Unfortunately, many health care professionals have never heard of HFE, let alone understand how its’ principles, methods, and tools can be readily used in health care systems to assist in realizing important outcomes like improved quality, reduced costs, and improved accessibility. As an introduction to human factors & ergonomics for health care professionals, I’ve provided a sample of books, chapters, articles, and presentations on the topic, along with some of the thought leaders working in this area.

Books: General

Casey, S. (2006). The atomic chef: And other true tails of design, technology, and human error. Santa Barbara, CA: Aegean Publishing Company.

Norman, D.A. (1988). The design of everyday things. New York, NY: Doubleday.

Vicente, K.J. (2003). The human factor: Revolutionizing the way people live with technology. New York, NY: Routledge.

Books: Health Care-Related

Carayon, P. (2012). Handbook of Human Factors and Ergonomics in Patient Safety (2nd Ed). Boca Raton, FL: CRC Press.

Dekker, S. (2011). Patient safety: A human factors approach. Boca Raton, FL: CRC Press.

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

Reid, P.P., Compton, W.D., Grossman, J.H., & Fanjiang, G. (Eds.) (2005). Building a better delivery system: A new engineering/health care partnership. Washington, DC: The National Academies of Science.

Stanton, N.A., Hedge, A., Brookhuis, K., Salas, E., Hendrick, H.W. (2004). Handbook of Human Factors and Ergonomics Methods. Boca Raton, FL: CRC Press.

Chapters

Morrow, D. G., North, R. A., Wickens, C. D. (2006) Reducing and mitigating human error in medicine. In R. Nickerson (Ed.), Annual Review of Human Factors and Ergonomics, vol. 1 (pp. 254-296). Santa Monica, CA: Human Factors & Ergonomics Society.

Articles

Buckle, P., Clarkson, P.J., Coleman, R., Ward, J., & Anderson, J. (2006). Patient safety, systems design and ergonomics. Applied Ergonomics, 27, 491-500.

Carayon, P. (2006). Human factors of complex sociotechnical systems. Applied Ergonomics, 37, 525-535.

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

Durso, F.T., & Drews, F.A. (2010). Health care, aviation, and ecosystems: A socio-natural systems perspective. Current Direction in Psychological Science, 19, 71-75.

Holden, R.J., & Karsh, B. (2009). A theoretical model of health information technology usage behaviour with implications for patient safety. Behaviour & Information Technology, 28, 21-38.

Leape, L.L. (2004, Summer). Human factors meets health care: The ultimate challenge. Ergonomics in Design, 6-12.

Salas, E., Baker, D., King, H., & Battles, J. (2006). Special section commentary: Opportunities and challenges for human factors and ergonomics in enhancing patient safety. Human Factors, 48, 1-4.

Schutz, A.L., Counte, M.A., & Meurer, S. (2007). Assessment of patient safety research from an organizational ergonomics and structural perspective. Ergonomics, 50, 1451-1484.

Vicente, K.J. (2008). Human factors engineering that makes a difference: Leveraging a science of societal change. Theoretical Issues in Ergonomics Science, 9, 1-24.

Presentations

Shaver, E.F. (2012, January 31). Human factors is vital for transforming health care in the 21st century.

Thought Leaders

Marilyn Sue Bogner, Ph.D., Institute for the Study of Human Error, LLC

Pascale Carayon, Ph.D., University of Wisconsin-Madison

Sidney Dekker, Ph.D., Griffith University

John Gosbee, M.D., M.S., Red Forest Consulting, LLC

Ben-Tzion Karsh, Ph.D., University of Wisconsin-Madison

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.

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.

Last November, the Institute for Medicine (IOM) issued a prepublication copy of a report entitled Health IT and Patient Safety: Building Safer Systems for Better Care. According to the press release, the purpose of the report is:

To protect Americans from potential medical errors associated with the use of information technology in patient care, a new report by the Institute of Medicine calls for greater oversight by the public and private sectors.  The report examines a broad range of health information technologies, including electronic health records, secure patient portals, and health information exchanges, but not software for medical devices.

