Importance Of Human Factors In Healthcare

Principles of Human Factors in Healthcare

Question:

Discuss about the Human Factors And Workplace.

Human factors are attributes in a healthcare work environment which helps in enhancing clinical performance. Safe clinical practice can be developed by effects of combined teamwork’s, tasks, proper equipment, workspace, organizational culture and others on the human behaviour as well as the abilities of the stakeholders involved in healthcare (Carayon et al., 2014). It also involves application of proper knowledge in the clinical settings for maintenance of safety and care in the healthcare of patients. The domain is also called ergonomics. Ergonomics is defined by researchers as the established discipline of science that underpins current patient safety and helps in the improvement of quality of care (Holden et al., 2013). It also contains providing an integrated as well as evidence and coherent approach to patient safety and clinical excellence.

The principles of the human factors are based on optimizing different human performance by better understanding of the different types of behaviors of individuals. It takes into consideration their interactions with each other so that human frailties can be minimized as well as mitigated. This in turn helps in reducing medical errors and thereby prevents adverse consequences lie patient death, negative outcomes, harms and longer stays at hospitals (Russ et al., 2013). The adoption of this science in a healthcare ensures cultural changes and also empowers not only the professionals but also the organization to put clinical excellence and patient safety at the heart. Moreover it is also seen that human factor principles are helpful in proper identification as well as assessment and management of different types of risks associated with patient safety. Thereby incidents can be analyzed to identify learning as well as corrective actions. Hignett and Wolf have stated in 2016 that human factors understanding and its various techniques associated with human factors are extremely helpful in informing quality improvement teams and different services along with the support change management. They also help to emphasize the importance of the design of the equipments, associated procedures and different processes (Clack & Sax, 2017).

Human factors mainly provide importance to four important components.  They are the user and person centered design which ensures that health care in provided in such way which suits the people. The third component is the tasks which are allocated and also aligns with the fourth component which is the environment which remain involved during healthcare (Wilson, 2014). It ensures that the care which is provided should be effective, safe and also efficient. International Ergonomics Association has stated that “[Human factors] is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data, and other methods to design in order to optimize human well-being and overall system performance” in 2010. The main components of human factors are knowledge about human behaviors, their limitations and abilities which are important to shape the care to be provided to patients who comes from different backgrounds and with different needs. De Vault et al., (2014) has stated that it also involves other characteristics which are important to design different systems, tasks and activities, environments a well as different technologies and equipments. Moreover human factors also have the components that involve proper designing of trainings programs as well as instructional materials which will develop and support the different performance of the tasks or use the technology or equipments (Vincent & Blandford, 2017).

Components of Human Factors

A model for human factors which was proposed by Csaza in the year 2001 can be discussed here in order to make the concept easier to understand.

This model contains persons who are involved in the healthcare management like the care recipients and the care givers. Secondly it contains the task in which they are engaged. Here a case study for diabetes management in an old man in home is taken.  Therefore the tasks applied  is blood glucose monitoring, help with activities of daily life regularly and others, the equipment or technology which are important to conduct the tasks as well as the environments in which the task are taking place. This may be community, social, physical and others. Different people have different levels of knowledge’s, skills, abilities, education, preferences, inhibitions, health conditions and attitude (Cook et al., 2014). These are inculcated by them in their practices that impact the care. As a result different individuals’ interact with the tasks and equipments differently due to their cognitive, physical or perceptual capabilities.  Herlihey et al., (2016) has stated that the type and magnitude of different factors like sensory, cognitive and physical demands that the take an equipment imply on people may vary and are directly associated with personal capabilities of the professionals and also the care receivers.

Avery good example of the integration of human factors can be provided with the help of a case study. An old man residing in home along with his old wife needs to use glucometer to check his blood glucose level. A nurse at a distant clinic checks the data with a telemonitoring machine. Here the old man is the service user, the old woman and the nurses are the caregiver, the glucometer and the telemonitoring machine are the equipments and the task is properly checking blood glucose level and properly conducting the care through the telemonitoring device. The old man may face difficulty in doing the task may be due to his lack of vision, health literacy, inability to remember the use of the device and others. The wife may also not be able to provide proper care to her husband and may not handle the telemonitoring equipment properly which requires ability to read the display, remembering operating options and others. The environment may also come to play which may be rural or may not have internet access. All these may lead to several errors which may hamper the health of the individual leading to adverse situations. Therefore the human factor interaction needs to fit among the different system components in order to develop efficiency, safety and effectiveness of the components so that the symptoms of the disorder are properly managed and quality of life get better. If the fit remains poor, the patients may develop complications which would require him to be hospitalized associated with poor quality life and longer stays at hospitals.

