Keywords

FormalPara Tools

Cognitive walk-through, contextual inquiry, focus groups, heuristic analysis, interviews, prototyping, questionnaires and surveys, the Systems Engineering Initiative for Patient Safety model, task analysis, time and motion studies, and usability evaluation, physical ergonomics, cognitive ergonomics, microergonomics, work system, process, outcomes

Definition

Human factors engineering (HFE) is “the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance”(http://www.iea.cc/whats/index.html).

Domains of Specialization Within HFE

There are three sub-domains within the discipline of HFE: physical ergonomics, cognitive ergonomics, and macroergonomics [1].

  • Physical ergonomics focuses on how to (re)design physical environments (e.g., physical layout of an intensive care unit) or tools (e.g., ergonomics and design of laparoscopic surgery instruments) to improve human performance.

  • Cognitive ergonomics develops solutions to improve overall system performance considering the cognitive abilities and limitations (e.g., limitations in working memory and attention) of human beings. Common areas of focus under this sub-domain include better management of mental workload, improvement of decision-making, enhancement of human-computer interaction, and development of effective training programs.

  • Macroergonomics uses a variety of HFE tools and methods to (re)design the overall work system, taking into account the interactions and fit between different system components. Enhancing teamwork and coordination, improving safety culture, and redesigning jobs (e.g., scheduling breaks, changing the duration of shifts) are examples of improvement efforts that can benefit from macroergonomics.

Conceptual Model to Guide Health-Care Quality Improvement and Research Efforts

According to the Systems Engineering Initiative for Patient Safety (SEIPS) model (Fig. 1), a human factors engineering model of quality and safety of care, the performance and outcomes (e.g., readmission rates, health-care acquired infections) in any health-care organization, depends on the design of the work system (structure) and the related processes (both care processes and other processes). HFE experts study the interactions between individuals and elements of the work system in which they work including physical environment, tasks, tools and technologies, teamwork, and organizational environment. They then develop solutions (i.e., redesigning particular aspects of the work system) while systematically considering the interactions among different work system elements to avoid any potential unanticipated negative impact of the proposed solutions [2].

Fig.1
figure 1

Systems Engineering Initiative for Patient Safety (SEIPS) model (Carayon et al. [2], p. i51)

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Human Factors Engineering Methods

Human factors engineers use a variety of qualitative (e.g., interviews, focus groups) and quantitative methods (e.g., questionnaire, time and motion studies) for data collection and analysis. A sample list of these methods is given in Table 1. It is important to note that Table 1 provides descriptions of only a very small subset method; interested readers are encouraged to consult other resources (e.g., [3]) to learn more about the HFE methods.

Table 1 A sample list of methods and tools used in human factors engineering
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Application Domains

Human Factors Engineering can be used in almost all aspects of health-care quality improvement efforts (See [4] for detailed examples). Some examples of the use of HFE in health care are listed below:

  • To reduce health-care acquired infections through work system redesign such as standardization, reducing ambiguity in systems [5], and improving culture of safety

  • To assess risks associated with a new electronic health record system implementation proactively (before implementation) and to develop appropriate strategies with the purpose of mitigating these risks

  • To conduct effective root cause analysis and medical-error accident investigations for creating more effective learning organizations

  • To evaluate and compare different brands of medical devices from a usability point of view in order to inform purchasing decisions

  • To improve care coordination and teamwork among clinicians

  • To identify patient and family member needs and to develop solutions for increasing the patient and family centeredness of care