The report is the outcome of efforts performed by the Committee on Patient Safety and Health Information Technology “…to review the evidence about the impact of health IT on patient safety and to recommend actions to be taken by both the private and public sectors.” (p. ix).  The report provides 10 recommendations, two of which specifically highlight human factors, although several others fall within the realm of the human factors and ergonomics discipline.  They are:

Recommendation 5: All health IT vendors should be required to publicly register and list their products with ONC, initially beginning with EHRs certified for the meaningful use program.

Recommendation 10: HHS, in collaboration with other research groups, should support cross-disciplinary research toward the use of health IT as part of a learning health care system. Products of this research should be used to inform the design, testing, and use of health IT. Specific areas of research include: (a) User-centered design and human factors applied to health IT; (b) Safe implementation and use of health IT by all users; (c) Sociotechnical systems associated with health IT; and (d) Impact of policy decisions on health IT use in clinical practice.

The report can be downloaded here.  Also, the briefing slides can be downloaded here (.pdf).

National Health Expenditure Accounts are estimates of the “… total annual dollar amount of health care consumption in the United States, as well as the dollar amount invested in medical sector structures and equipment and non-commercial research to procure health services in the future.”  Additional definitions, along with the methodology behind calculating these estimates can be found here (.pdf).

Some of the highlights include:

• Total health expenditure: $2,593.6 trillion
• Health consumption: $2,444.6 trillion
• Investment: $149 billion
• Per person expenditure: $8,402
• Percent of GDP: 17.9%
• Annual growth from 2009: 3.9%
• Private health insurance (as a % of NHE spending): 33%; 2.4% growth from 2009
• Medicare (as a % of NHE spending): 20%; 5.0% growth from 2009
• Medicaid (as a % of NHE spending): 15%; 7.2% growth from 2009

References

Martin, A.B., Lassman, D., Washington, B., Catlin, A., & the National Health Expenditure Accounts Team (2012). Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009. Health Affairs, 31, 1, 208-219.

ANSI Z535.6-2011, first published in 2006, was developed “…to complement the existing Z535 standards by addressing various aspects of the provision of safety information in collateral materials” (p. vii). Moreover, it was created to address the challenge of organizations using ANSI Z535.4, American National Standard for Product Safety Signs and Labels, as a substitute to format safety information provided in collateral materials. The latest edition was published on September 15, 2011 with an errata released on November 1, 2011.

Several changes have been incorporated in the latest edition. According to the forward:

“The 2011 edition of this standard was revised with minor clarifications and updated to permit the use of the safety alert symbol in the middle of a line of text. In addition, the definitions for “accident,” “harm,” and “incident” were refined across the Z535 series to more clearly delineate a separation between physical injury and other safety-related issues (e.g., property damage).” (p. ix)

Some additional changes include:

• Added “informative” and “normative” definitions.
• Added additional example embedded safety messages for (1) signal word panel and (2) safety alert symbol.
• Added “SAFETY INSTRUCTIONS” signal word and definition to Annex A.
• Removed “CAUTION” (without safety alert symbol) signal word from Annex A.
• Expanded the “Translations of Signal Words” from 16 to 29 in Annex B.

Last week, Dave Chase (@chasedave) wrote a guest post for TechCrunch entitled “Healthcare Field of Dreams In Idaho: Health System Opens Innovation Center” discussing the recent developments of the center. Specifically, the piece discusses some of the reasons why Dr. Pate (@drpatestlukes) joined St. Luke’s in 2009, the recent hiring of Tony Tomazic (@tonahawk) as the new Chief Transformation Officer, the venture philanthropy model being considered by Bill Boeger to fund potential projects, and benefits of it being located in Idaho.

One of the key passages that resonated with me is:

“There are innovation centers at pharmaceutical and insurance companies but they don’t possess the advantage of a direct connection with individuals and must take a broader view. By taking an approach that leads with the community and individuals, rather than an institution, there’s a great opportunity for technology companies to test their wares in the real world with St. Luke’s direct connection to individuals, community and business leaders critical to having a broad-based success.”

