As I dust off the old blog here, I should thank my colleagues for helping me keep this going with a few inspired guest posts. Several of us at the Centre have been to various presentations and conferences lately, but as it goes when we are away from work, we spend a lot of time playing catch up once we return and often can’t find the time to share our experiences with the team.
As an attendee at such events, I know all too well how the momentum from being inspired by awesome presentations and other people’s hard work quickly drops off once we get back behind our own desks. And as a person behind the scenes of such events (whether organizing, speaking or writing about), I know all too well how much work goes into these experiences and how lovely it is when the conversations keep going long after the event is over.
So it is in that vein that Varuna Prakash wrote up what she got out of the recent inaugural HFES symposium, and she is a super smart lady so don’t be surprised to learn something from the following.
Reflections on the inaugural Symposium on Human Factors and Ergonomics in Health Care
It’s an exciting time for Human Factors in healthcare. Just over a decade has passed since the landmark Institute of Medicine report, “To Err is Human: Building a Safer Health System” made waves in the healthcare community and brought to light critical issues of preventable medical errors and patient safety. Since then, momentum has been slowly building for for the patient safety and human factors movement. Joe Cafazzo, our Senior Director of Healthcare Human Factors, uses an aviation metaphor to describe the situation:
“In the past 10 years, the patient safety movement has been like a plane taxiing down the runway. Now, in 2012, we’re just taking off.”
As an HF practitioner who only entered the field during this takeoff phase, I have a lot to learn. And what better place to learn than the inaugural Symposium on Human Factors and Ergonomics in Healthcare, organized by the Human Factors and Ergonomics Society (HFES) in Baltimore in March. The goal of the Symposium was to bridge the gap between human factors professionals and the healthcare community. Over 400 attendees participated (large by Human Factors standards), presenting a tremendous diversity and amount of work.
Breaking down silos.
One of my main takeaways from the event is that one rarely (if ever) sees HF engineers, medical device manufacturers, cognitive psychologists, designers, physicians, and government regulators in the same room. The confluence is tremendously exciting. The three-day Symposium had a varied mix of talks and posters on Medical Device Design, Patient Safety, and Healthcare IT – all put together by people open to this radical notion that human factors and usability matter deeply in healthcare.
Healthcare is a massive space, so effecting change really requires effort at all levels – top–down and bottom-up. Probably the most encouraging thing was to see people working across so many jurisdictions, from single physicians on a medical unit pointing out usability issues that had disastrous consequences for patients, to the federal government’s Food and Drug Administration mandating that human factors testing be performed on all regulatory submissions for medical devices.
Another pervasive theme was that as a healthcare community, we need to challenge ourselves to allow more creativity into our design process. Most importantly, we need to force ourselves to always consider the user’s perspective. I went to two great talks by designers who have been doing just this. One group at the Royal College of Art in London worked with the National Health Service to redesign ambulances.
Take a look at their incredible, thorough process of design and evaluation. The end result is a much roomier, accessible ambulance that allows paramedics to focus their attention on the patient rather than scrambling to grab supplies.
Another great talk was on redesigning Instructions for Use for at-home devices. That little folded instruction manual that most of us throw away? Picture an 80-year old with crippling arthritis using it at home. Picture a scared first-time patient trying to decipher which way is up on a scary device she has to jab into her thigh. It is easy to see just how important it is to get all of it right. The details matter.
We’ve come a long way, but we also have a long way to go.
Somedays, it feels like healthcare is racing forward. We’ve gone from complex machines with fiddly buttons and rotary knobs to touchscreen anesthesia machines and monitoring apps on iPhones. But while technology races forward, how does the rest of healthcare catch up? For instance, operating rooms now contain an astonishingly array of surgical and imaging equipment, all housed in a tiny, cramped room in a building that was only intended to hold a fraction of this equipment in the 1950s. How do we make sure that all this technology fits and works, instead of getting in the way?
Similarly, we now have extremely sophisticated patient monitoring systems that are integrated so that nurses can keep tabs on critical patients even from several rooms down the hall. But a downside of this constant monitoring is the very real danger of alarm fatigue. How do we design these systems so that they support our clinicians, rather than overburdening them? This was another interesting theme at the symposium – taking stock of new challenges introduced by rapid technological development.
I’ll end with a thought broached by the keynote presentation at the Symposium, given by Dr. Lucian Leape, a founder of the patient safety movement. Although the days following his opening presentation focused heavily on medical technology and IT, Dr. Leape made a very human-centred point that established an important lens for the rest of the talks:
Healthcare, unlike any other industry of this size in the world, has institutionalized disrespect.
Whether this disrespect is literal (a surgeon being rude to a nurse, for instance) or more intangible (keeping patients waiting hours for their appointments, or leaving patients to figure out poorly designed homecare technologies), it is unacceptably pervasive in healthcare. And it is incumbent upon us – as human factors practitioners, clinicians, medical device manufacturers, designers – to fix the systems that enable this disrespect.
Big thanks to Varuna for sharing her thoughts. Did anyone else attend HFES? Did you see other stand-out projects or presentations?