A strategy for human factors/ergonomics: developing the discipline and profession

Designing digital patient experiences: The digital health design framework

BACKGROUND

Digital health (DH) brings considerable benefits, but it comes with potential risks. Human Factors (HF) play a critical role in providing high-quality and acceptable DH solutions. Consultation with designers is crucial for reflecting on and improving current DH design practices.

OBJECTIVES

We investigated the general DH design processes, challenges, and corresponding strategies that can improve the digital patient experience (PEx).

METHODS

A semi-structured interview study with 24 design professionals. All audio recordings were transcribed, deidentified, grammatically corrected, and imported into ATLAS.ti for data analysis. Three coders participated in data coding following the thematic analysis approach.

RESULTS

We identified eight DH design stages and grouped them into four phases: preparation, problem-thinking, problem-solving, and implementation. The analysis presented twelve design challenges associated with contextual, practical, managerial, and commercial aspects that can hinder the design process. We identified eight common strategies used by respondents to tackle these challenges.

CONCLUSIONS

We propose a Digital Health Design (DHD) framework to improve the digital PEx. It provides an overview of design deliverables, activities, stakeholders, challenges, and corresponding strategies for each design stage.

Human Factors Contributing to Infection Prevention in Outpatient Hemodialysis Centers: A Mixed Methods Study

RATIONALE & OBJECTIVE

Infection prevention efforts in dialysis centers can avert patient morbidity and mortality but are challenging to implement. The objective of this study was to better understand how the design of the work system might contribute to infection prevention in outpatient dialysis centers.

STUDY DESIGN

Mixed methods, observational study.

SETTING & PARTICIPANTS

Six dialysis facilities across the United States visited by a multidisciplinary team over 8 months.

ANALYTICAL APPROACH

At each facility, structured macroergonomic observations were undertaken by a multidisciplinary team using the SEIPS 1.0 model. Ethnographic observations were collected about staff encounters with dialysis patients including the content of staff conversations. Selective and axial coding were used for qualitative analysis and quantitative data were reported using descriptive statistics.

RESULTS

Organizational and sociotechnical barriers and facilitators to infection prevention in the outpatient dialysis setting were identified. Features related to human performance, (eg, alarms, interruptions, and task stacking), work system design (eg, physical space, scheduling, leadership, and culture), and extrinsic factors (eg, patient-related characteristics) were identified.

LIMITATIONS

This was an exploratory evaluation with a small sample size.

CONCLUSIONS

This study used a systematic macroergonomic approach in multiple outpatient dialysis facilities to identify infection prevention barriers and facilitators related to human performance. Several features common across facilities were identified that may influence infection prevention in outpatient care and warrant further exploration.

Multi-Objective Optimization of an Assembly Layout Using Nature-Inspired Algorithms and a Digital Human Modeling Tool

OCCUPATIONAL APPLICATIONSIn the context of Industry 5.0, our study advances manufacturing factory layout planning by integrating multi-objective optimization with nature-inspired algorithms and a digital human modeling tool. This approach aims to overcome the limitations of traditional planning methods, which often rely on engineers' expertise and inputs from various functions in a company, leading to slow processes and risk of human errors. By focusing the multi-objective optimization on three primary targets, our methodology promotes objective and efficient layout planning, simultaneously considering worker well-being and system performance efficiency. Illustrated through a pedal car assembly station layout case, we demonstrate how layout planning can transition into a transparent, cross-disciplinary, and automated activity. This methodology provides multi-objective decision support, showcasing a significant step forward in manufacturing factory layout design practices.

The evolution of new and emerging occupational health and safety risks: A qualitative review

BACKGROUND

Work itself and occupational health and safety (OHS) have evolved through industrial revolutions and will also continue to evolve in the future.

OBJECTIVE

The aim of this qualitative literature review was to examine how the scientific discussion on new and emerging risks (NERs) related to OHS has evolved in recent decades in developed and newly industrialized countries.

METHODS

A search of the Scopus database yielded 34 articles published before 2000 and from 2020 onwards.

RESULTS

A review of the articles identified NERs themes related to changes in work patterns, changing workforce and growth in some sectors, climate change, new materials or increased use of materials, new technology and technological development, and viruses. In both article collection periods, possible adverse OHS effects discussed included musculoskeletal disorders, exposure to toxic agents, chemical compounds and hazardous materials, increased stress, increased likelihood of errors and accidents, psychosocial problems, mental fatigue, and increases in work-related illnesses and accidents.

CONCLUSIONS

The articles published during both periods discussed similar themes. The main differences were regarding specific time-related cases, such as climate change and COVID-19. Based on the findings of this review, points to consider in OHS management and future studies are discussed.

Leading Quality and Safety on the Frontline - A Case Study of Department Leaders in Nursing Homes

Purpose

The role of healthcare leaders is becoming increasingly complex, and carries great responsibility for patients, employees, and the quality of service delivery. This study explored the barriers and enablers that department leaders in nursing homes encounter when managing the dual responsibilities in Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS).

Methodology

Case study design with data collected through semi structured interviews with 16 department leaders in five Norwegian municipalities. We analyzed the data using qualitative content analysis.

Results

Data analysis resulted in four themes explaining what department leaders in nursing homes experience as barriers and enablers when handling the dual responsibility of HSE and QPS: Temporal capacity: The importance of having enough time to create a health-promoting work environment that ensures patient safety. Relational capacity: Relationships have an impact on work process and outcomes. Professional competence: Competence affects patient safety and leadership strategies. Organizational structure: Organizational frameworks influence how the dual responsibilities are handled.

