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HUMAN FACTORS                 Dr Rona Patey    Consultant Anaesthetist NHS GrampianHead of Division of Medical and Dental ...
Who are we?1.   Nursing                                      11%2.   AHP                                      11%3.   Medi...
Are you currently working on a human          factors initiative?                                       20%   •   Yes – st...
Have you had previous education / training         around human factors?                                         20%   •  ...
Things don’t always go right!
Human Factors• ‘the scientific discipline concerned with the understanding  of interactions between humans and other eleme...
Human Factors• Organisational /         • Workgroup(s) / Team (s)  management                 – Team structures / processe...
Exercise• A picture will appear on the screen for around 15  seconds• Examine the picture closely and look for a change• R...
Safety• Error is inevitable and ubiquitous!   – Humans are fallible                                            Helmreich 1...
Wrist Admitted                On 5                                        fracture six with UTI             Medications   ...
Safety• Systems should be designed with ‘defenses in depth’   – Organisational, management, equipment design,     workspac...
Lessons from other industries• Human factors & safety integrated to the core curriculum   – undergraduate   – continuing p...
Lessons from other industries               15/1/2009               Flight 1549               Routine flight from New     ...
What about healthcare?
ANTS SystemCategories   Elements                                         + Confirms roles and responsibilities of         ...
Taking a human factors approach     A healthcare example?
Human Factors                                 http://www.chfg.org/‘about making it easier to do the right job’            ...
Human factors training should be  incorporated as a core skill?                        20%•   Strongly Agree              ...
 Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
 Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
 Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
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Parallel Session 3.5 Crossing Boundaries to Improve Outcomes

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Parallel Session 3.5 Crossing Boundaries to Improve Outcomes

  1. 1. HUMAN FACTORS Dr Rona Patey Consultant Anaesthetist NHS GrampianHead of Division of Medical and Dental Education University of Aberdeen
  2. 2. Who are we?1. Nursing 11%2. AHP 11%3. Medicine 11%4. Healthcare education – undergraduate 11%5. Healthcare education – postgraduate 11%6. Healthcare management 11%7. Human factors research 11% 08. Human resources of 11% 1009. Other 11%
  3. 3. Are you currently working on a human factors initiative? 20% • Yes – still in planning stage 20% • Yes – within my team 20% • Yes – across institutions 0 20% of 100 • No – but I would like to 20% • No
  4. 4. Have you had previous education / training around human factors? 20% • No, not really thought about it 20% • No, but would be keen to know more 20% • Yes, a one off session 20% 0 • Yes, as part of a larger programme of 100 20% • Don’t know
  5. 5. Things don’t always go right!
  6. 6. Human Factors• ‘the scientific discipline concerned with the understanding of interactions between humans and other elements of the system, and the profession that applies theory, principles, data, and methods to design in order to optimise human well being and overall system performance’ International Ergonomics Association 2000
  7. 7. Human Factors• Organisational / • Workgroup(s) / Team (s) management – Team structures / processes – Safety culture – Team leadership – Management • Individual worker leadership – Cognitive – Communication • Situation awareness• Work environment • Decision making – Work environment and – Personal resources hazards (ergonomics • Management of stress • Management of fatigue
  8. 8. Exercise• A picture will appear on the screen for around 15 seconds• Examine the picture closely and look for a change• Raise your hand when you spot a change
  9. 9. Safety• Error is inevitable and ubiquitous! – Humans are fallible Helmreich 1996• Critical incident students reveal that around 80% of underlying issues relate to human factors – Frequently avoidable
  10. 10. Wrist Admitted On 5 fracture six with UTI Medications months ago Mobilises with a frame Lack of staff training Accident TrajectoryPatient Drug ChartCondition Medical Records Ward Workforce & Environment CommunicationThe latent failure model of complex system failuremodified from James Reason, 1997
  11. 11. Safety• Systems should be designed with ‘defenses in depth’ – Organisational, management, equipment design, workspace layout – Should provide the human in the systems with the necessary knowledge and skills to deal with threats in their environment / to act as hero • technical skills are not enough! Reason 1997
  12. 12. Lessons from other industries• Human factors & safety integrated to the core curriculum – undergraduate – continuing professional development• Compulsory adverse event reporting with investigation and learning (organisation and industry)• Briefing and debriefing part of the culture
  13. 13. Lessons from other industries 15/1/2009 Flight 1549 Routine flight from New York to Charlottesville
  14. 14. What about healthcare?
  15. 15. ANTS SystemCategories Elements + Confirms roles and responsibilities of team members + Discusses case with surgeons orTask  Planning and preparing colleaguesManagement  Prioritising + Considers requirements of others  Providing and maintaining standards before acting + Co-operates with others to achieve  Identifying and utilising resources goalsTeam  Co-ordinating activities with team members Example behaviours forWorking  Exchanging information good practice  Using authority and assertiveness  Assessing capabilities  Supporting others Example behaviours for poor practiceSituation  Gathering information − Reduces level of monitoring becauseAwareness  Recognising and understanding of distractions  Anticipating − Responds to individual cues withoutDecision  Identifying options confirmation − Does not alter physical layout ofMaking  Balancing risks and selecting options  Re-evaluating workspace to improve data visibility − Does not ask questions to orient self to situation during hand-over
  16. 16. Taking a human factors approach A healthcare example?
  17. 17. Human Factors http://www.chfg.org/‘about making it easier to do the right job’ Martin Bromiley
  18. 18. Human factors training should be incorporated as a core skill? 20%• Strongly Agree 20%• Agree 20%• Neutral 20% 0 of• Disagree 100 20%• Strongly Disagree

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