Human Factors is Vital for Transforming Health Care in the 21st Century

January 31, 2012 by · Leave a Comment
Filed under: health care, human factors, innovation 

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Human Factors as an Innovation for Patient Safety

January 28, 2012 by · Leave a Comment
Filed under: health care, human factors, innovation 

In 2010, Pascale Carayon published an article in Applied Ergonomics entitled Human Factors in Patient Safety as an Innovation.

It’s an important article for a couple reasons. First, it provides one of the best justifications I’ve seen for why Human Factors and Ergonomics (HFE) should be considered an innovation. As the article notes, this is important to assist with “…the uptake and use of HFE tools, methods, concepts and theories in order to speed up and improve patient safety efforts” (p. 657).

Second, it provides a list of recommendations for HFE professionals, researchers, and educators that should be heeded “…in order to improve the spread of HFE innovations for patient safety” (p. 663). The only thing I would add is that most of the recommendations shouldn’t be constrained just too patient safety. Instead, they are mostly applicable to all aspects of health care, let alone other industries where HFE efforts have been implemented.  The recommendations include:

HFE Professionals

  • Be aware of barriers to systems thinking; develop approaches for dealing with those barriers
  • Know the complexity of HFE tools and methods; appropriately simplify HFE tools and methods
  • Use an incremental approach to implementation of HFE innovations: from simple to complex; from low to high knowledge
  • Use HFE knowledge to improve work and working conditions of healthcare professions
  • Work on patient safety projects with healthcare organizations that have strong leadership, strategic vision and climate conducive to experimentation and risk
  • Be aware of professional boundaries and social networks within healthcare organizations
  • Conduct significant preparation work before applying HFE tool and method, including assessing potential impact of HFE innovation and evaluating support and resources
  • Be aware of innovation adoption stages (i.e. awareness, information and training, and feedback); adapt HFE innovation to the adoption stage
  • Be flexible
  • Evaluate patient safety impact of HFE innovations
  • Get involved in healthcare policy development
  • Communicate with healthcare leaders and top managers about HFE and its (potential) benefits for patient safety; establish formal programs for disseminating HFE in healthcare and patient safety; work with ‘boundary spanners’ [For national and international HFE associations]
  • Share best practices and lessons learned about patient safety improvement projects

HFE Researchers

  • Develop evidence of the impact of HFE innovations on patient safety: criteria, research designs, generalizability, role of context
  • Develop and test simple, reliable and valid HFE tools and methods
  • Conduct research on significant patient safety issues
  • Develop models and theories about mechanisms between work system characteristics and other HFE variables and patient safety
  • Disseminate research results to different types of healthcare organizations (e.g., small and large hospital)
  • Work on multidisciplinary research projects
  • Conduct action research with cycles of learning and feedback
  • Develop HFE tools and methods adapted to different healthcare settings and to the complexity and cultural and structural characteristics of healthcare organizations
  • Get involved in healthcare policy development

HFE Educators

  • Teach about healthcare culture (e.g., scientific inquiry)
  • Teach diverse knowledge of HFE
  • Teach about working in multidisciplinary teams
  • Teach about innovation process and stages of adoption
  • Develop HFE students’ ability to deal with uncertainty and ambiguity in innovation process
  • Teach communication skills, in particular communication with top management and leadership
  • Encourage HFE students to work on practical projects in healthcare
  • Train healthcare professionals in HFE
  • Teach HFE students how to be change agents

References

Carayon, P. (2010). Human factors in patient safety as an innovation. Applied Ergonomics, 41, 657-665.

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Introduction to Macroergonomics

According to Hendrick and Kleiner (2002), macroergonomics is “the subdiscipline of ergonomics that focuses on the design of the overall work system.  Conceptually, a top-down sociotechnical systems approach to the design of work systems and the carry-through of the overall work system characteristics to the microergonomic design of human-job, human-machine, and human-software interfaces to ensure that the entire work system is fully harmonized” (p. 394).  A work system consists of (1) personnel subsystem, (2) technological subsystem, (3) internal environment, (4) organization and management; and (5) external environment (Kleiner, 2008).

Hal W. Hendricks is considered the father of macroergonomics based on work he performed in the 1980s and 1990s, but its roots extend to research in sociotechnical systems theory from the 1940s and 1950s (Hendrick & Kleiner, 2002, p. 14).

Macroergonomic principles have been applied to a variety of industries, including:

  • Aviation
  • Construction
  • Food
  • Health Care
  • High-Technology
  • Manufacturing
  • Petroleum
  • Trucking

Interested readers are encouraged to review the following references to learn more about macroergonomics:

Hendrick, H.W., & Kleiner, B.M. (2002).  Macroergonomics: Theory, methods, and applications. Mahwah, New Jersey: Lawrence Erlbaum Associates.

Haro, E., & Kleiner, B.M. (2006).  Macroergonomics as an organizational process for systems safety.  Applied Ergonomics, 39, 450-458.

Holden, R.J., Or, C.K.L., Alper, S.J., Rivera, A.J., & Karsh, B-T. (2008).  A change management framework for macroergonomic field research.  Applied Ergonomics, 39, 459-474.

Kleiner, B.M. (2004).  Macroergonomics as a large work-system transformation technology.  Human Factors and Ergonomics in Manufacturing, 14, 99-115.

Kleiner, B.M. (2008).  Macroergonomics: Work system analysis and design.  Human Factors, 50, 461-467.

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Dan Buettner on Universal Lifestyle Behaviors

January 24, 2012 by · Leave a Comment
Filed under: behavior, health care 

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The Rise of the e-Patient

January 19, 2012 by · Leave a Comment
Filed under: health care, innovation 

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