Conclusion

Evidence from this study showed that external contextual factors (eg, legislations and finances) and internal factors (eg, relationships and expectations) are experienced as barriers and enablers when department leaders are enacting the dual responsibility of HSE and QPS. Of these, relationships were found to be the most significant contributor.

Hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts

OBJECTIVE

Musculoskeletal discomforts (MSDs) are prevalent occupational health issues that are associated with a wide range of risk factors. This study aimed to investigate some of the occupational hidden risk factors and the mediating role of sleep in work-related musculoskeletal discomforts.

METHODS

In a cross-sectional study, the role of job stress and shift work as two hidden risk factors and sleep problems as the mediator in work-related musculoskeletal discomforts was investigated in 302 healthcare workers using the path analysis models. For this aim, healthcare workers' Occupational Stress and musculoskeletal discomforts were evaluated using the Health and Safety Executive questionnaire and Cornell questionnaire, respectively. Moreover, the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) were used to examine the sleep characteristics of participants. Shift work and job stress as predictor variables and sleep characteristics as mediating variables were analyzed.

RESULTS

The results showed that the path coefficients of job stress on indexes of quality sleep and insomnia severity were significant. Also, the path coefficient of shift work on quality sleep index was significant. In return, the path coefficients of shift work on the insomnia severity index were not significant. Additionally, there was a mutually significant association between indexes of quality sleep and the severity of insomnia and musculoskeletal discomforts. The direct effect coefficient of job stress on MSDs was significant, whereas the direct effect coefficient of shift work on MSDs was insignificant. This means that shift work alone does not significantly impact these disorders.

CONCLUSION

It would seem that shift work and job stress as two occupational hidden risk factors can mediate sleep indexes and indirectly play a critical role in the incidence of musculoskeletal discomforts. Moreover, sleep disorders and musculoskeletal discomforts are mutually related and have a bidirectional relationship.

Applying the sustainable system-of-systems framework: wastewater(s) in a rapidly urbanising South African settlement

Addressing wastewater infrastructure needs in urban informal settlements must simultaneously address legacies of past failures, current aspirations and constraints, as well as increasingly changing needs related to global environmental change. This study applied the Sustainable System-of-Systems framework for ergonomics and human factors to gain a better understanding of how small in-situ constructed wetlands could be a form of greywater treatment infrastructure in an informal settlement. Using 24 months of interviews, surveys, workshops and photo-ethnographic observations, we identified that the rapidly changing nature of parent (e.g. residency transience and land ownership) and sibling (e.g. housing and drinking water) systems put pressure on the target wetland system to adapt, often decreasing its capacity to deliver the service of water cleaning. Greywater treatment was not a common goal among stakeholders involved in the nested hierarchy system which likely contributed to the constructed wetlands needing to adapt to remain relevant.Practitioner summary: The value of the Sustainable Systems-of-Systems framework for ergonomics/human factors professionals in determining the sustainability of an ergonomics/human factors intervention is demonstrated using a greywater treatment system case study for an urban informal settlement. Understanding the variety of stakeholder goals and the pace of change in related systems was key to a sustainable intervention.

Knowledge mapping analysis of safety ergonomics: a bibliometric study

Although a significant attention, the field of safety ergonomics has not yet been systematically profiled based on recent studies. To fully understand the current research status, basis, hotspots, and development trends in the field, 533 documents from the Web of Science core database were used for knowledge mapping analysis by the bibliometric method. The study found that the USA is the top country in publications, and Tehran University is the institution with the highest number of publications. Ergonomics and Applied Economics are the authoritative safety ergonomics journals. Through co-occurrence and co-citation analysis, current safety ergonomics research is focussed on healthcare, product design, and occupational health and safety. The keyword timeline view indicates that the main research paths are occupational health and safety, and patient safety research. The analysis of burst keywords shows that safety ergonomics research in management, model design, and system design areas are research frontiers in the field.Practitioner summary: This paper presents a knowledge mapping of safety ergonomics research through bibliometric analysis. The research results show the research status, research hotspots, and research frontiers in the field of safety ergonomics, which provides a direction for other scholars to quickly understand the development of this field.

Interactions in Sociotechnical Systems: Achieving Balance in the Use of an Augmented Reality Mobile Application

OBJECTIVE

We explore relationships between barriers and facilitators experienced by users to understand dynamic interactions in sociotechnical systems and improve a mobile phone-based augmented reality application that teaches users about the contents of a standardized pediatric code cart.

BACKGROUND

Understanding interactions between performance obstacles and facilitators can provide guidance to (re)designing sociotechnical systems to improve system outcomes. Clinicians should know about contents and organization of code carts, and an augmented reality mobile application may improve that knowledge but changes the sociotechnical system in which they learn. Prior work identified barriers and facilitators impacting the use of this application-participants described dimensions together, indicating interactions that are explored in the current study.

METHOD

We conducted four focus groups (number of clinicians = 18) and two interviews with clinicians who used the application. We performed a secondary analysis of focus group data exploring interactions between previously identified barriers and facilitators to application use. We used epistemic network analysis to visualize these interactions.

