Towards total systems human factors Dr Beverley Norris Human Factors Lead National Patient Safety Agency Dr Ken Catchpole Senior Post Doctoral Scientist.

Towards total systems human factors

Dr Beverley Norris

Human Factors Lead

National Patient Safety Agency

Dr Ken Catchpole

Senior Post Doctoral Scientist

John Radcliffe Hospital

Oxford

Human factors...

International Ergonomics Association (IEA) defines ergonomics or human factors as:

..concerned with the ..interactions among humans and other elements of a system, and applies theory, principles, data, and other methods to design in order to optimize human well-being and overall system performance “

Human factors…

• Designing to fit people

It says I need to upgrade my brain to be compatible with its new software

“Making it easy to do the right thing”

Human factors approach to safety

1. Eliminate – the hazard through DESIGNforcing functions, anaesthetic machines,

bar- coding

2. Barriers – between the hazard and the userchild resistant containers, controlled drug

cupboards, double checking

3. Mitigate – the consequences of the hazardantidote drugs, limited dose infusions

4. Educate – users to prevent or avoid the hazard

(adapted from Hale and Glendon, 1987)

Human factors principles in system design

• Human error is to be expected, and some errors can be predicted

• Human error is often a consequence of performance shaping factors in the system design

• Poor system design poor usability workarounds, errors, reliance on training, inefficiency

How do we make it easy to do the right thing…?

….standardisation

Graphical language…intuitive?

It’s not just equipment design..what about work design?

- Do we design jobs or do they just ‘happen’?

- How much variation in practice is there across a Trust?

- When new protocols are introduced do we assess how they impact on daily work?

- Do we involve staff when introducing new ways of working?

Applying human factors principles to procedures

2222Standardised crash team number

Human factors integration plans

• Started in defence, now common in off shore industries, air traffic management, rail transport

• Step by step process to ensure HF considered in system development

• Techniques include task analysis, workload assessment, human factors checklists

• System lifecycle – commissioning, maintenance, review, technology changes, decommissioning

Human factors issues in HFI

Consideration of human factors issues must be part of the technology design and certification process and of thedevelopment of operating procedures”

Eurocontrol (Euro. Org. for the Safety of Air Navigation), 2000

Procedures, roles and responsibilities• Allocation of function • Maintain situational awareness• Assess workload issues• Address trust and confidence in system• Minimise skill degradation• Procedures and documentation:

• in appropriate format and place.• clear and comprehensible.• adequately structured• realistic and reflect the way tasks are / should be carried out.

Human machine interaction

HSE human factors integration ‘maturity’ scale

“Human factors is not a stand alone activity; best practice is achieved only when human factors is integrated into the mainstream of system development” (HSE, 2002)

1. Human factors is irrelevant

2. Human factors is thought to be common sense

3. Human factors is unfocussed

4. Human factors activities are integrated into development

5. Human factors fully integrated throughout lifecycle

Key messages

• Human factors is more than training• Human factors is vital to the design of safe

systems• Work design still to be explored• Human Factors methods including HFI need

to be explored in healthcare