User-centered Design

Different components can be obtained if human factors are dissected into several sections. Researchers are of the opinion that organizational factors involve culture, manager’s leadership and communication. It has been tried nowadays by a large number of healthcare organizations to modify the culture of safety in such a way that the organization’s design process and workforce can develop clear goal (Kushiniruk et al., 2014). This goal should be clear to all individuals for the dramatic improvement in the safety as well as reliability o the care process. Safety interventions or change in the organizational culture to maintain safety should be addressed for not only patients but also for workers and therefore different safety culture tools can be used by the organization to evaluate the success of the change culture in the organization. Another factor as stated by researchers Wahr et al., (2013) is managerial leadership which can productively impose direct efforts in the healthcare setups. This would help in fostering a culture and commitment which the professionals need to address for the underlying causes of medical errors and harms to service users. They should tale workarounds for monitoring the work of other team members; help them in handling equipments, developing the skills of team members and other to ensure patent safety. They should emphasize safety over productivity and also adopt a centralized style for implementing the right human factors. They also become involved in safety initiatives and should really corporate visions for safety supervisors. Also ensuring compliance over regulatory requirements, providing resources for safety programs showing concern for people and also showing consistent commitment for safety should be conducted by leaders. Communication is yet another component of human factors that need to be handed efficiently. A failure of communication leads to adverse events on patients leading to compromising safety of patients. Researchers have reported that safe and effective delivery of health services needs proper communication between individuals serving different riles, experience and training an also perspectives of care. Some issues created by improper communication are clinical handovers, delegations, quality of information documented in patient files, incident reports, power struggles preventing juniors from speaking up and others. Moreover organizational failures, transmission failures, reception failures and others may be prevented with proper following human factor models.

Researchers have stated that a proper team work may help in decreasing the rate of errors and increasing the quality o care provided to patients.  A team should comprise of an efficient team leaders who should have the right amount of knowledge, skill, attitudes. Je should follow a proper leadership style and personality that would encourage the members to abide by safety rules and practices the best evidence based care. The leaders should ensure proper interventions for making the team members knowledgeable, skillful and portray the correct work attitude and personality. The main dynamics which would be benefitted by a proper team work would be goal comprehension where all the members should have a shared understanding of goals and thereby aligning with common objectives to meet the goal. Moreover proper communication, conflict management, proper decision making are also ensured by high quality team work (Hoffman et al., 2013). A proper division of tasks according to specialty of team members and their performance evaluation depends on the leaders. Effective leadership, process monitoring and giving proper feedback would ensure maintain quality care for patents.

Task Allocation

Many researchers are also of the opinion that at the individual level, situation awareness is another component which can b described as the perception of elements in the environment within a particular volume of time and space and proper comprehension of the meanings and thereby the correct projection of the status in the future. Ever individual should be always on toes constantly monitoring what is going on along with the perceptions like what is going to happen in coming moments and others. Being always alert and active will help to avoid many occurrences of errors in patient care. Increasing interest in attention skills (healthcare professionals being more attentive in workplace) in the workplace can be helped by rapid development of different types of computer based monitoring systems as well as other technological advances (Machida et al., 2014). They are very much helpful in providing service to distant patients. Failures in situation awareness can lead to preventable deaths and longer stays of patients in hospitals and also cues the organization to spend resources which could have been avoided.

Another component which acts an individual level is decision making capability which is very much essential preventing errors.  Often improper decisions made at critical timing may result in not only harm to the patient’s condition but may also involve professionals in legal and ethical battles which may harm the career of the healthcare professional. Not only that, reputation of the organization may also be compromised. Therefore proper decision making is one of the major components of human factors which need to be mastered properly (Youngson et al., 2015). Two stages of decisions making are diagnosing the situation effectively and the providing logical reasoning to choose the course of action followed by accomplishments. Researchers have stated four different types of decisions aiming. The first one is the recognition primed decision making process where the situation is first recognized and then action is performed after recalling from memory. The next is the rule based method where decisions are taken as per rule book after situation is identified. Other methods are choice through comparison of options where the best option for action among many is selected which is found to be the best. The last one is the creative method where a new course of action be devised (Harte et al., 2017).

Stress is one of the most important human factors that often affect service delivery of different organization.  Occupational stress often takes place among different healthcare professionals which relate to workload, improper time off as well as restricted autonomy of healthcare staffs. This may results in emotional exhaustion as well as aversion to work for patients. These in turn lead to different types of work errors and feelings of discomfort. It also results in reduced productivity, physical and mental ailments and also in poor team performance. These failures to cope with work pressure causes medical errors to occur which may affect patient safety (Weaver et al., 2016).

