Human Factors Scoping Study Nicola Davey & Heather Shearer

1. Human Factors Scoping Study Nicola Davey & Heather Shearer NHS Institute for Innovation and Improvement Harry Blanchard & Finola Austin Human Engineering Ltd.

2. Scoping Study • What we studied • HF training provision • NHS views on HF training requirements • NHS trust experiences in developing a human factors capability • What we explored further • HF skills and capabilities • HF capacity & capability in the NHS • What next? • HF outside of the high tech arena

3. Complementary HF strands • Person-level human factors • Communication & decision-making • Risk aware • Managing stress and fatigue • Team work • Leadership • Practical • Developed for particular groups of practitioners • Reflecting demands & experiences of medical specialisms. • System-level human factors • Incident investigation • Assessment of new procedures • Design • Repertoire of management responses to human-related risks • Closely related to • Systems-engineering • Safety governance in organisations.

4. Trends in HF training provision • Primarily in person-level human factors • Moving towards splitting the course delivery between a main session and a follow-up session later • Moving towards training multidisciplinary teams who routinely work together to deliver care • Exploring delivery through interactive or digital media • Steps towards some type of assessment

5. What HF training is out there?

6. One option….

7. Gaps in Human Factors training provision in the NHS • Absence of a human factors strategy at a national level to support local capability building • Availability of resources (staff time, cost) • Limited system-level training provision • Limited access to training outside of critical care and surgery

8. What we explored further • HF capacity & capability in the NHS • A conceptual model to provoke discussion and further thinking • HF outside of the high tech arena • Boundaried and non-boundaried settings • Absence of artifact descriptors in non-boundaried settings

9. Conceptual Model: Different Levels of Human Factors Proficiency HF skills and capabilities

10. Capacity and capability: a conceptual Model Human factors proficiency requirement Person-level System-level Typical roles Nurse Doctor Pharmacist 2 - Application 1 - Awareness Sister/Matron Consultant 2 - Application 1 - Awareness Clinical Risk Manager Organisational capacity 2 - Application 2 - Application Clinical Systems Specialist 1 - Awareness 2 - Application Chief Executive Medical Director 1 - Awareness 1 - Awareness New dedicated Role – Person level 3 - Mastery 2 - Application Health Community New dedicated Role – System level 2 - Application 3 - Mastery

11. Typical roles Human factors capability required to support Patient Safety work Appropriate human factors training (content and delivery) Person-level System-level Nurse Doctor Pharmacist • Combination of workshop and on-the-job training, supplemented by e-learning or video resources • Initial training to focus on factual content, with periodic top-up sessions to emphasise behavioural change • Training specific to job role • Recognise system-level human factors issues in equipment or procedures, and report to their team leaders • Apply person-level human factors in their patient care work Front line staff

12. Typical roles Human factors capability required to support Patient Safety work Appropriate human factors training (content and delivery) Person-level System-level • Lectures, self-study and some formal evaluation (coursework or learning portfolio of practical work) • Training to build on existing safety management skills • Lead incorporation of system-level human factors in Trust safety governance processes • Identify system-level human factors issues in adverse events, and incident records Clinical Risk Manager • Support development of person-level training initiatives across the Trust • Monitor effectiveness of person-level human factors training in improving Trust patient safety performance Safety Manager

13. Typical roles Human factors capability required to support Patient Safety work Appropriate human factors training (content and delivery) Person-level System-level • Understand the person-level human factors relating to the way NHS staff use equipment and processes • Use system-level human factors to support the design of equipment and processes • Evaluate equipment and processes designed by other suppliers and monitor human-system interface of items procured for use in Trust • Lectures, self-study and some formal evaluation (coursework or learning portfolio of practical work) • Training to build on existing technical skills Clinical Systems Specialist Non- clinical support

14. HF outside high tech arena • Boundaried • High levels of acuity & risk • critical care, theatres • Distinct physical environments • highly controlled access, monitored airflow • Well defined roles and processes • specialised skills sets, specific roles, time dependent, high tech equipment, • Non-boundaried • Lower levels of acuity & immediate risk • wards, outpatients, community health teams, general practice • Diffuse care settings • outliers, interface with & dependency on external organisations and agencies • Loosely defined roles and processes • Broad skill set, interchangeable roles, flexible schedule, low tech equipment

15. Human Factors Scoping Study Nicola Davey & Heather Shearer NHS Institute for Innovation and Improvement Harry Blanchard & Finola Austin Human Engineering Ltd. www.institute.nhs.uk/humanfactors