Download The Wide World of Human Factors in Healthcare

The Wide World of Human
Factors in Healthcare
Rich Halstead-Nussloch, Ph.D., CPE
[email protected]
Agenda
• Introduction
• Definitions
• Range- Wide World of Human Factors in
Healthcare
• Physical Ergonomics
• Cognitive Ergonomics
• HCI in Healthcare
• Human Factors Risk Management
• Summary Conclusions and Recommendations
• Questions and Answers
2
Introduction
• Speaker- Rich Halstead-Nussloch, Ph.D., C.P.E.
• Today’s objectives- Participants will be able to
– State a range of healthcare practices involving HF
– Provide details on selected examples of the practices
aiming towards identifying best practices
– Follow-up with good sources of additional information
• How we will proceed– Go through slides, pausing for questions along way
– End with summary discussion, questions and answers
• Contact after the seminar- [email protected]
3
Definitions We Will Use Today
• Human Factors (HF)- Designing systems to fit
human’s physical and cognitive capabilities
• Ergonomics- A synonym for Human Factors
• HF Problem- System requires performance
beyond human capability
• Human-Computer Interaction (HCI)- Studying,
designing, planning and testing how people
interact with computers
• Healthcare- Processes to restore and maintain
human health through the practice of trained and
licensed professionals
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Definitions We Will Use Today
• Best Practice- According to the IIE:
– A method, process, activity, incentive, or reward that
is believed to be more effective at delivering a
particular outcome than any other technique,
method, or process, when applied to a particular
condition or circumstance.
– They are the processes, practices, and systems
identified in public and private organizations that
performed exceptionally well and are widely
recognized as improving an organization's
performance and efficiency in specific areas.
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Range- Wide World of Human Factors
in Healthcare- Today
• Healthcare is much larger than human factors
• Healthcare overlaps most of human factors
Healthcare
Human
Factors
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Range- Wide World of Human Factors
in Healthcare
Traditional
• Physical ergonomics
• Cognitive ergonomics
• Human-Computer
Interaction (HCI)
– Usability/Usability Testing
– User-centered design
• Human errors and reliability
• Risk management
• Robustness and resilience
Contemporary Additions,
Updates and Expansion
• Big data; Extreme crossdiscipline designs
• Patient (User) experience
• Emotion and emotional
capabilities and responses
• Patient as co-producer of
quality of health and life
• HCI-Security
• Health 2.0; Self-service
medical records/history, etc.
• Crowd sourcing ; citizen
science; citizen design
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Future- Wide World of Human Factors
Will Grow to Cover More of Healthcare
• Healthcare- still larger than human factors
• Healthcare- overlapped more by human
factors
Healthcare
Human
Factors
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Trend- More Cross-Discipline
Cooperation in Healthcare
Past- Everybody Worked Own
Ideas, Farm, Game, Territory, etc.
Present and Future- More CrossDiscipline Cooperation is Key
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Physical Ergonomics
in Healthcare
• What- The design of devices, tasks and the
environment to fit human size, strength, etc.
• HF Problem- BLS statistics show lifting/handling
patients is a top cause of (back) injury in
healthcare [1,2]
• Best Practice- OSHA 2009 Guidelines [3]
– Process- What to do and how to do it
– Equipment- Devices to enhance human capability
– Training- What staff need to know and best way to
learn and retain that knowledge
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Physical Ergonomics in HealthcareWhere to Learn More
• CDC-NIOSH- Safe Patient Handling Portal
http://www.cdc.gov/niosh/topics/safepatient/
• OSHA- Safe Patient Handling Portal
http://www.osha.gov/SLTC/healthcarefacilities/safepati
enthandling.html
• VA- Safe Patient Handling web sites:
– http://www.publichealth.va.gov/employeehealth/clini
cal_occhealth/safe_patient_handling.asp
– http://www.visn8.va.gov/patientsafetycenter/safepth
andling/
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Physical Ergonomics in HealthcareWhere to Learn More
• IIE Best Practices in Managing Human Factors
in Healthcare Conference 8/26/13
http://www.iienet2.org/HumanFactorsHealth
– Dawn Cole, R.N. and Johnny F. Williams, R.N. are
speakers and well experienced in safe patient
handling
– Amanda Mewborn, R.N. will present on Lean Tools
in Architectural Design to Develop Ergonomic
Healthcare Work Environments
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Cognitive Ergonomics
in Healthcare
• What- The design of devices, tasks and the
environment to fit human mental capabilitiesperception, memory, problem solving, etc.
