Human Factors approaches, widely used in high risk industries such as aviation, seek to build a safety culture by addressing ‘people issues’: how we see, hear, think and function physically, how we relate to each other and how the environment, job design and organisational factors shape human performance.

  • Human Factors approaches seek to build a safety culture by addressing the ‘people issues’ – how we see, hear, think and function physically, how we relate to each other, and how we relate to our environment – which need to be considered to optimise performance and assure safety.
  • Widely used in high-risk industries such as aviation, there has in recent years been increasing interest in the application of HFs approaches to the provision of healthcare – especially following the issues with a poor safety culture in the NHS highlighted in the Francis and Berwick reports.
  • However, many healthcare applications of Human Factors to date have stopped at the provision of training, and most have been focused on critical care contexts. Work by the University of Hertfordshire Patient Safety Group is focused on developing a more sustained capacity-building intervention, and on taking this into new contexts such as maternity, primary care and mental health.

The model, now being rolled out across the East of England, originated in a collaboration between the University of Hertfordshire and the Luton and Dunstable Hospital NHS Trust, where work was undertaken first in the maternity department and subsequently in the Trust’s medical departments.

Interventions begin with an immersion event, bringing together as many as 200 people from across a trust or practice and introducing them to the HFs approach. At the same time, a number of Human Factors leaders are identified. These participate in an additional day of training, at which they are taught how to educate others on the Human Factors approach, and identify practical improvement projects on which they plan to work. The improvement projects then provide a context in which the Leaders can apply their new skills in both teaching and implementing Human Factors approaches, and delivering training to a wider audience. Throughout, they receive modelling, coaching and support from the University of Hertfordshire team.

The process is designed to leave participating organisations not just with a number of completed improvement projects, but also the capacity to continue improving – with a large number of staff learning about the approach, and a smaller number of Human Factors leaders with in-depth skills in implementation and teaching.

The original pilot programme in Luton and Dunstable Hospital NHS Trust delivered statistically significant improvements in patient safety culture, teamwork climate, team morale and job satisfaction – alongside the completion of four service improvement projects and high levels of staff satisfaction with the training.
The current phase of work has focused on developing an evaluation framework prior to wider roll-out. Two sites have been involved:
  • A maternity site in Peterborough, where 300 staff have been involved in a baseline assessment of safety culture, eight HFs Leaders have been trained, four wider trainings offered (to around 100 staff) with more planned, and seven improvement projects undertaken.
  • A GP practice in Luton, where 44 staff have been involved in a baseline assessment, and 33 additional interviews have been conducted to allow a more in-depth analysis of the need for HFs training in a primary care setting.
The evaluation framework is now in place for the wider roll-out.
The model will now be offered and evaluated across the East of England region, with the following targets for participation:
  • Primary care.
  • Four maternity units.
  • East of England Ambulance Service NHS Trust
  • Five mental health trusts (this strand of work is funded by the Health Foundation).

This programme of work will enable the team to test and, where necessary, refine their delivery model across a wider range of contexts.

The Eastern AHSN’s patient safety collaborative will build on our existing work by encouraging  and supporting NHS organisations across the region to use Human Factors approaches as part of our patient safety interventions.

For further information about the project, please contact Dr Cinzia Pezzolesi

© Eastern AHSN