As a human factors and ergonomics professional, I appreciate the individual and community focus being pursued by St. Luke’s. As one might expect, this would include a strong emphasis on the patient – as it rightly should. But, it needs to extend beyond just focusing on the patient. Instead, it should utilize a comprehensive people-centered, process-oriented, systems approach to identify, understand and meet the needs, wants, and desires of people (e.g., patients, family members, physicians, nurses, support staff, etc.) in the health care system, along with the surrounding community, in order to realize maximum value. This, in turn, would be the catalyst for designing, developing, deploying, and testing innovative healthcare solutions.

Some additional notable points from the piece include:

• “…St. Luke’s is a microcosm of the U.S. healthcare system with large city hospitals down to small remote clinics.”
• “…a broader community-focused effort can demonstrate how new approaches can scale nationally across a wide array of settings.”
• “Providers realize that the most important member of the patient’s care team is the patient themselves as the 99% of their life when they are away from the healthcare provider is when they maintain or return to health.”

The Center for Innovation is an exciting opportunity, not only for the St. Luke’s Health System, but for the local community, the State of Idaho, our region, and the healthcare industry. Moreover, it has the potential to be a driving force in assisting the transformation of 21st century healthcare.

I look forward to seeing how St. Luke’s nurtures this opportunity from concept to reality.

I recently finished reading “Only the Paranoid Survive: How to Exploit the Crisis Points that Challenge Every Company and Career” by Andrew S. Grove.

Dr. Grove is one of the co-founders of Intel Corporation, where he served in a variety of roles including COO, President, CEO, and Chairman of the Board. Currently he serves as a Senior Advisor to the organization.

Even though the book was published 15 years ago, its’ many insights are just as relevant to the current business environment. While there are many passages that could be highlighted, one that really resonates is:

Your career is literally your business. You own it as a sole proprietor. You have one employee: yourself. You are in competition with millions of similar businesses: millions of other employees all over the world. You need to accept ownership of your career, your skills and the timing of your moves. It is your responsibility to protect this personal business of yours from harm and to position it to benefit from the changes in the environment. Nobody else can do that for you. (p. 6)

This advice is equally applicable to the high school student starting college, the young professional entering the job market in a challenging economy, and the established professional seeking to continuously navigate treacherous waters.

I encourage you to invest the necessary time to read and thoroughly study this book.

References

Grove, A.S. (1996). Only the paranoid survive: How to exploit the crisis points that challenge every company and career. New York, NY: Currency Book.

This was one of many recommendations emerging from an investigation of a multiple-vehicle accident that occurred in Gray Summit, Missouri on August 5, 2010.

The NTSB also released a Fact Sheet entitled “Putting the Brakes on Distracted Driving” (.pdf).

The topic of distracted driving is something I’ve posted about in the past.

• Team Training
• Distributed Simulation Training for Teams
• Synthetic Task Environments for Teams
• Event-Based Approach to Training (EBAT)
• Team Building
• Measuring Team Knowledge
• Team Communications Analysis
• Questionnaires for Distributed Assessment of Team Mutual Awareness
• Team Decision Requirement Exercise: Making Team Decision Requirements Explicit
• Targeted Acceptable Responses to Generated Events or Tasks (TARGETs)
• Behavioral Observation Scales (BOS)
• Team Situation Assessment Training for Adaptive Coordination
• Team Task Analysis
• Team Workload
• Social Network Analysis

References

Stanton, N.A., Hedge, A., Brookhuis, K., Salas, E., Hendrick, H.W. (2004). Handbook of Human Factors and Ergonomics Methods. Boca Raton, FL: CRC Press.

As a refresher, let’s start with a generally accepted definition of teams:

“…are composed of two or more individuals who (a) exist to perform organizationally relevant tasks, (b) share one or more common goals, (c) interact socially, (d) exhibit task interdependencies (i.e., work flow, goals, outcomes), (e) maintain and manage boundaries, and (f ) are embedded in an organizational context that sets boundaries, constrains the team, and influences exchanges with other units in the broader entity.” (Kozlowski & Bell, 2003, p. 334).

