In my experience, Human Factors as a term sometimes prompts a vague look from people. If that is the case, I mention ergonomics instead because this may be more familiar to some.

The word ergonomics is derived from the Greek words, ergon (work) and nomis (law) and is often used in relation to the physical aspects of the environment, such as workstations, while ‘human factors’ is often used in relation to the wider system in which people work but both terms can be used interchangeably.

Human Factors (or ergonomics) involves designing and evaluating tasks, jobs, equipment, environments and systems, via measurements, observations and conversations and making them more compatible with the capabilities and limitations of staff to help them avoid working in an uncomfortable, stressful or dangerous way. My role highlights where Human Factors knowledge is essential and which enables me to advise on most acceptable systems.

Human Factors requires systems thinking. A system are things or parts that function together to fulfil a purpose. The healthcare system, a communications system, mobile phones, are all systems. The essential component of any system is the person because it produces and uses it.

When an error occurs, one ought not focus solely on human failings, but on the surroundings that allowed such events to transpire. For example, surgical checklists can prevent some adverse events, but they need to be carefully designed and further interventions may be required such as the creation of more usable and safer medical devices.

The Hierarchy of Intervention Effectiveness (Hackett, 2018) below demonstrates that in isolation, system-focused interventions are more effective than people-focused interventions.

Human Factors can improve human performance, optimise well-being, improve staff and patient safety and experience and improve overall system performance by:

• Identifying both systemic and individual errors when investigating near misses and incident causes. This is possible by building upon current Root Cause Analysis methodology used to investigate Serious Incidents, thereby avoiding a ‘blame culture’.

• Studying the interaction between staff and hardware, software, websites and mobile devices (Human-Computer Interaction) to create a positive user experience. This is relevant to clinical staff using tablets and mobile phone apps during patient care.

• Investigating the physical impact of work on the human body and applying the fundamentals of anthropometry (measurement of the size and proportions of the human body) when evaluating and improving work activities. For example, midwifery may involve bending, lifting and holding the body in fixed positions for long time periods.

• Considering dust and vibration, and risk factors such as manual handling and minimising and managing physical health risks at work, which is relevant when preparing medicines using the correct Personal Protective Equipment.

• Measuring and understanding the effects of the physical environment on staff, including the effects of noise, vibration, heat, cold, thermal comfort, vision and lighting. For example, the comfort of non-clinical staff in an open-plan office.

Regarding adoption and spread, Human Factors innovations are more likely to be adopted if adopters “are aware of the innovation; have sufficient information about what it does and how to use it; and are clear about how the innovation will affect them personally” (Greenhalgh, et al., 2004).

In spreading Human Factors innovation, it is important to clarify what needs to be communicated to the targeted audience, such as information about the scientific evidence of innovations, or knowledge on the feasibility of a Human Factors method. Any dissemination programme should be formally evaluated in relation to its objectives and intermediate milestones (Carayon, 2010). Organisations such as the Academic Health Science Network have a role to play in establishing and implementing efforts for disseminating Human Factors in healthcare and patient safety.

Healthcare is complex and Human Factors acknowledges human fallibility and the inevitability of human error, but harm is not inevitable if the workplace and objects within it are designed to minimise the likelihood of error or its consequence.

Richard’s role will focus on providing Human Factors support as an enabler within the Patient Safety Collaborative (PSC) adopt and spread workstream. He welcomes conversations from PSC colleagues who wish to discuss Human Factors support. You can contact him by phone 01223 661 499 or email him at This email address is being protected from spambots. You need JavaScript enabled to view it.

Author

Richard Goorney