1. HUMAN FACTORS
Dr Rona Patey
Consultant Anaesthetist NHS Grampian
Head of Division of Medical and Dental Education
University of Aberdeen

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% 0
8. Human resources of
11% 100
9. Other
11%

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. 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. Things don’t always go right!

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. 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. 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. 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. Wrist
Admitted On 5
fracture six
with UTI Medications
months ago
Mobilises with
a frame Lack of
staff training
Accident
Trajectory
Patient Drug Chart
Condition Medical Records Ward
Workforce &
Environment
Communication
The latent failure model of complex system failure
modified from James Reason, 1997

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. 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. Lessons from other industries
15/1/2009
Flight 1549
Routine flight from New
York to Charlottesville

14. What about healthcare?

17. ANTS System
Categories Elements + Confirms roles and responsibilities of
team members
+ Discusses case with surgeons or
Task  Planning and preparing
colleagues
Management  Prioritising + Considers requirements of others
 Providing and maintaining standards before acting
+ Co-operates with others to achieve
 Identifying and utilising resources
goals
Team  Co-ordinating activities with team members Example behaviours for
Working  Exchanging information good practice
 Using authority and assertiveness
 Assessing capabilities
 Supporting others Example behaviours for
poor practice
Situation  Gathering information − Reduces level of monitoring because
Awareness  Recognising and understanding
of distractions
 Anticipating − Responds to individual cues without
Decision  Identifying options confirmation
− Does not alter physical layout of
Making  Balancing risks and selecting options
 Re-evaluating workspace to improve data visibility
− Does not ask questions to orient self to
situation during hand-over

19. Taking a human factors approach
A healthcare example?

20. Human Factors
http://www.chfg.org/
‘about making it easier to do the right job’
Martin Bromiley

21. 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