1. 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

2. 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 “

3. 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”

4. Human factors approach to safety 1.Eliminate – the hazard through DESIGN forcing functions, anaesthetic machines, bar- coding 2. Barriers – between the hazard and the user child resistant containers, controlled drug cupboards, double checking 3. Mitigate – the consequences of the hazard antidote drugs, limited dose infusions 4. Educate – users to prevent or avoid the hazard (adapted from Hale and Glendon, 1987)

5. 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

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

8. Graphical language…intuitive?

9. 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?

10. Applying human factors principles to procedures 2222 Standardised crash team number

11. 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

12. Human factors issues in HFI Consideration of human factors issues must be part of the technology design and certification process and of the development of operating procedures” Eurocontrol (Euro. Org. for the Safety of Air Navigation), 2000

13. 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.

14. Human machine interaction Input devices Visual displays. Information requirements Alarm handling Console or immediate working area Usability User requirements Health risks Distractions Fatigue Noise Lighting Temperature, humidity and air quality Workplace design Workplace capacity - people, equipment and furniture required.

15. 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

16. 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