Environmental Factors

It is extremely important to consider human factors and its effect on healthcare settings as it has an intrinsic relationship with patient safety and quality service. The care recipients, caregivers, tasks are allocated; equipments and technologies are important parts where the system needs to fit in properly with no errors for uninterrupted service to patients. Proper organizational culture, managerial leaderships and communication need to be monitored to maintain safety and quality in the organizations. Moreover, at an individual level, proper decision making skill and proper handling of stress may help the professionals to develop skills which will ensure decrease in error and increase in quality of care. Moreover proper teamwork will help in developing a work culture where occurrence of errors can be eliminated and workplace culture can be developed in such a way that the health care industry becomes the best service providing industry in the global outlook.

References:

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics, 45(1), 14-25.

Carthey, J. (2013). Implementing Human Factors in Healthcare:‘How to’Guide–Volume 2 ‘Taking Further Steps’. London: Patient Safety First.

Clack, L., & Sax, H. (2017). Annals for Hospitalists Inpatient Notes-Human Factors Engineering and Inpatient Care—New Ways to Solve Old ProblemsInpatient Notes: Human Factors Engineering and Inpatient Care. Annals of Internal Medicine, 166(8), HO2-HO3.

Cook, T. M., Andrade, J., Bogod, D. G., Hitchman, J. M., Jonker, W. R., Lucas, N., … & Paul, R. G. (2014). 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent, and medicolegal issues. British journal of anaesthesia, 113(4), 560-574.

DeVault, D., Artstein, R., Benn, G., Dey, T., Fast, E., Gainer, A., … & Lucas, G. (2014, May). SimSensei Kiosk: A virtual human interviewer for healthcare decision support. In Proceedings of the 2014 international conference on Autonomous agents and multi-agent systems (pp. 1061-1068). International Foundation for Autonomous Agents and Multiagent Systems.

Harte, R., Glynn, L., Rodríguez-Molinero, A., Baker, P. M., Scharf, T., Quinlan, L. R., & ÓLaighin, G. (2017). A human-centered design methodology to enhance the usability, human factors, and user experience of connected health systems: a three-phase methodology. JMIR Human Factors, 4(1).

Herlihey, T. A., Gelmi, S., Flewwelling, C. J., Hall, T. N., Bañez, C., Morita, P. P., … & Hota, S. (2016). Personal protective equipment for infectious disease preparedness: a human factors evaluation. infection control & hospital epidemiology, 37(09), 1022-1028.

Hignett, S., & Wolf, L. (2016). Reducing inpatient falls: Human Factors & Ergonomics offers a novel solution by designing safety from the patients’ perspective. International journal of nursing studies, 59, A1-A3.

Hoffman, R. B., Segal, C. G., Foster, J. A., & Rhoads, L. C. (2013, June). Adaptation of the human factors analysis and classification system to patient safety studies. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 2, No. 1, pp. 108-113). Sage CA: Los Angeles, CA: SAGE Publications.

Holden, R. J., Carayon, P., Gurses, A. P., Hoonakker, P., Hundt, A. S., Ozok, A. A., & Rivera-Rodriguez, A. J. (2013). SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics, 56(11), 1669-1686.

Kushniruk, A., Kaipio, J., Nieminen, M., Hyppönen, H., Lääveri, T., Nohr, C., … & Borycki, E. (2014). Human Factors in the Large: Experiences from Denmark, Finland and Canada in Moving Towards Regional and National Evaluations of Health Information System Usability: Contribution of the IMIA Human Factors Working Group. Yearbook of medical informatics, 9(1), 67.

Machida, K., Mikami, S., Masutani, M., Mishima, K., Kobayashi, T., & Imataka, H. (2014). A translation system reconstituted with human factors proves that processing of encephalomyocarditis virus proteins 2A and 2B occurs in the elongation phase of translation without eukaryotic release factors. Journal of Biological Chemistry, 289(46), 31960-31971.

Russ, A. L., Fairbanks, R. J., Karsh, B. T., Militello, L. G., Saleem, J. J., & Wears, R. L. (2013). The science of human factors: separating fact from fiction. BMJ Qual Saf, 22(10), 802-808.

Vincent, C. J., & Blandford, A. (2017). How do health service professionals consider human factors when purchasing interactive medical devices? A qualitative interview study. Applied ergonomics, 59, 114-122.

Wahr, J. A., Prager, R. L., Abernathy, J. 3., Martinez, E. A., Salas, E., Seifert, P. C., … & Sanchez, J. A. (2013). Patient safety in the cardiac operating room: human factors and teamwork. Circulation, CIR-0b013e3182a38efa.

Weaver, C. A., Ball, M. J., Kim, G. R., & Kiel, J. M. (2016). Healthcare information management systems. Cham: Springer International Publishing.

Wilson, J. R. (2014). Fundamentals of systems ergonomics/human factors. Applied ergonomics, 45(1), 5-13.

Youngson, G., Paterson-Brown, S., & Russ, S. (2015). Response to:‘Lack of standardisation between specialties for human factors content in postgraduate surgical training: an analysis of specialty curricula in the UK’by Greig et al. BMJ Qual Saf, bmjqs-2015.