume 10Issue 1March 2020ISSN: 2192-0923eISSN: 2192-0931 Published onlineApril 2, 2020 InformationAviation Psychology and Applied Human Factors (2020), 10, pp. 1-2 https://doi.org/10.1027/2192-0923/a000187.© 2020Hogrefe PublishingPDF download

Personnel Benefit From Advanced Drilling Simulators for Well-Control Training

This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 194181, “Advanced Drilling Simulators for Well-Control Training: Bringing Together People, Procedures, and New Technology,” by Robert Howell, Brian McKenzie, Craig Leslie, and Isabel Poletzky, Maersk Training, prepared for the 2019 SPE/IADC Drilling Conference and Exhibition, The Hague, 5–7 March. The paper has not been peer reviewed. As new technologies enable the drilling of increasingly complex and challenging wells, well control remains a critical operation that requires personnel to possess not only technical skill but also the ability to communicate effectively during stressful situations. This paper focuses on the preparation for, and implementation of, well-control training, while highlighting the integration of people skills into curricula and what advantages operators and drilling contractors have obtained. Conventional Well-Control Training Well control is of paramount importance and relies on trained teams to maintain well integrity throughout the drilling process. Conventional courses remain the cornerstone in competency training and provide a solid foundation for understanding the fundamental physics associated with well control, and should always remain part of the core curriculum. Crews that use high-fidelity simulations with integrated crew resource management (CRM) will be equipped to mitigate challenges in deepwater drilling environments better. Students who score consistently above average on an individual well-control examination should then be considered for advanced training. Such intensive courses involve a fully immersive simulated drilling rig that mimics real-life situations and well-control scenarios while being guided by drilling and human-factors specialists. On the first day of class, participants will be tested and, upon completion of the course, will be awarded the appropriate certification. Throughout the remainder of the week, participants will be immersed in a realistic and advanced simulated environment where their behavior and interactions, as well as their technical knowledge, will be assessed. First Steps for Training As deepwater drilling operations become more complex using managed-pressure-drilling (MPD) technology, it is fitting that crews receive specialized training focusing on the rig and on company-specific equipment, procedures, and well-control situations. Typically, the training is completed in conjunction with the service company using MPD software and a high-fidelity drilling-floor simulator. To prepare for this training, the MPD provider and operator meet 5 to 6 months before the training date to discuss the details of the venture and develop rig-specific procedures. Then, typically 2 to 3 months before training commences, the providers begin involvement with the operator to establish expectations. During this period, the schedule is developed on the basis of the crew’s experience with MPD and the software being used; well data are also provided to build different scenarios in the simulator to make them as realistic as possible, and to mirror the actual well that will be drilled. The degree of difficulty for each scenario varies depending on the operator and the crew’s experience with MPD operations capabilities. Given the limited exposure that offshore rig contractors have had with MPD, initial scenarios are used to familiarize participants with the software, the limitations of their equipment, and appropriate procedures. Scenarios evolve throughout the course of the training as participants become more knowledgeable. Part of this evolution includes gaining an understanding of how problems with other departments, such as marine, engine-room, and crane personnel, can affect rig-floor activities.

Assessing Human Factors Maturity

Human factors is an integral part of achieving successful organisational and health and safety performance. It is a discipline which focuses on the human element to understand and improve the interaction between people and complex systems. In the process industries, human factors is concerned with human behaviour and performance, particularly in relation to reducing the risk of incidents and accidents.Many factors influence health and safety performance and behaviour and there are recurring themes related to how people have contributed to major accidents in the past. Applying human factors requires consideration of the depth of the different topic areas, whilst recognising the breadth of coverage and the need to approach the subject from a holistic perspective. Typically, it is challenging to know where to start, and to know which specific Human factors areas should be prioritised.The Human Factors Maturity Model (HFM M) was developed by the Keil Centre to enable organisations to assess their own level of Human Factors Maturity (Human Factors Maturity is a registered trademark of The Keil Centre Ltd). The model presents an opportunity for organisations to assess how mature they are in managing human factors, but importantly, to pinpoint where to focus future efforts. The HFM M uses a 5-level scale to determine an organisation's level of maturity. It includes 12 key human factors elements which have been identified from empirical research and from mining human factors literature. The model was developed using the combined expertise of seven human factors specialists at the Keil Centre and tested with the cooperation of an industry partner.The model was further developed into an interactive tool for application in a workshop format. A cross-section of organisational representatives is invited to participate to assess their current level of Human Factors Maturity for each of the 12 elements using a card-sort methodology. Once the level for each element has been determined, the current arrangements are described and the requirements to improve maturity to the next level for each element are identified. At this point, the priorities for action are defined based on their importance to the organisation, taking account of the elements most in need of development. This assessment supports the development of a human factors strategy and an action plan. The HFM M has been tested in the energy and chemical production sectors.

The acceptance of CIRS among orthopedic and trauma surgeons in Germany-Significant gap between positive perception and actual implementation in daily routine.

Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. Between April 10, 2015 and May 22, 2015, a web-based questionnaire, which was designed by an expert team consisting of orthopedic and trauma surgeons, aeronautic human factors specialists, and psychologists (Lufthansa Aviation Training), was sent to all members of the German Society for Orthopedic and Trauma Surgery. The survey consisted of three questions regarding CIRS and its use in German hospitals. A total of 669 orthopedic and trauma surgeons working in German hospitals completed the questionnaire. All participants rated CIRS as useful, although 71.3% of participants did not report a critical incident in the last 12 months. In that time period, only 13.4% of participating residents reported at least one incident, but 44.7% of chief physicians reported one incident within the same period. The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.