RESULTS

Work system barriers interacted with barriers and facilitators interacted with facilitators to amplify cumulative negative or positive impact, respectively. Facilitators balanced barriers, mitigating negative impact. Facilitators also exacerbated barriers, worsening negative impact.

CONCLUSION

Barriers and facilitators interact and can amplify, balance, and exacerbate each other-notably, positives are not always positive. To obtain desired outcomes, interactions must be further considered in sociotechnical system design, for example, the potential improvements to the application we identified.

Safety on the ground: using critical incident technique to explore the factors influencing medical registrars' provision of safe care

BACKGROUND

Avoidable patient harm in hospitals is common, and doctors in training can provide underused but crucial insights into the influencers of patient safety as those working 'on the ground' within the system. This study aimed to explore the factors that influence safe care from the perspective of medical registrars, to identify targets for safety-related improvements.

METHODS

This study used enhanced critical incident technique (CIT), a qualitative methodology that results in a focused understanding of significant factors influencing an activity, to identify practical solutions. We interviewed 12 out of 17 consenting medical registrars in Scotland, asking them to recount their observations during clinical experiences where something happened that positively or negatively impacted on patient safety. Data were analysed manually using a modified content analysis with credibility checks as per enhanced CIT, with data exhaustiveness reached after six registrars.

RESULTS

A total of 221 critical incidents impacting patient safety were identified. These were inductively placed into 24 categories within 4 overarching categories: Individual skills, encompassing individual behavioural and technical skills; Collaboration, regarding how communication, trust, support and flexibility shape interprofessional collaboration; Organisation, concerning organisational systems and staffing and Training environment, relating to culture, civility, having a voice and learning at work. Practical targets for safety-related interventions were identified, such as clear policies for patient care ownership or educational interventions to foster civility.

CONCLUSIONS

This study provides a rigorous and focused understanding of the factors influencing patient safety in hospitals, using the 'insider' perspective of the medical registrar. Safety goes beyond the individual and is reliant on safe system design, interprofessional collaboration and a culture of support, learning and respect. Organisations should also promote flexibility within clinical practice when patient needs do not conform to standardised care pathways. We suggest targeted interventions within educational and organisational priorities to improve safety in hospitals.

Managing patient safety and staff safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities-a case study

Objective

Within healthcare, the role of leader is becoming more complex, and healthcare leaders carry an increasing responsibility for the performance of employees, the experience and safety of patients and the quality of care provision. This study aimed to explore how leaders of nursing homes manage the dual responsibility of both Health, Safety and Environment (HSE) and Quality and Patient Safety (QPS), focusing particularly on the approaches leaders take and the dilemmas they face. In addition, we wanted to examine how leaders experience and manage the challenges of HSE and QPS in a holistic way.

Design/setting

The study was designed as a case study. Data were collected through semi structured individual interviews with leaders of nursing homes in five Norwegian municipalities.

Participants

13 leaders of nursing homes in urban and rural municipalities participated in this study.

Results

Data analysis resulted in four themes explaining how leaders of nursing homes manage the dual responsibility of HSE and QPS, and the approaches they take and the dilemmas they face: 1.Establishing good systems and building a culture for a work environment that promotes health and patient safety.2.Establish channels for internal and external collaboration and communication.3.Establish room for maneuver to exercise leadership.4.Recognizing and having the mandate to handle possible tensions in the dual responsibility of HSE and QPS.

Conclusions

The study showed that leaders of nursing homes who are responsible for ensuring quality and safety for both patients and staff, experience tensions in handling this dual responsibility. They acknowledged the importance of having time to be present as a leader, to have robust systems to maintain HSE and QPS, and that conflicting aspects of legislation are an everyday challenge.

Examining human factors and ergonomics aspects in a manufacturing organisation's metrics system: measuring up to stakeholder needs

This research examines the status of human factors and ergonomics (HF/E) metrics in the case context of product realisation in an electronics manufacturing company. Interactions with 100+ stakeholders over a five year period were thematically analysed for metrics-related views and content. A disconnect between engineering metrics and HF/E metrics was evident. Engineers and HF/E specialists expressed different understandings of the gap between the disciplines and how to generate HF/E metrics that would fit the organisation. Other emerging themes provided insight for metrics development including improving indicator relatability, considerations for communication of information, and barriers to implementation of metrics. The results led to seven recommendations to help guide practitioners in developing and refining HF/E metrics as part of an organisation's metrics system. This macroergonomic case study provides key points for consideration when developing HF/E focussed metrics to support organisations being more proactive with HF/E in work system design. Practitioner summary: Metrics' presence, stakeholder views on metrics, and metrics-related content in a case organisation were thematically analysed with a macroergonomics focus. Human factors and ergonomics metrics (HF/E) were disconnected from engineering metrics thus limiting the design team's ability to handle human factors in design. Factors influencing HF/E metrics creation and integration were identified, resulting in seven recommendations for developing HF/E metrics.

A systematic review of literature on occupational health and safety interventions for older workers

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents 'A future research agenda for older worker health, safety and well-being interventions.' This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design.Practitioner summary: We conducted a systematic literature review of studies focussed on workplace interventions to improve the physical and psychological safety of older workers. Within the existing literature, evidence for effective interventions and guidance for organisations is weak. We present a future research agenda with a systems approach to address these gaps.