Below I have provided a sample of the books, chapters, and articles on the topic, along with some of the thought leaders conducting work in this area.

Books

Bowers, C., Salas, E., & Jentsch, F. (2006). Creating high-tech teams: Practical guidance on work performance and technology. Washington, D.C.: American Psychological Association.

Hackman, J.R. (2002). Leading teams: Setting the stage for great performances. Boston, MA: Harvard Business School Press.

Salas, E., & Fiore, S.M. (2004). Team cognition: Understanding the factors that drive process and performance. Washington, D.C.: American Psychological Association.

Stanton, N.A., Hedge, A., Brookhuis, K., Salas, E., Hendrick, H.W. (2004). Handbook of Human Factors and Ergonomics Methods. Boca Raton, FL: CRC Press.

Wageman, R., Nunes, D.A., Burruss, J.A., & Hackman, J.R. (2008). Senior leadership teams: What it takes to make them great. Boston, MA: Harvard Business School Press.

Chapters

Kozlowski, S. W. J., & Bell, B. S. (2003). Work groups and teams in organizations. In W. C. Borman, D. R. Ilgen, & R. Klimoski (Eds.), Handbook of psychology: Industrial and organizational psychology: Vol. 12 (pp. 333-375). London: Wiley.

Salas, E., Rosen, M. A., Burke, C. S., Goodwin, G. F., & Fiore, S. (2006). The making of a dream team: When expert teams do best. In K. A. Ericsson, N. Charness, P. J. Feltovich & R. R. Hoffman (Eds.), The Cambridge Handbook of Expertise and Expert Performance (pp. 439-453). New York: Cambridge University Press.

Salas, E., Stagl, K. C., & Burke, C. S. (2004). 25 years of team effectiveness in organizations: Research themes and emerging needs.  In C. L. Cooper & I.T. Robertson (Eds.), International review of industrial organizational psychology: Vol. 19 (pp. 47-92).  New York: John Wiley & Sons.

Salas, E., Stagl, K. C., Burke, C. S., & Goodwin, G. F. (2007). Fostering team effectiveness in organizations: Toward an integrative theoretical framework of team performance. In R. A. Dienstbier, J. W. Shuart, W. Spaulding, & J. Poland (Eds.), Modeling complex systems: Motivation, cognition and social processes: Nebraska Symposium on Motivation: Vol 51 (pp. 185–243). Lincoln: University of Nebraska Press.

Stagl, K. C., Salas, E., & Burke, C. S. (2007).  Best practices in team leadership: What team leaders do to facilitate team effectiveness.  In J.A. Conger & R.E. Riggio (Eds.), The practice of leadership: Developing the next generation of leaders (pp. 172-197).  San Francisco, CA: Jossey-Bass.

Articles

Burke, C. S., Stagl, K. C., Klein, C., Goodwin, G. F., Salas, E., & Halpin, S. M. (2006). What type of leadership behaviors are functional in teams? A meta-analysis. Leadership Quarterly, 17(3), 288-307.

Hulsheger, U. R., Anderson, N., & Salgado, J. F. (2009). Team-level predictors of innovation at work: A comprehensive meta-analysis spanning three decades of research. Journal of Applied Psychology, 94(5), 1128-1145.

Ilgen, D. R., Hollenbeck, J. R., Johnson, M., & Jundt, D. (2005). Teams in organizations: From input-process-output models to IMOI models. Annual Review of Psychology, 56, 517–543.

Klein, C., DiazGranados, D., Salas, E., Le, H., Burke, C.S., Lyons, R., & Goodwin, G.F. (2009). Does team building work? Small Group Research, 40, 181-222

Kozlowski, S. W. J., & Ilgen, D. R. (2006). Enhancing the effectiveness of work groups and teams. Psychological Science in the Public Interest, 7, 77–124.

Mathieu, J., Maynard, M.T., Rapp, T., & Gilson, L. (2008).  Team effectiveness 1997-2007: A review of recent advancements and a glimpse into the future.  Journal of Management, 34, 410-476.

