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Copyright 2012 Terema Ltd
Teaching Human Factors in Healthcare
Captain Phil HigtonDirector of Training, Terema Ltd
philhigton@terema.co.uk
Copyright 2012 Terema Ltd
Overview
• Hearts over minds– A behavioural rather than intellectual exercise
• Getting past ego– Reframing as a professional duty
• Viewing HF in the round– Three dimensional view in a complex environment – avoiding
over simplification
• Tools without insight– A balancing act
• Integration– Connected to the clinical, not stand-alone topics and isolated
groups
Copyright 2012 Terema Ltd
The Ergonomic Spectrum
The physical working
environment
The man – machine
interface
Interpersonal. Group dynamics and teamworking
Intrapersonal.Self
management
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• Error is normal
• Performance is variable
• System and Process interact with People and Culture
Human Factor Principles
System and Process
People and Culture
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The Vulnerable Human
Human Performance and Limitations
‘No system is foolproof to a sufficiently inventive fool’
(Mark Twain)
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Safety
SituationAwareness
RiskManagement
Communication
ChoosingBehaviour
Feedback
Leadership Followership
andMotivation
Human Factor Topics
SituationAwareness
Communication
Choosing Behaviour
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Arousal
• Performance
Workload
Physiology
Psyche
Interpersonal
Environment
Technology
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CHECKLISTS• Normal (routine)• Non-normal• Emergency
All have their specific mode of use For effective use there needs to be a shared
understanding of purpose, structure and discipline
Address issues of attention, distraction, memory and co-ordination
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NORMAL CHECKLISTS
BEFORE START
WINDOWS............................................................LOCKED, L/R
OXYGEN.......................................................................SET, L/R
FLIGHT INSTRUMENTS...............................................SET, L/R
ALTIMETERS...............................QNH____ SET AND X-CHKD
PARK BRAKE……………......................................................SET
FUEL CONTROL………..................................................CUTOFF
FUEL……………………..........................................____TONNES
PASSENGER SIGNS..............................................................ON
BUGS……………………..................ASI____ALT____ENG____
CDU………………………........................................................SET
TRIMS …………………....................____UNITS, ZERO & ZERO
FLIGHT CONTROLS…….............................................CHECKED
CHALLENGE
RESPONSE
Checklist, not a ‘TO DO’ list
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BriefingThe effective briefing will be operationally thorough, interesting and will address co-
ordination, planning and potential problems.
Leadership / Followership / Concern for the Task
The extent to which appropriate leadership and followership are practiced..
Communication and DecisionReflects the extent to which free and open
communication is practiced. Active participation in decisions encouraged.
Interpersonal Relationships / Group Climate
Reflects the quality of relationships among the team, the overall climate in the workplace
Team Self FeedbackThe extent to which a team recognises the need
to give and receive feedback.
Preparation / Planning / VigilanceReflects the extent to which teams plan ahead,
maintain situation awareness and anticipate contingencies.
Enquiry / Advocacy / AssertionTeam members advocate, with appropriate
persistence, the course of action they feel is best, even if it involves disagreement.
Workload / DistractionsThis is a rating of time and workload
management. It reflects how the team distributes tasks, avoids overload and distractions.
NASA / UT Teamskills
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Getting things done
• Hierarchy– Pecking Order– Organisational
structure– Responsibility– Stable / fixed in the
short term
• Authority Gradient– Power– Proximity– Relationships– Flexible
Copyright 2012 Terema Ltd
Review• Hearts over minds
– A behavioural rather than intellectual exercise
• Getting past ego– Reframing as a professional duty
• Viewing HF in the round– Three dimensional view in a complex environment – avoiding
over simplification
• Tools without insight– A balancing act
• Integration– Connected to the clinical, not stand-alone topics and isolated
groups
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