Shaping the development and use of Artificial Intelligence: how human factors and ergonomics expertise can become more pertinent

New developments in Artificial Intelligence (AI) are extensively discussed in public media and scholarly publications. While in many academic disciplines debates on the challenges and opportunities of Artificial Intelligence (AI) and how to best address them have been launched, the human factors and ergonomics (HFE) community has been strangely quiet. I discuss three main areas in which HFE could and should significantly contribute to the socially and economically viable development and use of AI: decisions on automation versus augmentation of human work; alignment of control and accountability for AI outcomes; counteracting power imbalances among AI stakeholders. I then outline actions that the HFE community could undertake to improve their involvement in AI development and use, foremost translating ethical into design principles, strengthening the macro-turn in HFE, broadening the HFE design mindset, and taking advantage of new interdisciplinary research opportunities.Practitioner summary: HFE expertise could and should significantly contribute to the socially and economically viable development and use of AI. Translating ethical into design principles, opening up to broader multi-stakeholder perspectives, and engaging in interdisciplinary collaboration within a design science framework are discussed as measures to achieve that.

Safety and usability of proning pillows in intensive care: A scoping review

OBJECTIVES

Proning is an established technique for the care of intubated patients with severe respiratory failure. Positioning devices used to support the head and body of patients placed in the prone position are often associated with the formation of pressure injuries. Despite robust literature on the prevention and monitoring of pressure injuries, little is described about the role of proning pillows on pressure injuries. The objective of this review is to understand the extent of evidence pertaining to the safety and usability of different types of proning pillows in the intensive care setting.

REVIEW METHOD

A scoping review of the literature was completed using predefined search terms in three databases and identified 296 articles. An additional 26 were included from reference lists. Twenty studies are included in the analysis; most were published in the past 3 years, with >50% in surgical settings.

DATA SOURCES

Three databases were searched: PubMed, Scopus, and EMBASE.

REVIEW METHODS

The review followed the PRISMA Extension for Scoping Reviews, and data were reviewed using Covidence.

RESULTS

The most prevalent proning pillow is a standard, noncontoured foam head positioner. It is responsible for the majority of facial pressure injuries in all settings of care. Memory foam pillows and helmet-based systems offer improved surface pressure distribution, although their usability in the intensive care setting remains poorly studied. Inflatable air-cell-based devices present an alternative, but the lack of supporting research and the costs may explain their poor uptake. Several articles proposed the use of pressure sensor systems to evaluate devices. We propose a set of ergonomic parametres to consider when choosing or designing a positioning device for proned patients.

CONCLUSION

The evidence pertaining to the safety and usability of proning pillows in the intensive care setting is scarce, which provides opportunities for future research to improve the efficacy in the prevention of pressure injuries and the user experience.

Proposal of guidelines to assist managers to face pressing challenges confronting Latin American universities: a complexity theory perspective

The Covid-19 pandemic exacerbated pre-existing problems in Latin America and posed unprecedented challenges for Latin American universities (LAU). These challenges can be characterised as complex problems that cannot be understood through reductionist approaches. This paper aims (i) to provide a complex system perspective of the challenges confronting LAUs and (ii) to propose guidelines for managers of LAUs to address them in practice. A multidisciplinary group was formed and conducted an iterative process of research, brainstorming and debate of potential solutions to the following problems considered particularly important by their universities: mental health issues in the university environment, student learning gaps, brain drain, and anti-science movements. Complexity theory and E/HF concepts are integrated to demonstrate that understanding what LAUs are experiencing in a fragmented manner is impossible, and that the interactions between the challenges should be at the centre of the managers' actions plans. Practitioner summary: Managers of LAUs can benefit from the guidelines proposed to understand the pressing challenges confronting universities and develop systemic approaches to address them.

Do work-family conflict or family-work conflict mediate relationships between work-related hazards and stress and pain?

INTRODUCTION

Previous research has identified associations between work-family conflict (WFC) and health outcomes (e.g., musculoskeletal pain). This study investigated whether WFC and family-work conflict explain relationships between exposure to work-related hazards and musculoskeletal pain and stress for workers undertaking some or all of their work at home. Possible differences by home workspace location were also explored.

METHODS

Longitudinal survey data were collected from workers in Australia engaged in work from home for at least two days per week. Data was collected at four timepoints approximately 6 months apart (Baseline [October 2020] n = 897; Wave 1 [May/June 2021] n = 368; Wave 2 [October/November 2021] n = 336; Wave 3 [May 2022] n = 269). Subjective measures of work-related psychosocial hazards, occupational sitting and physical activity, musculoskeletal pain, and stress were collected via an online questionnaire. Mediation analyses were conducted using the R package "mediation." Analyses were also conducted with the data set stratified by home office location, using R version 4.1.3.

RESULTS

Both WFC and family-work conflict acted as mediators between psychosocial work-related hazards and musculoskeletal pain and stress. WFC mediated more relationships than family-work conflict. Location of home workspace was important, particularly for those working in a space at home where they may be subject to interruptions.

CONCLUSION

Addressing WFC is a legitimate means through which musculoskeletal pain and stress can be reduced. Organizational risk management strategies need to address all work-related risks, including those stemming from work-life interaction.

