Human Factors in Healthcare

Articles

Projects

Project: Computer-Human Interaction for Medical Devices, CHI+MED
Website: www.chi-med.ac.uk
CHI+MED is an interdisciplinary research project combining expertise in human factors and computer science which considers interactive medical devices in their socio-technical context. They aim to transform the way interactive medical devices are designed, bought and used in ways that both prevents and reduces the consequences of human error. They are working with the various groups of people who are involved in the entire lifecycle of an infusion pump, including designers, regulatory bodies, NHS purchasers, nurses on the ward and, increasingly, patients in their own homes in order to understand the context in which these key players work. To find out how and why people make errors, they are investigating the underlying cognitive causes of different kinds of errors and how people avoid them. They are exploring how the design of the number entry interface can affect the way in which errors are made, and what design alterations can mitigate error (for example in protecting against the types of errors likely to be made after someone has been interrupted).
The CHI+MED project is a six year multi-site research project (taking place at City University, Queen Mary University of London, Swansea University and UCL with the Royal Free and Singleton Hospitals) which is funded by the EPSRC.

Project: Designing Out Medical Error, DOME
Website: www.domeproject.org.uk
The DOME project aimed to better understand and map healthcare processes on surgical wards, establishing an evidence base to design equipment and products which better supports these processes and therefore reduce instances of medical error. This three-year multidisciplinary project was set up with the aim to reduce medical error by creating a better fit between healthcare processes on surgical wards and the equipment and products that support them. The research team consisted of designers from the Helen Hamlyn Centre for Design at the Royal College of Art, surgeons and psychologists from Imperial College London and Imperial College NHS Trust, operations management expertise from Imperial College Business School as well as human factors input. The team mapped surgical processes with NHS staff and patients, investigated how safety is managed in analogous industries, and used novel research techniques to identify and prioritise the five most error-prone processes on surgical wards – hand hygiene, information handover, vital signs monitoring, isolation of infection and medication delivery. Interventions were designed for each process and tested in a simulated ward environment.

Project: Multidisciplinary Assessment of Technology Centre for Healthcare, MATCH
Website: www.match.ac.uk
MATCH is a collaboration between four UK universities (Nottingham, Brunel, Birmingham and Ulster) that has been working since 2003 to improve the quality of medical devices produced in the UK. As part of this project, human factors researchers from Nottingham University are working alongside researchers from fields such as psychology, engineering and computer science, as well a cohort of device manufacturers and health providers to study how human factors methods and approaches can contribute to the development of new medical technology. MATCH has worked with the manufacturers of clinical devices to study how user requirements of patients and healthcare professionals can be collected, understood and incorporated into the development process. They have also investigated the use of verbal protocol methods for understanding the interactions between medical technology and users within a range of clinical environments in order to improve adoption, safety, effectiveness and health outcomes. Another focus of MATCH has been on the devices that are used by patients to treat, support and monitor health conditions such as Type II diabetes, anaphylaxis and Chronic Obstructive Pulmonary Disease. Future MATCH research will focus on home and patient-use devices and will aim to develop improved ways of motivating, encouraging and supporting patients to use these devices correctly, safely and regularly.

Project: Advancing Knowledge of Telecare for Independence and Vitality in later life, AKTIVE
Website: www.aktive.org.uk
The AKTIVE project explores how telecare can be developed to improve the life of individuals who are prone to falls or have memory problems to live a full and independent life. The social research team from CIRCLE (Centre for International Research on Care, Labour and Equalities) and Oxford Institute for Ageing will be conducting an analysis over the period of up to one year in up to 60 households in Leeds and Oxfordshire with older adults. The research team conducted interviews with experts in the field of telecare from academia, policy, practice and commissioning, discussion groups with paid care workers and interviews with unpaid carers. During these, they have highlighted issues which will need to be addressed and explored further in the Everyday Life Analysis. AKTIVE also aims to contribute towards telecare market knowledge which will make it easier for UK providers to commercialise their technologies and services in this market. The project received funding contribution from the Technology Strategy Board as part of their Assisted Living Innovation Platform.

