1. Quality Education for a Healthier Scotland Multidisciplinary The nature and reality of working safely Mark Johnston Training and Research Officer (Patient Safety) NHS Education for Scotland mark.johnston@nes.scot.nhs.uk 0131 656 3258 @markjohnston71

2. Quality Education for a Healthier Scotland Multidisciplinary Ergonomics and Human Factors Known as Human Factors in the United States, everywhere else Ergonomics; they mean the same thing! Ergonomics from the Greek – Ergo “Work” and Nomics “Laws of” Therefore the discipline is concerned with the laws that govern human work. Uses methods to evaluate human work in order to optimise well-being and performance of individuals and organisations

3. Quality Education for a Healthier Scotland Multidisciplinary You’re amazing!

4. Quality Education for a Healthier Scotland Multidisciplinary

5. Quality Education for a Healthier Scotland Multidisciplinary Factors impacting on an individual that contribute to error Stress Fatigue Illness Hunger/Thirst Hazardous attitudes Language and cultural factors These are NOT Human Factors, these are the consequences of not adopting Human Factors. 

6. Quality Education for a Healthier Scotland Multidisciplinary Human Factors A common language “…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 optimise human well-being and overall system performance.” International Ergonomics Association Cognitive Organisation Physical Human

7. Quality Education for a Healthier Scotland Multidisciplinary Domains of Ergonomics and Human Factors Physical ergonomics - human anatomy, anthropometry, physiological and biomechanical characteristics as they relate to physical activity. Cognitive ergonomics - mental processes, such as perception, memory, reasoning, and motor response, as they affect interactions among humans and other elements of a system. Organisational ergonomics - sociotechnical systems, organizational structures, policies, and processes.

8. Quality Education for a Healthier Scotland Multidisciplinary Summary Key points Ergonomics and Human Factors mean the same thing The Twin aims are enhanced well-being and performance of individuals and organisations These aims are interdependent It is a scientific discipline; 4yr degree course + practice + specialisation

9. Quality Education for a Healthier Scotland Multidisciplinary Bad people? Errors occur due to system design and how those designs influence behaviour Why do errors happen?

10. Quality Education for a Healthier Scotland Multidisciplinary Even experts err

11. Quality Education for a Healthier Scotland Multidisciplinary The dilemma of “human error” If 1 event out of 100,000 goes wrong, humans are assumed to be responsible in 80%-90% of cases It follows that If 99,999 out of 100,000 events go right then humans are responsible in 80%-90% of cases Which outcome results in investigation?

12. Quality Education for a Healthier Scotland Multidisciplinary Inaction, Breach, Violation, Loss of Situation Awareness – all are just substitute terms for ‘Human Error’ Human Error is not the cause Human Error is a symptom

13. Quality Education for a Healthier Scotland Multidisciplinary Captain Hindsight https://www.youtube.com/watch?v=opfXmYlTotc

14. Quality Education for a Healthier Scotland Multidisciplinary Why don’t we (usually) bump into each other?

15. Quality Education for a Healthier Scotland Multidisciplinary Our response... Safety 1 – focuses on what went wrong and tries to control by introducing further restriction (pre work view - little or nothing goes wrong, contradicted by hindsight) Safety 2 – facilitating the performance adjustments that are necessary for everyday work to succeed. People not systems are intrinsically safe!

16. Quality Education for a Healthier Scotland Multidisciplinary So….handwashing. How is that going for you? What for you is the front line reality of trying to implement those guidelines and best practice? Safety 1 Would a safety 2 approach help?

17. Quality Education for a Healthier Scotland Multidisciplinary Tips for Safety 2 Look at what goes right, as well as what goes wrong Things do not go well because people simply follow the procedures. Things go well because people make sensible adjustments according to the demands of the situation. Find out what these adjustments are and try to learn from them Work is Vs work as imagined (do people follow the rule all the time?) A small improvement of everyday performance may count more than a large improvement of exceptional performance Allow time to reflect, to learn, and to communicate (Be mutually accountable) Adapted from Van Stralen

18. Quality Education for a Healthier Scotland Multidisciplinary It goes right more than it goes wrong Celebrate that Be curious as to why Change Culture? Choose your attitude.

19. Quality Education for a Healthier Scotland Multidisciplinary The nature and reality of working safely Mark Johnston Training and Research Officer (Patient Safety) NHS Education for Scotland mark.johnston@nes.scot.nhs.uk 0131 656 3258 @markjohnston71