Development of a new set of Heuristics for the evaluation of Human-Robot Interaction in industrial settings: Heuristics Robots Experience (HEUROBOX)

Humans and robots will increasingly have to work together in the new industrial context. Therefore, it is necessary to improve the User Experience, Technology Acceptance, and overall wellbeing to achieve a smoother and more satisfying interaction while obtaining the maximum performance possible out of it. For this reason, it is essential to analyze these interactions to enhance User Experience. The heuristic evaluation is an easy-to-use, low-cost method that can be applied at different stages of a design process in an iterative manner. Despite these advantages, there is rarely a list of heuristics in the current literature that evaluates Human-Robot interactions both from a User Experience, Technology Acceptance, and Human-Centered approach. Such an approach should integrate key aspects like safety, trust, and perceived safety, ergonomics and workload, inclusivity, and multimodality, as well as robot characteristics and functionalities. Therefore, a new set of heuristics, namely, the HEUROBOX tool, is presented in this work in the form of the HEUROBOX tool to help practitioners and researchers in the assessment of human-robot systems in industrial environments. The HEUROBOX tool clusters design guidelines and methodologies as a logic list of heuristics for human-robot interaction and comprises four categories: Safety, Ergonomics, Functionality, and Interfaces. They include 84 heuristics in the basic evaluation, while the advanced evaluation lists a total of 228 heuristics in order to adapt the tool to the evaluation of different industrial requirements. Finally, the set of new heuristics has been validated by experts using the System Usability Scale (SUS) questionnaire and the categories has been prioritized in order of their importance in the evaluation of Human-Robot Interaction through the Analytic Hierarchy Process (AHP).

Healthcare leaders' and elected politicians' approach to support-systems and requirements for complying with quality and safety regulation in nursing homes - a case study

BACKGROUND

Healthcare leaders play an important and complex role in managing and handling the dual responsibility of both Health, Safety and Environment (HSE) for workers and quality and patient safety (QPS). There is a need for better understanding of how healthcare leaders and decision makers organize and create support structures to handle these combined responsibilities in practice. The aim of this study was to explore how healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS in a Norwegian nursing home context. Moreover, we explore how they interpret, negotiate, and manage the dual responsibility and possible tensions between employee health and safety, and patient safety and quality of service delivery.

METHODS

The study was conducted in 2022 as a case study exploring the experience of healthcare leaders and elected politicians in five municipalities responsible for providing nursing homes services in Norway. Elected politicians (18) and healthcare leaders (11) participated in focus group interviews (5) and individual interviews (11). Data were analyzed using inductive thematic analysis.

RESULTS

The analysis identified five main themes explaining how the healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS: 1. Establish frameworks and room for maneuver in the work with HSE and QPS. 2. Create good routines and channels for communication and collaboration. 3. Build a culture for a health-promoting work environment and patient safety. 4. Create systems to handle the possible tensions in the dual responsibility between caring for employees and quality and safety in service delivery. 5. Define clear boundaries in responsibility between politics and administration.

CONCLUSIONS

The study showed that healthcare leaders and elected politicians who are responsible for ensuring sound systems for quality and safety for both patients and staff, do experience tensions in handling this dual responsibility. They acknowledge the need to create systems and awareness for the responsibility and argue that there is a need to better separate the roles and boundaries between elected politicians and the healthcare administration in the execution of HSE and QPS.

The work of first line managers - A key to resilience in manufacturing

First-line managers (FLMs) have a vital role in developing stable output and organizational competitiveness through their ability to manage front-line operations in daily work. It is also well known that FLMs are strong determinants of good ergonomics and well-being for front-line staff. However, research focusing on how FLMs deal with their important role is lacking particularly regarding empirical studies. The focus here is how they deal with uncertainties and disruptive interruptions and develop more resilient performance in daily work - introduced in this article as resilient action strategies. This research uses two conceptual frameworks on resilient engineering for analysis of FLM's actions in daily work in two manufacturing companies, to explore how resilient action strategies can be organizationally supported. The study combines analysis of front-line activities with multilevel organizational support based on 30 semi-structured in-depth interviews with FLMs and support functions, 21 workshops as well as policy documents of the two companies. The analysis exemplifies how resilience engineering was enabled in practice in the organizations. The study contributes to the empirical understanding of how resilience can be organizationally supported in daily front-line work. Our results show that a developed and consistent infrastructure in companies promotes the emergence of resilient action strategies in front-line work. We propose an extended model for resilient front-line performance enhancement by including coordination as a linking aspect between the earlier suggested resilient potentials - anticipate, monitor, respond and learn. This highlights the importance of both organizational support and coordination between system levels to enable the development of resilient action strategies by FLMs.

Can home care work be organized to promote health among the workers while maintaining productivity? An investigation into stakeholders' perspectives on organizational work redesign concepts based on the Goldilocks Work principles

BACKGROUND

Due to the aging population, the need for home care services is increasing in most Western countries, including Norway. However, the highly physical nature of this job could contribute to make recruiting and retaining qualified home care workers (HCWs) challenging. This issue may be overcome by adopting the Goldilocks Work principles, aiming at promoting workers' physical health by determining a "just right" balance between work demands and recovery periods while maintaining productivity. The aim of this study was to 1) gather suggestions from home care employees on suitable organizational (re)design concepts for promoting HCWs' physical health and 2) have researchers and managers define actionable behavioral aims for the HCWs for each proposed (re)design concept and evaluate them in the context of the Goldilocks Work principles.

METHODS

HCWs, safety representatives, and operation coordinators (n = 14) from three Norwegian home care units participated in digital workshops led by a researcher. They suggested, ranked, and discussed redesign concepts aimed at promoting HCWs' health. The redesign concepts were subsequently operationalized and evaluated by three researchers and three home care managers.