Project: Moving & Handling Strategy: Standards for Handling People and Objects in Health and Social Care
Email: david@couzens-howard.wanadoo.co.uk
This essential document covers moving and handling in health and social care settings. As such the emphasis is quite naturally on person handling, such as a patient, service user, etc. The ultimate aim of this document is to enable manual handling practitioners/back care advisors (MHPs/BCAs) to make an effective contribution to their employer’s needs and aspirations to deliver high quality care in a way that is safe for the patient/service user and the staff, in a cost effective way, and for this contribution to be recognised. The document brings together all of the legislative and regulatory requirements, links them to best practice and provides, in one cover, all of the requirements for delivering safe and effective moving and handling. The target audience is mainly those who are charged with the responsibility of providing, monitoring and reviewing moving and handling, and back care advisory services within health and social care. The approach is strategic so that the moving and handling and back care advisory service can be comprehensive (holistic), balanced, robust and sustainable, and capable of being integrated with the organisation’s other systems for governance, risk management, and occupational health & safety.
The intention is for this document to take its place alongside other authoritative texts in providing nationally accepted standards for moving and handling. The CD with this document costs £25, plus £3 p&p. Please send enquiries to David Couzens-Howard.

Project: Virtual Restorative Environment Therapy (VRET)
Websites: www.birmingham.ac.uk/stone; www.birmingham.ac.uk/schools/eece/news/virtual-wembury.aspx
Previous research suggests that exposing individuals to natural settings can promote stress reduction and assist in the recovery of attentional capacity and cognitive function following mental fatigue. Restorative environments as simple as window views onto garden scenes have also been shown to reduce post-operative recovery periods and the level or frequency of analgesic administration. The aim of the VRET project is to conduct a long-term, patient-centric investigation into the development and evaluation of Virtual Restorative Environments (VREs), based on interactive 3D recreations of natural or rural scenarios. Specifically, the project focuses on the possible future deployment of VREs within hospitals and other healthcare facilities (including elderly care homes) where natural views are not available to support a patient’s rapid return to physical and psychological well-being. In addition, and, through the use of appropriate commercial off-the-shelf interactive technologies, the project seeks to provide at-bed, at-chair, at-gym (and ultimately at-home) motivational and pain-distracting ‘virtual exercises’ for injured and traumatised patients, including amputees who are preparing for prosthetic device fitting. In conjunction with clinical and nursing staff at the Queen Elizabeth Hospital, Birmingham and the Royal Centre for Defence Medicine, and working with patients based both in the Intensive Care Unit and the main Military Ward of that hospital, a number of early pilot studies addressing technology usability have been, and continue to be undertaken. Based on two extensive interactive 3D recreations of popular locations in Devon, Wembury Bay and Burrator Reservoir, both of which present patients with simulated sights and sounds linked to the real time of day, the project aims to deliver mature interactive display systems for a more longitudinal period of evaluation in 2013. Amongst the interactive technologies being investigated are standard gamepads, retro-style joysticks, mini hand-/finger-mounted motion controllers and contactless gesture tracking systems, together with conventional large-screen monitors, tablet computers and head-mounted displays.

Organisations

Organisation: Human Interface Technologies Team, University of Birmingham
Website: www.birmingham.ac.uk/stone
The University of Birmingham’s Human Interface Technologies (HIT) Team consists of a multidisciplinary group of researchers within the School of Electronic, Electrical & Computer Engineering who focus on human-centred research issues related to future interactive technologies, including task and usability analysis, human factors integration, ergonomics and the design and evaluation of advanced interfaces. In addition to the Team’s award-winning research and development addressing the exploitation of Virtual Environment systems for defence training, its medical and healthcare projects have, over the past decade, been built on over 18 years of experience in the medical Human Factors and Simulation arena. With notable historical achievements such as, in 1995, the human-centred design of the world’s first and most validated medical skills simulator, MISTVR (Minimally Invasive Surgical Trainer), members of the HIT Team have experience in a range of medical technology-based training projects, from developing haptic feedback and stereo viewing systems for specialised surgical training to ergonomic evaluations of operating theatre robots. During the MoD-funded Human Factors Integration Defence Technology Centre programme (2003-2012), the HIT Team conducted a number of studies addressing games-based technologies for defence surgical training, post-traumatic stress disorder counselling, and the exploitation of human factors knowledge in the design of Pulse!!, a virtual ‘clinical learning lab’ for healthcare training (with the US Office of Naval Research and Texas A&M University Corpus Christi). More recently, the Team has been collaborating with clinical and nursing specialists within the Queen Elizabeth Hospital in Birmingham and the Royal Centre for Defence Medicine, addressing the use of Virtual Environments for both post-operative psychological recovery and subsequent exercise- and games-based rehabilitation for seriously injured patients and amputees. The HIT Team also collaborates with the Hollier Simulation Centre, the European Centre for Environment & Human Health and is a founding member of the Birmingham Defence & Civilian Simulation Team.

