Human Factors

WeCare Morning Report #5

Tuesday, March 24th 2015 at 7:30am

2450 Riverside Avenue

Minneapolis, MN

We'll meet on the 6th floor of Masonic (6140) for our morning report focused on Patient Safety. All fellows and residents are invited to attend!

Overview

Human factors studies the interaction between humans and other elements of the system in order to optimize human well-being and overall system performance[i]. It is sometimes referred to as ergonomics because the goal is to reduce stress and eliminate injuries[ii]. In healthcare, this goal applies both to the healthcare worker and to the patient. Human factors considers healthcare workers, the tools or equipment they use in the workplace and the environment in which they work[iii]. This enables the intentional design of tasks, work spaces, controls, displays, tools, lighting, and equipment that simultaneously improves healthcare worker performance and optimizes patient safety. Human factors engineering is a proactive way of designing a system that reduces errors and injuries while practicing evidence-based medicine because it brings in the end-user perspective and considers the various interactions that take place within the system[iv].

Work system model

Work system model[v] illustrates the systems engineering perspective for patient safety. Each of these different components of the work system interact to influence the ultimate outcomes for patients and health workers. The components of the work system are defined in the table below:

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I'M SAFE

As individuals, we are more prone to errors when we are tired, ill, or hungry. We can apply human factors to recognize how we might be more prone to make errors. The following personal checklist acronym (IM SAFE) from aviation industry is a useful self-assessment to determine if you are safe to begin work each day[i]:



  • Illness – Any illness or symptom that might affect your work?
  • Medication – Are you taking any medications (rx or OTC)?
  • Stress – Is there emotional or psychological stress that might affect your performance?
  • Alcohol – Have you had anything to drink in the last 8-24 hours?
  • Fatigue– Have you had sufficient sleep and rest recently?
  • Eating– Are you sufficiently nourished?

Conclusion

A consideration of human factors ensures that healthcare workers have the right tools and environment to perform their tasks safely and coordinate efforts. It recognizes both latent system errors (‘resident pathogens’) and active failures that are due to individual errors (‘skills-rules-knowledge’ as well as poor communication). Medical trainees need to be mindful of situations that increase the likelihood of error.

For more information:

References

[i]Hignett, Sue, et al. "Human factors and ergonomics and quality improvement science: integrating approaches for safety in healthcare." BMJ quality & safety (2015): bmjqs-2014.

[ii] Workplace Safety & Health Topics. Center for Disease Control and Prevention. http://www.cdc.gov/niosh/topics/ergonomics/, accessed on March 17, 2015

[iii] Kohn, Linda T., Janet M. Corrigan, and Molla S. Donaldson, eds. To Err Is Human:: Building a Safer Health System. National Academies Press, 2000.

[iv] Karsh, B. T., et al. "A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional." Quality and Safety in Health Care 15.suppl 1 (2006): i59-i65.

[v] Carayon, Pascale, et al. "Human factors systems approach to healthcare quality and patient safety." Applied ergonomics 45.1 (2014): 14-25.

[vi] What is human factors and why is it important to patient safety? WHO Patient Safety Curriculum accessible at http://www.who.int/patientsafety/education/curriculum/who_mc_topic-2.pdf