RESULTS

Workshop participants suggested five redesign concepts, namely "operation coordinators should distribute work lists with different occupational physical activity demands more evenly between HCWs", "operation coordinators should distribute transportation modes more evenly between HCWs", "Managers should facilitate correct use of ergonomic aids and techniques", "HCWs should use the stairs instead of the elevator", and "HCWs should participate in home-based exercise training with clients". Only the first two redesign concepts were considered to be aligned with the Goldilocks Work principles. A corresponding behavioral aim for a "just right" workload was defined: reduce inter-individual differences in occupational physical activity throughout a work week.

CONCLUSIONS

Operation coordinators could have a key role in health-promoting organizational work redesign based on the Goldilocks Work principles in home care. By reducing the inter-individual differences in occupational physical activity throughout a work week, HCWs' health may be improved, thus reducing absenteeism and increasing the sustainability of home care services. The two suggested redesign concepts should be considered areas for evaluation and adoption in practice by researchers and home care services in similar settings.

The Electronic Health Record as a Quality Improvement Tool: Exceptional Potential with Special Considerations

The electronic health record (EHR) offers an exciting opportunity for quality improvement efforts. An understanding of the nuances of a site's EHR landscape including the best practices in clinical decision support design, basics of data capture, and acknowledgment of the potential unintended consequences of technology change is essential to ensuring effective usage of this powerful tool.

Human factors in anaesthesia: a narrative review

Healthcare relies on high levels of human performance, as described by the 'human as the hero' concept. However, human performance varies and is recognised to fall in high-pressure situations, meaning that it is not a reliable method of ensuring safety. Other safety-critical industries embed human factors principles into all aspects of their organisations to improve safety and reduce reliance on exceptional human performance; there is potential to do the same in anaesthesia. Human factors is a broad-based scientific discipline which aims to make it as easy as possible for workers to do things correctly. The human factors strategies most likely to be effective are those which 'design out' the chance of an error or adverse event occurring. When errors or adverse events do happen, barriers are in place to trap them and reduce the risk of progression to patient and/or worker harm. If errors or adverse events are not trapped by these barriers, mitigations are in place to minimise the consequences. Non-technical skills form an important part of human factors barriers and mitigation strategies and include: situation awareness; decision-making; task management; and team working. Human factors principles are not a substitute for proper investment and appropriate staffing levels. Although applying human factors science has the potential to save money in the long term, its proper implementation may require investment before reward can be reaped. This narrative review describes what is known about human factors in anaesthesia to date.

Human factors and safety analysis methods used in the design and redesign of electronic medication management systems: A systematic review

INTRODUCTION

Poorly designed electronic medication management systems (EMMS) or computerized physician order entry (CPOE) systems in hospital settings can result in usability issues and in turn, patient safety risks. As a safety science, human factors and safety analysis methods have potential to support the safe and usable design of EMMS.

OBJECTIVE

To identify and describe human factors and safety analysis methods that have been used in the design or redesign of EMMS used in hospital settings.

MATERIALS AND METHODS

A systematic review, following PRISMA guidelines, was conducted by searching online databases and relevant journals from January 2011 to May 2022. Studies were included if they described the practical application of human factors and safety analysis methods to support the design or redesign of a clinician-facing EMMS, or its components. Methods used were extracted and mapped to human centered design (HCD) activities: understanding context of use; specifying user requirements; producing design solutions; and evaluating the design.

RESULTS

Twenty-one papers met the inclusion criteria. Overall, 21 human factors and safety analysis methods were used in the design or redesign of EMMS with prototyping, usability testing, participant surveys/questionnaires and interviews the most frequent. Human factors and safety analysis methods were most frequently used to evaluate the design of a system (n = 67; 56.3%). Nineteen of 21 (90%) methods used aimed to identify usability issues and/or support iterative design; only one paper utilized a safety-oriented method and one, a mental workload assessment method.

DISCUSSION AND CONCLUSION

While the review identified 21 methods, EMMS design primarily utilized a subset of available methods, and rarely a method focused on safety. Given the high-risk nature of medication management in complex hospital environments, and the potential for harm due to poorly designed EMMS, there is significant potential to apply more safety-oriented human factors and safety analysis methods to support EMMS design.

Analysing dynamic work systems using DynEAST: a demonstration of concept

The capability of current Ergonomics methods to capture dynamism is limited, stifling our understanding of work-as-done, distributed situational awareness and organisational drift. This paper provides a demonstration of concept of DynEAST; an extension of the EAST framework underpinned by principles from Dynamic Network Analysis, to capture elements of dynamism within work systems. The DynEAST concept is applied to a railway maintenance case study. Case study findings demonstrate how DynEAST outputs can be used to advance our understanding of the aforementioned phenomena and better equip practitioners for current and future Ergonomics challenges.Practitioner summary: This paper introduces the DynEAST method. DynEAST enables HF/E practitioners to model and analyse dynamic features of complex work systems. The development of DynEAST is timely due to the concurrent proliferation of increasingly complex sociotechnical systems and stagnation of HF/E methods development; particularly those able to model systemic dynamism. Abbreviations: DynEAST: dynamic event analysis of systemic teamwork; EAST: dynamic event analysis of systemic teamwork; HF/E: human factors and ergonomics; HF: human factors; DNA: dynamic network analysis; HTA: hierarchal task analysis; CWA: cognitive work analysis; CAST: causal analysis based on system theory; STAMP: system theoretic accident model and processes; FRAM: functional resonance analysis method; SNA: social network analysis; DSA: distributed situational awareness; PPO: possession protection officer; PO: protection officer; RTS: railway track signals; LPA: local possession authority; SMEs: subject matter experts.