McGrath, J.E., Arrow, H., & Berdahl, J.L. (2000).  The study of groups: Past, present, and future.  Personality and Social Psychology Review, 4, 95-105.

Salas, E., Cooke, N.J., & Rosen, M.A. (2008).  On teams, teamwork, and team performance: Discoveries and developments.  Human Factors, 50, 540-547.

Salas, E., DiazGranados, D., Klein, C., Burke, C.S., Stagl, K.C., Goodwin, G.F., & Halpin, S.M. (2008). Does team training improve team performance? A meta-analysis. Human Factors, 50, 903-933.

Thought Leaders

C. Shawn Burke, Ph.D.

J. Richard Hackman, Ph.D.

Steve W. J. Kozlowski, Ph.D.

Eduardo Salas, Ph.D.

Ruth Wageman, Ph.D.

“The purpose of this special issue is to introduce readers of the American Psychologist to recent theory and research on leadership. The articles are written by some of the leading theorists in the study of leadership and are intended to present an overview of much (although certainly not all) of the field as it exists today. The goal is not to present only the latest findings or cutting-edge research, but rather, to serve as a tutorial providing background that might whet readers’ appetites to read more.” (Sternberg, 2007, p. 1)

Prompted by concerns raised by Bennis (2007) about the need for leadership scholars to “…reframe the important questions about leadership,” Hackman and Wageman (2007) produced the following five questions:

Question 1: Not do leaders make a difference, but under what conditions does leadership matter?

Question 2: Not what are the traits of leaders, but how to leaders’ personal attribute interact with situational properties to shape outcomes?

Question 3: Not do there exist common dimensions on which all leaders can be arrayed, but are good and poor leadership qualitatively different phenomena?

Question 4: Not how do leaders and followers differ, but how can leadership models be reframed so they treat all system members as both leaders and followers?

Question 5: Not what should be taught in leadership courses, but how can leaders be helped to learn?

References

Bennis, W. (2007). The challenges of leadership in the modern world: Introduction to the special issue. American Psychologist, 62, 2–5. (.pdf)

Hackman, J.R., & Wageman, R. (2007). Asking the right questions about leadership: Discussion and conclusions. American Psychologist, 62, 43-47. (.pdf)

Sternberg, R.J. (2007). Forward to the special issue on leadership. American Psychologist, 62, 1.

Started in 2005 by the Usability Professionals’ Association “…to ensure that the services and products important to life are easier to access and simpler to use.”

Each year it has a different focus. This year the theme is: “Education: Designing for a Social Change.”

• Macroergonomic Organizational Questionnaire Survey (MOQS)
• Interview Method
• Focus Groups
• Laboratory Experiment
• Field Study and Field Experiment
• Participatory Ergonomics (PE)
• Cognitive Walk-Through Method (CWM)
• Kansei Engineering
• HITOP Analysis™
• TOP-Modeler©
• The CIMOP System©
• Anthropotechnology
• Systems Analysis Tool (SAT)
• Macroergonomic Analysis of Structure (MAS)
• Macroergonomic Analysis and Design (MEAD)

References

Stanton, N.A., Hedge, A., Brookhuis, K., Salas, E., Hendrick, H.W. (2004). Handbook of Human Factors and Ergonomics Methods. Boca Raton, FL: CRC Press.

“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” (Hendrick & Kleiner, 2002, p. 394).

Below I have listed a sample of the books, chapters, and articles on the topic, along with some of the thought leaders and research facilities conducting working in this area.

Books

Hendrick, H.W., & Kleiner, B.M. (2001). Macroergonomics : An introduction to work system design. Santa Monica, CA: Human Factors and Ergonomics Society.

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

Stanton, N.A., Hedge, A., Brookhuis, K., Salas, E., Hendrick, H.W. (2004). Handbook of Human Factors and Ergonomics Methods. Boca Raton, FL: CRC Press.

