HEKSS is supporting national efforts to develop understanding and use of the ‘human factors’ approach to enhance the safety and quality of healthcare across the service.
Human factors in healthcare is about applying an understanding of the effects of teamwork, tasks, equipment and the working environment and culture on human behaviour to enhance clinical performance. The description used by the Clinical Human Factors Group is that human factors:
…encompass all those factors that can influence people and their behaviour. In a work context, human factors are the environmental, organisational and job factors, and individual characteristics which influence behaviour at work.
Already well established in many other industries, particularly where safety is paramount, human factors has come to the fore in the NHS since the signing of the human factors concordat in November 2013 by the members of the National Quality Board (NQB) including Health Education England, the General Medical Council, Nursing and Midwifery Council and NHS England.
The concordat recognises that, by acknowledging human strengths and limitations, human factors offers ways to strengthen the design of healthcare systems and processes, so reducing medical error and its consequences. It states that the system-wide adoption of these concepts offers a unique opportunity to support cultural change and empower the NHS to put patient safety and clinical excellence at its heart.
Nationally, the work stemming from the concordat is focused on three priorities:
- Raising awareness and understanding of human factors in healthcare
- Scoping out the service’s capability and capacity to apply human factors
- Developing a programme to support individual healthcare organisations to embed human factors.
Locally, HEKSS will be working with healthcare education providers across the region to ensure that human factors is embedded in the training and education programmes it commissions.
Professor Ian Curran, professor of innovation and excellence in healthcare education at Queen Mary University of London and a clinical adviser to HEKSS, was an expert adviser to the NQB concordat. He said:
Few organisations can truly say they are doing all they can to be high performing in terms of quality and safety. Too often we’re making the same mistakes today that we made yesterday, and not learning the lessons to prevent them happening again tomorrow.
Safety is paramount, but human factors is about so much more. It’s about being a high-performing industry, one that is not only safe but also high quality, efficient and resilient. Doing the right thing, first time, every time is good for our patients and incredibly cost effective.
Human factors is very intuitive to people once they begin to explore it. However, like many things, until you have a theoretical framework it is very difficult to piece all the elements together. Nationally, we’re making a good start, but this really needs to be taken up and owned by local healthcare organisations.
Jane Carthey, a highly experienced clinical human factors expert working with HEKSS, said:
In healthcare, unlike other industries, health professionals often work in an environment that sets them up to fall into error traps. For example, look-alike and sound-alike medications, indistinct packaging for devices, unintuitive equipment and organisational structures and cultures that do not encourage staff to speak up if they spot a safety issue.
Reflecting on human factors in incident investigations and redesigning working environments can not only enhance safety but also improve efficiency and productivity. It can also greatly benefit the staff experience, with the aim of developing a culture that offers good leadership and role clarity. It is just as much about developing the right culture as the physical environment.
For more information on HEKSS’s human factors work, please contact Rosie Courtney.