It practically drives itself: autonomous vehicle technology, psychological attitudes, and susceptibility to risky driving behaviors

This study examines how favourable attitudes towards autonomous vehicle technology and automation-induced complacency relate to unsafe driving behaviours using semi-autonomous vehicles as an exemplar. The sample consisted of 441 college students and a repeated measures design was used to examine the relationships between psychological attitudes and susceptibility to risky driving behaviours across three scenarios. Linear regression analyses were conducted for hypothesis testing. Study 1 showed that favourable attitudes towards autonomous vehicle technologies were not significantly associated with susceptibility to risky driving behaviours. Study 2 replicated this finding, however, automation-induced complacency was significantly associated with susceptibility to risky driving behaviours. Additionally, evidence was found for the incremental validity of automation-induced complacency over favourable attitudes towards autonomous features. In distinguishing favourable attitudes towards autonomous features from automation-induced complacency, future research and policy-making can separately address these constructs for the promotion of traffic safety and policy-making.Practitioner summary: We aimed to assess inclinations towards risky driving behaviours in semi-autonomous vehicles. Using vignettes, we found that favourable attitudes towards autonomous vehicles are not associated with risky behaviours, but automation-induced complacency was. Our findings suggest policies like educational programs can be implemented to prevent misuse of semi-autonomous vehicles.

The medication self-management work system of patients and informal carers from a human factors & ergonomics perspective: A scoping review protocol

Background: Healthcare is increasingly delivered closer to the patients' homes, which increases the level of responsibility that patients and informal carers take for managing their medication-taking, although this is associated with hazards. Medication self-management has been conceptualised as work taking place in non-formal settings ( e.g., households), which are complex systems. Human factors and ergonomics (HFE) models provide a framework for studying such systems. The Systems Engineering Initiative for Patient Safety (SEIPS) is one framework that considers work system elements and how they interact with each other to shape processes that lead to outcomes ( e.g., safety). Given the increasing amount of diverse research on patient and carer work and on system-shaping factors, the objectives of this review are to: (i) identify available evidence in a structured and systems-oriented way, (ii) explore approaches that have been applied and (iii) highlight research gaps. Methods: An evidence-informed patient, public and carer involvement (PPCI) approach will be implemented at all post-protocol stages to ensure the relevance, uptake and translation of the scoping review. The review will systematically search MEDLINE, Embase, PsycInfo, CINAHL and Web of Science to identify relevant qualitative studies. The methodological approach will be guided by Johanna Briggs Institute methodology and will be reported according to the PRISMA-ScR standards. Data charting and qualitative content analysis directed by SEIPS will explore how the work system and its constituting elements have been described in the literature and identify specific gaps and opportunities for future research. Borrowing from realist approaches, included studies will be assessed in terms of richness and relevance to our review question. Discussion: Strengths of this scoping review include PPCI and a converging focus on medication safety, medication self-management and HFE. Ultimately, this approach will advance our understanding of this complex system and guide opportunities to broaden and strengthen the evidence base.

Ergonomics management model based on good practices of large industrial companies: Structured elements through the fuzzy set theory

BACKGROUND

Most organizations perceive the concept of ergonomic actions as a local tool used to improve workplace issues. Ergonomics however is not included in global management systems. The paradigm of ergonomics action in large organizations proposed by this study is that of management systems whose primary objective is the pressing need for continuous performance improvement, acquisition of excellence, and integration into all aspects of the business.

OBJECTIVE

The general objective of this work is to draw a frame presenting a model of ergonomics management based on good practices in managing this discipline in large industrial companies.

METHOD

In this study, we describe a strategy based on the fuzzy set theory to aggregate a group of good practices expressed by experienced ergonomists attached to large industrial companies for handling the lack of ergonomics in an organization.

RESULTS

A set of good practices was compiled as a basis for application in ergonomics in large companies.

CONCLUSION

This study shows that ergonomics should not be considered an isolated phenomenon but in a strategic, proactive, integrated, and perennial way as one of the management subjects.

Barriers and Challenges to Human Factors/Ergonomics Knowledge Transfer to Small Business Enterprises in an Industrially Developing Country

OCCUPATIONAL APPLICATIONWe found that small business enterprises (SBEs) face intra- and extra-organizational barriers in different dimensions related to their work system to practically implement human factors/ergonomics (HFE) knowledge transfer and to achieve its benefits in an industrially developing country. Utilizing a three-zone lens, we evaluated the feasibility of overcoming the barriers identified by stakeholders, especially ergonomists. To overcome the identified barriers in practice, three types of macroergonomics interventions (top-down, middle-out, and bottom-up) were distinguished through macroergonomics theory. The bottom-up approach of macroergonomics, as a participatory HFE intervention, was considered as the entry point to overcome the perceived barriers in the first zone of the lens, which included such themes as lack of competence, lack of involvement and interaction, and inefficient training and learning approaches. This approach focused on improving emotional literacy as a care zone among the small business enterprise personnel.

