Consider Human Factors Engineering When Designing Patient Safety Projects

Wilson has studied the implementation HFE in relation to the mock code process and will begin a study on the use of HFE principles when designing clinical response teams. Prior to each project, she creates a table that outlines basic HFE principles to consider in relation to that specific process and what type of action is being taken to incorporate HFE thinking.

"We have a column that says, 'Is this amenable to incorporating human factors engineering?' and then we talk about what in the current process creates confusion," says Wilson.

For example, reducing reliance on memory is one important factor that can be applied to nearly any initiative. Wilson and her team will go through every step of a process and find where reliance on memory can be lessened through checklists, protocols, or automated reminders.

"I think back to when I worked as a nurse," Wilson says. "At three in the morning, when you're tired and haven't slept much, the last thing I want is to have a staff who has to rely on their memory when I know they're not functioning at 100%."

Considering each of these factors and understanding the vulnerabilities inherent with employees, Wilson suggests that facilities examine what processes can be put in place to minimize the risk of error. Doing so will require input from the facility's top clinicians. It's important to involve those people who are using the process every day and know where HFE principles could be best applied.

Recommendations for utilizing HFE
Although Seagull recommends enlisting the support of a trained HFE professional, there are some actions that can be taken at a unit or hospital level with existing staff. They include "understanding the personal responsibility of not just making sure your patients are doing well, but that all patients in a similar situation will do well, and working on improving the system because problems usually don't happen because of individuals, but because of systems and the way they're designed," says Seagull.

In addition, ask why clinicians may stray away from using certain technologies, says Emily Patterson, PhD, assistant professor at Ohio State University's College of Medicine, School of Allied Medical Professionals, Health Information Management and Systems Division in Columbus.

Also, when introducing new systems, observe whether staff continue to use the old system for certain features, determine what those are, and investigate why they may be doing this.

"We looked at the ED and asked why, if electronic whiteboards are starting to take off, why is there still a manual whiteboard in most EDs? What about that functionality is not in the new system yet?" asked Patterson.