Organisation: Clinical Human Factors Group, CHFG
Website: www.chfg.org
The CHFG is an independent campaign group which aims to stimulate dialogue and demonstrate through concrete action how a better understanding of the role of human factors can have a significant impact on safety, quality and productivity in healthcare. They are a broad coalition of healthcare professionals, managers and users of services who have partnered with experts in human factors from healthcare and other high-risk industries to campaign for change in the NHS. Their vision is of a healthcare system that places an understanding of human factors at the heart of improving clinical, managerial and organisational practice. Their campaign manifesto is built on three pillars of activity: 1. Human Factors Education & Training, 2. Building ‘high reliability’ organisations, 3. Intelligent regulation and independent investigation

Organisation: National Association of Medical Device Educators & Trainers, NAMDET
Website: www.namdet.org
NAMDET is the National Association of Medical Device Educators & Trainers and was established in 2010 to raise and promote awareness of medical devices and support Medical Devices Educators and Trainers. Their objectives are to: Raise the status and standing of Medical Device Trainers and Educators, Provide a forum for mutual support and assistance between members, Represent the consensus views and opinions of members at regional and national level, Inform and improve national policy and the regulatory landscape by communicating NAMDET member positions on issues of importance, Positively contribute to reducing adverse medical device incidents. NAMDET has already established regional groups across the UK, which provides strong benefits locally to members and participating organisations. This helps in networking, mutual support and the dissemination and sharing of best practice. Membership is free and this should lead to the development of a collaborative approach to training provision and delivery across the National Health Service and wider UK healthcare delivery sector.

Organisation: Association for Simulated Practice in Healthcare, ASPiH
Website: www.aspih.org.uk
Formed in 2009 through the merger of the National Association of Medical Simulators and the Clinical Skills Network the overarching goal of ASPiH will be to enable wider sharing of knowledge, expertise, and educational innovation related to simulated practice across the healthcare professions. Its aims are: to provide an effective communication network for those involved in simulated practice in the UK and beyond, to provide quality exemplars of best practice in the application of simulated practice to education, training, assessment and research in healthcare, to establish key benefits and evidence of impact linking simulated practice with improvements in patient safety and quality of care, to develop and share key operational and strategic resources for members drawn from experience within the association and from links with relevant educational bodies nationally and internationally, to encourage and support scholarly development and recognition of members through wider dissemination of innovative practice at scientific meetings and publications.

Organisation: Quality, Reliability, Safety and Teamwork Unit
Website: www.nds.ox.ac.uk/qrstu/
Based at the University of Oxford, the QRSTU analyses the safety and quality of surgery, and concentrates particularly on developing and evaluating interventions to improve systems of work. The unit has developed a theoretical framework for the analysis of risk and error in surgery, based on the three dimensions of Culture, System and Technology. Previous studies have included the first detailed scientific study of the impact of an aviation-style CRM teamwork training programme on technical error rates in operating theatres, and a major study of the effect of applying the Lean quality improvement system on safety in a surgical ward. The Safer Delivery of Surgical Services (S3) research is programme of studies to identify how human factors approaches may be used to reduce errors and harm in surgery. It consists of an interconnected programme of observational studies, observational tool development programmes, and controlled before-after interventional studies with integrated economic, statistical, and knowledge management analyses. The programme is funded by the National Institute of Health Research, under the Programme Grants for Applied Research. The unit is also involved in studies of handover between clinical teams, and of the use of high-tech monitoring systems with computer analysis of vital signs to detect patient deterioration. Researchers from QRSTU have advised or participated in the development of the NHS Institute programme “the productive operating theatre” and the Health Foundation sponsored project on Safer Theatre Teams, and are actively involved in assisting the Clinical Human Factors Group in their work to improve surgical safety in the UK.