1. Copyright 2012 Terema Ltd Please go to www.isqua.org

2. Copyright 2012 Terema Ltd Teaching Human Factors in Healthcare Captain Phil Higton Director of Training, Terema Ltd philhigton@terema.co.uk

3. 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

4. Copyright 2012 Terema Ltd The Ergonomic Spectrum The physical working environment The man – machine interface Interpersonal. Group dynamics and teamworking Intrapersonal. Self management

5. Copyright 2012 Terema Ltd System and Process People and Culture

6. Copyright 2012 Terema Ltd Human Factors Team Skills Team Resource Management Human Factors / TRM

7. Copyright 2012 Terema Ltd Error is normal Performance is variable System and Process interact with People and Culture Human Factor Principles System and Process People and Culture

8. Copyright 2012 Terema Ltd The Vulnerable Human Human Performance and Limitations ‘No system is foolproof to a sufficiently inventive fool’ (Mark Twain)

9. Copyright 2012 Terema Ltd Safety Situation Awareness Risk Management Communication Choosing Behaviour Feedback Leadership Followership and Motivation Human Factor Topics Situation Awareness Communication Choosing Behaviour

10. Copyright 2012 Terema Ltd Arousal Performance Workload Physiology Psyche Interpersonal Environment Technology

11. Copyright 2012 Terema Ltd THE SPOKEN WORD Social Professional Crisis Jargon

12. Copyright 2012 Terema Ltd 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

13. Copyright 2012 Terema Ltd 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

14. Copyright 2012 Terema Ltd Briefing The 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 Decision Reflects 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 Feedback The extent to which a team recognises the need to give and receive feedback. Preparation / Planning / Vigilance Reflects the extent to which teams plan ahead, maintain situation awareness and anticipate contingencies. Enquiry / Advocacy / Assertion Team members advocate, with appropriate persistence, the course of action they feel is best, even if it involves disagreement. Workload / Distractions This is a rating of time and workload management. It reflects how the team distributes tasks, avoids overload and distractions. NASA / UT Teamskills

15. Copyright 2012 Terema Ltd Getting things done Hierarchy –Pecking Order –Organisational structure –Responsibility –Stable / fixed in the short term Authority Gradient –Power –Proximity –Relationships –Flexible

16. 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

17. Copyright 2012 Terema Ltd Questions or Comments philhigton@terema.co.uk Thank you