Human Factors Work at TSCSC

  • Learning from COVID-19 - A Human Factors Approach to Capturing System-Wide Learning and Adaptations within Therapy Services (CO-HF)
    • What we did: During the initial response to the COVID-19 pandemic, the Trust witnessed drastic changes to the way work was done. Despite the difficult times, the Trust saw staff across the organisation adapt and develop strategies of coping and keeping our healthcare system functioning. This project aimed to capture the resilience and adaptive ways of work that Therapy staff developed to cope with those unprecedented times. This included understanding the changes that occurred, the challenges staff faced, and aspects that worked well.
    • Methods: Focus groups, Systems analysis using Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model
    • Benefits and Impact: Better understanding of the challenges experienced by staff and the changes to the work system that occur during unique and unprecedented events, such as the COVID-19 pandemic, is essential to be able to prepare better for the future. This will provide the organisation with considerations for when work needs to rapidly change and the support, they need to provide staff so that they can undertake work safely and efficiently.
    • If you would like to read more about this project, please click here: 01_28..pdf
    • Time frame: 2020

 

  • Anticoagulation Chart - Testing the usability of a new anticoagulation chart in clinical practice
    • What we did: We are applied Human Factors methods to evaluate the design of a revised patient anticoagulation chart to better understand how it was being used in clinical practice in an acute NHS hospital.
    • Methods: Observation, focus groups and interviews, simulation, Hierarchical Task Analysis (HTA), Heuristic Assessment, Systematic Human Error Reduction and Prediction Approach (SHERPA)
    • Benefits and Impact: We aimed to reduce the risks of incidents and improve patient safety, by seeking to understand how clinical staff use the new chart and identify where there is opportunity to improve the process and chart design to support effective drug prescribing and administration. This is turn should support staff confidence and competence when they are prescribing and administering these drugs.
    • If you would like to read more about this project, please click here: Using a Systems Approach to Support the Redesign of an Inpatient Anticoagulant Medication Chart | SpringerLink (Not free access)
    • Time frame: 2019 - 2020

 

  • Promoting MDT Excellence - Using an understanding of complex systems to identify and implement change
    • What we did: The Cancer Multi-Disciplinary Team meeting (MDT) is a key decision-making point in a cancer patient’s journey and can have an impact on the quality of a cancer patient’s care. We brought together Human Factors, Quality Improvement and Organisational Development to describe and understand the system complexity of cancer MDTs and identify and pilot areas for change.
    • Methods:Observation, Focus Groups and Interviews, Information Flow Analysis, System Analysis (Work Domain, SEIPS).
    • Benefits and Impact: Better understanding of the complexity of the system will allow the service to target resources and implement change in the areas that will be most effective. Patients will then receive the best possible quality of discussion at MDTs. Clinicians’ time will be optimised and staff experience improved through the introduction of effective systems and processes.
    • If you would like to read more about this project, please click here: Identifying-work-system-components-and-constraints-of-cancer-multidisciplinary-team-meetings.pdf
    • Promoting MDT Excellence - Using an understanding of complex systems to identify and implement change
    • Time frame: 2018 - 2019

 

  • Hyperkalaemia Guidelines - Testing the usability of a new hyperkalaemia guideline prior to implementation in clinical practice
    • What we did: We applied Human Factors principles and the use of simulation to see whether the new guideline could be understood, followed and actioned by doctors and nurses at NUH.
    • Methods: Simulation, questionnaire and interviews, Perception Cognition Action (PCA), Hierarchical task Analysis (HTA), Flesch Reading Ease
    • Benefits and Impact: This study identified many positive design features with most participants finding the guideline readable and clear. However, a number of changes were required to improve the design of the flowchart to reduce ambiguity and increase accessibility, cognition and application in practice. As a result, NUH redesigned the guideline prior to it being implemented late 2018. This approach provided greater insight into the needs of the clinicians and highlighted design issues that would previously have not been considered. It provided an accessible approach to testing guidelines to ensure that clinical teams can access, understand and implement them in their clinical practice.
    • Time frame: 2018

 

  • TEAMS - Developing high reliability teams that focus on excellence and improvement
    • What we did: Over a 2-year period (2016-18), based on team STEPPS methodology, we developed and implemented a training curriculum including a collection of tools and strategies that focus on establishing high performing teams that have a focus on improvement and safety: team skills, expert practice, advocacy for patients, motivating colleagues, safety focused behaviours.
    • Methods: Team STEPPS, in situ simulation, Team Improvement groups, Teamwork Perception Questionnaire, Situation Judgement Responses
    • Benefits and Impact: Clinical teams identified many positive outcomes including greater understanding of team leadership, coaching skills and implementing change.Engaging and empowering the team to make improvements and developing a positive culture and team climate. Improvement outcomes included introduction of a structured briefing tool, dashboards.
    • Time frame: 2016 – 2018