CPD modules: Human Factors

You are free to download, print and study the modules. These modules on human factors do not have tests attached to them. They are for CPD but reflection is a better mode of recording your learning with these articles.

Human Factors How to Guide 

The purpose of this guide is to provide an introduction to the concept of human factors in healthcare and provide suggestions of how its elements can be applied by individuals and teams working to improve patient safety. It aims to build awareness of the importance of human factors in making changes to improve patient safety.

 

Human factors in anaesthesia: lessons from aviation 

Aviation safety has evolved over more than a century and has achieved remarkable results. Applying some of the lessons learned may help make healthcare safer. Although many of the ingredients for safe operation are frequently already present in our hospitals, and some individual clinical areas and departments achieve high levels of reliability and safety, we cannot expect improvements in human factors training and awareness to be fully effective in the healthcare setting without the parallel development of a simple and strong safety system across organizations. In the process, we may find that the safe hospital turns out somewhat differently to the safe airline.

 

Patient safety: latent risk factors 

The systems-centred approach assumes that humans are fallible and that systems must be designed so that humans are prevented from making errors. The factors that make errors more likely,
or more dangerous, can be characterized as latent risk factors (LRFs). Understanding how LRFs affect safety can enable us to design more effective control measures.

 

Improving patient safety in the operating theatre and perioperative care 

Human factors are major contributors to errors in healthcare that can impact patient safety. Improvements in the safety and outcomes of hospitalized patients have been slower than expected but
healthcare team-based approaches, including simulation, standardization, and training, could further improve patient safety.

 

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Human factors in complex trauma 

The establishment of major trauma centres around the UK has led to the concentration of trauma experience in key hospitals. Human factors such as communication, situational awareness, team working, and decision-making are all key to the timely assessment and treatment of a complex trauma patient. This article describes some of the key human factors required by the trauma team with notorious pitfalls and strategies to avoid them.

 

Beyond monitoring: distributed situation awareness in anaesthesia

Situation awareness (SA) is one of the essential non-technical skills for effective and safe practice in high-risk industries, such as healthcare; yet, there is limited research of
its significance in anaesthetic practice. This paper,  reviews this scant research that focuses on SA as patient monitoring alone and advocates for a more comprehensive view
of SA in anaesthetic practice and training that extends beyond monitoring, namely, a distributed cognition approach.

 

Human factors in the management of the critically ill patient

Unreliable delivery of best practice care is a major component of medical error. Critically ill patients are particularly susceptible to error and unreliable care. Human factors analysis, widely used in industry, provides insights into how interactions between organizations, tasks, and the individual worker impact on human behaviour and affect systems reliability. We adopt a human factors approach to examine determinants of clinical reliability in the management of critically ill patients

 

Lessons from the battlefield: human factors in defence anaesthesia

Anaesthetists in the Defence Medical Services spend most of their clinical time in the National Health Service and deploy on military operations every 6–18 months. The deployed operational environment has a number of key differences particularly as there is more severe trauma than an average UK hospital and injury patterns are mainly due to blast or ballistics. Equipment may also be unfamiliar and there is an expectation to be conversant with specific standard operating procedures. Anaesthetists must be ready to arrive and work in an established team and effective non-technical skills (or human factors) are important to ensure success. This article looks at some of the ways that the Department of Military Anaesthesia, Pain and Critical Care prepares Defence
Anaesthetists to work in the deployed environment and focuses on the importance of human factors.

 

Interaction between anaesthetists, their patients, and the anaesthesia team

Communication is a key skill for anaesthetic practice. The ‘non-informational’ aspects of communication, such as non-verbal elements and the degree to which the style of communication reflects the implied relationship between the sender and the recipient, are relevant to interactions both between anaesthetists and patients and to interactions with other members of staff in the team.

 

Human factors and the safety of surgical and anaesthetic care

Safety of patients in the operating theatre relies on a cordial and efficient working relationship between all members of the theatre team. A team that communicates well, defines the roles of its members and is aware of their limitations will provide safe patient care. In this review, we will examine how human factors engineering – the science of how to design processes, equipment and environments to optimise the human contributions to performance – can be used to improve safety and efficiency of surgery. Although these are often dismissed as ‘common sense’, we will explain how these solutions emerge not from healthcare but from diverse disciplines such as psychology, design and engineering.