Human factors and the healthcare imperative

Prof Paul O'Connor, a Human Factors Psychologist from the University of Galway, will speak about the growing use of human factors in healthcare at the Royal College of Physicians of Ireland Annual Symposium - St Luke's - on 19 October 2023. 

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With foundations in the defence and aviation sectors, Prof O'Connor has most recently been conducting research in healthcare with the aim of improving patient safety and quality of care by addressing the human factors that contribute to poor performance in this high-pressure environment.

So, what is human factors, and why is it important?

A simple way to view human factors is to think about three aspects – the job, the individual, and the organisation – and how they impact upon people’s behaviour.

According to Prof O’Connor human factors is particularly important in healthcare as it is characterised by high levels of human-to-human as well as human-to-technology interactions.

“The focus of human factors in healthcare to date has largely been on safety. A human factors approach can support our understanding of the contributors to incidents at all levels of the healthcare system and can help us to proactively improve safety through mitigation,” Prof O’Connor says.

“A human factors approach can also support improvements in quality of care, work practices, and workforce satisfaction, and can increase efficiency by supporting an improved understanding of how work processes and systems can be designed to optimise performance, productivity, and cost-effectiveness.”

However, Prof O’Connor says human factors is often misunderstood in healthcare, with an overwhelming focus on fixing the individual rather than fixing the system.

“People often think human factors is only concerned with teams skills such as decision making, teamwork, and communication, but this just perpetuates the idea that we have to fix the individual, when, in fact, it may be that other factors were at play, such as the suitability of the equipment or the organisational culture.”

“It is limiting to focus on the individual and not look at other contributing factors within the system.”

Comparing healthcare to the aviation industry, Prof O’Connor explains that designing a plane requires a lot of thinking about the design rather than simply training the pilot to fly. The system must support team and individual performance with consideration for the whole system we are designing for.

“So, for example, if a unit is getting a new piece of medical equipment, we need to consider how it will interface with other equipment being used in that specific environment.”

Prof O’Connor, who is Research Director of the Irish Centre for Applied Patient Safety and Simulation (ICAPSS), and Co-Director of the Diploma and Masters in Patient Safety and Simulation, says that simulation is an incredible tool not only for training but in testing and understanding human factors with practical applications. This non-training application of simulation is infrequent in healthcare, but common in other high-risk industries.

“Simulation can be used to predict and plan, or to analyse what went wrong or could have worked better in a specific situation,” Prof O’Connor says.

“Simulation, for example, can be used to test equipment to identify issues which may occur. In an ideal world, it could be a way for the end user or specialist to test the equipment before it is purchased.

“With human factors and simulation at our disposal, we should never have to say this is an accident waiting to happen. We would be able to test that assertion in a high-pressure simulated environment, clearly demonstrating the potential risk.”

Prof O’Connor says frontline staff who want a more efficient system should try and agitate for change within their own work environments- although he recognises the challenges to doing this. Healthcare management, and those who make purchasing decisions, must also be willing to listen and should in fact seek out input from the frontline staff on how to improve the healthcare system and understand ‘work as done’ rather than ‘work as imagined’.

Hear more from Prof  O’Connor at the Royal College of Physicians Annual Symposium – St Luke’s - on Thursday 19 October. He will be joined by Prof Dara Byrne, National Clinical Lead for Simulation, Health Service Executive.

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More information on human factors is available open access through the HSE - Introduction to Human Factors for  Healthcare Workers -  by Prof O’Connor and his colleague Dr Angela O’Dea.