• HF Problem- Developing and remembering effective
passwords for healthcare systems [4]
– Worst passwords: password; 12345678; qwerty; abc123
– Best passwords: make long- 12+ characters; use all
character categories; use favorites, e.g., foods, TV shows;
use different password for each system
• Best Practice– Process- Use checklist or provide guidelines
– Equipment- Biometrics/multi-point authentication
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Cognitive Ergonomics in HealthcareWhere to Learn More
• Atul Gawande- The Checklist Manifesto [5]
• Pubmedhttp://www.ncbi.nlm.nih.gov/pubmed
• Clinical Human Factors Group (UK NHS)
http://www.chfg.org/
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Cognitive Ergonomics in HealthcareWhere to Learn More
• IIE Best Practices in Managing Human Factors
in Healthcare Conference 8/26/13
http://www.iienet2.org/HumanFactorsHealth
– Brian H. Fillipo, M.D. will present on applying
Human Factors Engineering to improve reliability
of Healthcare, focusing on putting information
into the environment to support cognition and
reduce errors
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HCI
• What- The design and test of computers,
devices, workflows and the environment to fit
human physical and mental capabilities and
to increase accessibility and user satisfaction
• HF Problem- Use of computers/tablets for
medical records data entry and access
• Best Practice– Process- Always assess usability
– Equipment- Poka-yoke or mistake-proofing
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HCI in Healthcare- Where to Learn
More
• NIST Health Information Technology Usability
Portal (focuses on Electronic Health Records)http://www.nist.gov/healthcare/usability/
• Generic Guidance on Usability
http://www.usability.gov/
• Agency for Healthcare Research and Quality
Portal- http://healthit.ahrq.gov/ (Click on
Health IT Tools and Resources)
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HCI in Healthcare- Where to Learn
More
• IIE Best Practices in Managing Human Factors in
Healthcare Conference 8/26/13
http://www.iienet2.org/HumanFactorsHealth
– Laura Moody, Ph.D. will present on developing
partnerships with undergraduate IE programs to
pursue joint design, research and development
projects with industrial engineering undergrads
– Brian H. Fillipo, M.D. will present on applying Human
Factors Engineering to improve reliability of
Healthcare, focusing on putting information into the
environment to support cognition and reduce errors
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Human Factors and
Risk Management
• What- The identification, assessment,
prioritization and mitigation of risk
• HF Problem- Humans are the most complex
unknown and unpredictable sources of risk in
a system
• Best Practices– Risk Assessment with Focus on Human Factors
– Risk Mitigation
– Continuity Planning and Exercise
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Human Factors and Risk Management
in Healthcare- Where to Learn More
• NIST
– Risk Management Framework (for computer security)http://csrc.nist.gov/groups/SMA/fisma/framework.html
– HIPAA Security Toolkit http://scap.nist.gov/hipaa/
• British Health and Safety Executive Portal on Human
Factors and Risk Assessment
http://www.hse.gov.uk/humanfactors/resources/riskassessment.htm
• USDA Forest Service on Human Factors and Risk
Management http://www.fs.fed.us/rm/human-factors/
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Human Factors and Risk Management
in Healthcare- Where to Learn More
• IIE Best Practices in Managing Human Factors
in Healthcare Conference 8/26/13
http://www.iienet2.org/HumanFactorsHealth
– Joyce Holshouser Benton, R.N. will present on
current liability patterns and trends in nursing
practice highlighting recommendations to support
nurses in managing professional liability risk
– Lynda Enos, R.N., C.P.E. will overview a systematic
approach for building a business case for an
ergonomics program within a health care facility
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Summary Conclusions and
Recommendations
• Human factors and ergonomics play a major role in
healthcare and these roles are ever expanding
• There are many and wide-ranging significant areas for
human factors in healthcare from physical to cognitive
and HCI to risk management
• Employing best practices in human factors can aid and
enhance positive healthcare outcomes
• We have covered some of the major best practices
today
• For more, attend the 8/26/13 IIE Conference on Best
Practices in Managing Human Factors in Healthcare
http://www.iienet2.org/HumanFactorsHealth
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Questions and Answers
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References
1. NIOSH look at BLS Data, Table 14 retrieved 6 July, 2013
from http://www.cdc.gov/niosh/pdfs/2001-120.pdf
2. BLS Data, Table SNR02 retrieved 6 July, 2013 from
http://www.bls.gov/iif/oshwc/osh/os/ostb3180.pdf
3. OSHA, Guidelines for Nursing Homes, OSHA 3182-3R
2009, retrieved 6 July, 2013 from
http://www.osha.gov/ergonomics/guidelines/nursinghom
e/final_nh_guidelines.pdf
4. Sid Kirchheimer, Worst Passwords. AARP.org/Bulletin April,
2012, page 24.
5. Atul Gawande, The Checklist Manifesto. New York:
Metropolitan, 2009
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Graphic Credits
• Slide 1: Earth Photo courtesy NASA (Apollo 17)
• Other art from Microsoft Clip Art
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