1. Copyright 2009 Terema Ltd Phil Higton (Director of Training – Terema Ltd) philhigton@terema.co.uk The Quality Improvement Academy Human Factors, Safety and Culture

2. Copyright 2009 Terema Ltd Outline for today What are Human Factors (HF)? HF Teamskills and TRM Threat and Error Management Coping with Human Performance System / Process – People / Culture Three Building Blocks Effective Tools – SBAR / Briefing / Handover

3. Copyright 2009 Terema Ltd Human Factors Human factors encompass all those factors that can influence people and their behaviour. In a work context, human factors are the environmental, organisational and job factors and individual characteristics which influence behaviour at work. ‘How to’ guide “Implementing Human Factors in Healthcare” One definition…….

4. Copyright 2009 Terema Ltd Human Factors Practical and pragmatic solutions to two key issues……. Ergonomics / Behavioural Science / Psychology Performance is variable Error is normal

5. Copyright 2009 Terema Ltd People and Culture System and Process

6. Copyright 2009 Terema Ltd Human Factors Team Skills Team Resource Management

7. Copyright 2009 Terema Ltd Safety Situation Awareness Risk Management Communication Choosing Behaviour Feedback Leadership Followership and Motivation Team Resource Management

8. Copyright 2009 Terema Ltd Safety Situation Awareness Risk Management Communication Choosing Behaviour Feedback Leadership Followership and Motivation Team Resource Management

9. Copyright 2009 Terema Ltd Situation Awareness Making sense... (1.Take in information) (2. Make decisions……) (After Carl Jung)

10. Copyright 2009 Terema Ltd Dragon Video

11. Copyright 2009 Terema Ltd What do you see?

12. Copyright 2009 Terema Ltd What shapes do you see?

13. Copyright 2009 Terema Ltd Jump to conclusions

14. Copyright 2009 Terema Ltd Vocabulary Confirmation Bias Authority Gradient Mental Model Motor Programmes

15. Copyright 2009 Terema Ltd Error Management - How Avoid Trap Crisis Manage (React to the consequences) Situation Awareness Low High (Identify hazards a long way off) (Procedures to deal with hazards when they occur)

16. Copyright 2009 Terema Ltd © Terema Ltd 2007 Arousal Performance Workload Personal Best Z Z ZZ

17. Copyright 2009 Terema Ltd © Terema Ltd 2007 Arousal Performance Workload Danger

18. Copyright 2009 Terema Ltd Arousal Performance Personal Best Workload

19. Copyright 2009 Terema Ltd Arousal Performance Workload Physiology Psyche Interpersonal Environment Technology

20. Copyright 2009 Terema Ltd The Bucket

21. Copyright 2009 Terema Ltd Handover (Continuity of Care) Briefing (Sharing Mental Models) Call For Help (Escalation of concerns) Professional to Professional (Verbal) Knowledge Sharing

22. Copyright 2009 Terema Ltd The Spoken Word Social Professional Crisis Jargo n

23. Copyright 2009 Terema Ltd The Spoken Word Problems with speech……… –Lack of persistence - volatility Dependant on memory –Low value channel Slow data transfer Hearing loss under stress Visual override –Interpretation issues Different perspectives / Mental Models

24. Copyright 2009 Terema Ltd Organising thoughts Prepare –What is relevant? Précis –Distil – Reduce word-count Prioritise –Most important things first Bullet point thinking……………….

25. Copyright 2009 Terema Ltd Professional to Professional (Verbal) Knowledge Sharing Handover (Continuity of Care) Briefing (Sharing Mental Models) Call For Help (Escalation of Concerns) Roles and Responsibilitie s Chain of Command Licence and Assertiveness Preparing to Act Sharing a Plan Co-ordination of Effort Data, information and insight Acceptance of responsibility (competence) Point of transfer

26. Copyright 2009 Terema Ltd Psychological Core (Personality) Typical Response Learned (Parent/Child) Role Related (Adult) Choosing Behaviour What drives behaviour?

27. Copyright 2009 Terema Ltd One Brain - The effect of Stress and Workload In Control Out of Control Limit of Capacity Amalberti Demands to Act Demands to Think

28. Copyright 2009 Terema Ltd Watch This Elaine Bromily

29. Copyright 2009 Terema Ltd Understanding Human Factors helps manage risks which the humans introduce into the system and the system imposes on the humans. Error is normal Performance is variable Overload is a killer Bad things can happen to good people People and Culture System and Process Summary Thank you! Questions?