Chapters

Hendrick, H.W. (2007). Macroergonomics: The analysis and design of work systems. In D.A. Boehm-Davis (Ed.), Reviews of Human Factors and Ergonomics, Vol. 3 (pp. 44-78). Santa Monica, CA: Human Factors and Ergonomics Society.

Articles

Applied Ergonomics Special Issue Devoted to Macroergonomics (2008)

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.

Karsh, B., & Brown, R. (2010). Macroergonomics and patient safety: The impact of levels on theory, measurement, analysis and intervention in patient safety research. Applied Ergonomics, 41, 674-681.

Karsh, B., Holden, R.J., Alper, S.J., & Or, C.K.L. (2006). 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 I), i59-i65.

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.

Thought Leaders

Hal W. Hendrick, Ph.D. (1933-2011)

Brian Kleiner, Ph.D. (Virginia Tech)

Andrew S. Imada, Ph.D. (A.S. Imada & Associates)

Ben-Tzion Karsh, Ph.D. (University of Wisconsin-Madison)

Research Facilities

University of Wisconsin-Madison MacroErgonomics Safety and Health Laboratory

Virginia Tech Macroergonomics and Group Decision Systems Laboratory

Later this month, the 2nd Edition of the Handbook of Human Factors and Ergonomics in Health Care and Patient Safety will be published by CRC Press. The book is edited by Pascale Carayon and includes the following chapters:

Introduction

• Human Factors and Ergonomics in Health Care and Patient Safety
• Opportunities and Challenges in the Pursuit of Patient Safety
• Embedded Risks and Challenges of Modern Health Care and the Urgent Call for Proactive Human Factors

Macroergonomics and Systems

• Historical Perspective and Overview of Macroergonomics
• Work System Design in Health Care
• Error as Behavior and Murphy’s Law: Implications for Human Factors and Ergonomics
• Organizational Learning in Health Care
• The Relationship between Physician Professionalism and Health Care Systems Change

Job and Organizational Design

• The Effect of Workplace Health Care Worker Stress and Burnout on Patient Outcomes
• Safety Culture in Healthcare
• Handoffs and Transitions of Care
• High-Reliability Organizations in Health Care
• The Relation between Teamwork and Patient Safety
• Health-Care Work Schedules

Physical Ergonomics

• The Physical Environment in Health Care
• Assessment and Evaluation Tools for Health-Care Ergonomics: Musculoskeletal Disorders and
• Patient Handling

Technology

• Human Factors and Ergonomics of Health Information Technology Implementation
• Human–Computer Interaction Design in Health Care
• Trust in Health Technologies
• Human Factors in Telemedicine
• Using Health IT to Improve Health Care and Patient Safety

Human Error

• Human Error in Health Care
• Medical Failure Taxonomies
• Human Error Reduction Strategies in Health Care
• Communicating about Unexpected Outcomes, Adverse Events, and Errors
• Human Factors Engineering of Health Care Reporting Systems
• Error Recovery in Health Care

Human Factors and Ergonomics Methodologies

• Cognitive Work Analysis in Health Care
• Human Factors Risk Management for Medical Products
• Human Factors Analysis of Workflow in Health Information Technology Implementation
• Video Analysis: An Approach for Use in Health Care
• Usability Evaluation in Health Care
• Medical Simulation
• Simulation-Based Training for Teams in Health Care: Designing Scenarios, Measuring Performance, and Providing Feedback

Human Factors and Ergonomics Interventions

• Ergonomics Programs and Effective Implementation
• Work Organization Interventions in Health Care
• Team Training for Patient Safety
• Human Factors Considerations in Health IT Design and Development
• Human Factors and Ergonomics in Patient Safety Management

Specific Applications

• Human Factors and Ergonomics in Intensive Care Units
• Human Factors and Ergonomics in the Emergency Department
• Human Factors and Ergonomics in Pediatrics
• Human Factors and Ergonomics in Home Care
• Human Factors and Ergonomics in Primary Care
• In Search of Surgical Excellence: A Work Systems Approach
• Human Factors and Ergonomics in Medication Safety
• Human Factors and Ergonomics in Infection Prevention
• Human Factors in Anesthesiology