The effect of information level of digital worker guidance systems on assembly performance, user experience and strain

Worker guidance systems provide product-specific and digital assembly information and can make an important contribution to increasing productivity and quality and relieving employees, especially in flexible variant assembly. However, a critical factor here is the successful design of the systems. While much of the research focuses on aspects of the hardware, this article is dedicated to the question of how the configuration of the level of information, i.e. the amount and depth of information in worker guidance systems, is affected. For this purpose, two studies, a laboratory study at the Technical University of Darmstadt (N = 53) and a field study at a company (N = 30), were conducted and two variants of the information level of a worker guidance system were compared. The study results show that assembly quality in particular is significantly influenced by the level of information; to the advantage of detailed information. No significant differences were found for production times. For the subjective evaluation of the system as well as for the objective and subjectively perceived strain, it can be stated that the high level of information also performs better. The results thus help to design worker guidance systems more precisely so that they fulfill the information needs of the employees as well as possible.

Assessment of selected psychosocial risk factors: stress, job burnout, and bullying in the case of medical staff as part of workplace ergonomics during the COVID-19 pandemic-A prospective pilot study

Background

The purpose of the pilot study conducted by the authors was to assess occupational risk in selected areas of psychosocial risk factors among health professions in a pilot study. Medical staff working in the healthcare sector experience stress, job burnout and bullying on a daily basis. Monitoring occupational risks in the above areas provides an opportunity to take appropriate preventive measures.

Methods

The prospective online survey included 143 health care workers from various professional groups. Eighteen participants did not complete the survey, and the results of 125 participants were eventually included in the analysis. The study used health and safety questionnaires in the healthcare sector, which are not widely used as screening tools in Poland.

Results

The following statistical methods were performed in the study: the Mann-Whitney test, Kruskal-Wallis test, Dunn's test. In addition, multivariate analysis was performed. The results obtained in the study indicate that the questionnaires used in the study can be widely used by employers or occupational medicine as screening tools.

Conclusions

Our findings show that level of education attainment in healthcare is correlated with higher chance of experiencing stress and burnout. Among the surveyed professions, nurses reported a higher amount of stress and burnout. Paramedics reported the highest chance of being bullied at work. This can be explained by their nature of work which requires directly interacting with patients and their families. In addition, it should be noted that the tools used can be successfully applied in workplaces as elements of workplace ergonomics assessment in the context of cognitive ergonomics.

Understanding the domain of driving distraction with knowledge graphs

This paper aims to provide insight into the driving distraction domain systematically on the basis of scientific knowledge graphs. For this purpose, 3,790 documents were taken into consideration after retrieving from Web of Science Core Collection and screening, and two types of knowledge graphs were constructed to demonstrate bibliometric information and domain-specific research content respectively. In terms of bibliometric analysis, the evolution of publication and citation numbers reveals the accelerated development of this domain, and trends of multidisciplinary and global participation could be identified according to knowledge graphs from Vosviewer. In terms of research content analysis, a new framework consisting of five dimensions was clarified, including "objective factors", "human factors", "research methods", "data" and "data science". The main entities of this domain were identified and relations between entities were extracted using Natural Language Processing methods with Python 3.9. In addition to the knowledge graph composed of all the keywords and relationships, entities and relations under each dimension were visualized, and relations between relevant dimensions were demonstrated in the form of heat maps. Furthermore, the trend and significance of driving distraction research were discussed, and special attention was given to future directions of this domain.

Wearable Sensors and Artificial Intelligence for Physical Ergonomics: A Systematic Review of Literature

Physical ergonomics has established itself as a valid strategy for monitoring potential disorders related, for example, to working activities. Recently, in the field of physical ergonomics, several studies have also shown potential for improvement in experimental methods of ergonomic analysis, through the combined use of artificial intelligence, and wearable sensors. In this regard, this review intends to provide a first account of the investigations carried out using these combined methods, considering the period up to 2021. The method that combines the information obtained on the worker through physical sensors (IMU, accelerometer, gyroscope, etc.) or biopotential sensors (EMG, EEG, EKG/ECG), with the analysis through artificial intelligence systems (machine learning or deep learning), offers interesting perspectives from both diagnostic, prognostic, and preventive points of view. In particular, the signals, obtained from wearable sensors for the recognition and categorization of the postural and biomechanical load of the worker, can be processed to formulate interesting algorithms for applications in the preventive field (especially with respect to musculoskeletal disorders), and with high statistical power. For Ergonomics, but also for Occupational Medicine, these applications improve the knowledge of the limits of the human organism, helping in the definition of sustainability thresholds, and in the ergonomic design of environments, tools, and work organization. The growth prospects for this research area are the refinement of the procedures for the detection and processing of signals; the expansion of the study to assisted working methods (assistive robots, exoskeletons), and to categories of workers suffering from pathologies or disabilities; as well as the development of risk assessment systems that exceed those currently used in ergonomics in precision and agility.

Perceived human factors from the perspective of paramedics – a qualitative interview study

Background

The work environment in prehospital emergency medical care setting is dynamic and complex and includes many stressors. However, little is known about the perceived human factors from the perspective of paramedics. In this study, we investigated, from the perspective of paramedics, what are the human factors, and how are they linked to prehospital emergency medical care?

Methods

Data were collected through semi-structured interviews (n = 15) with Finnish paramedics. The material was analyzed using inductive content analysis.

Results

Three main categories of human factors were identified. The first main category consisted of factors related to work which were divided into two generic categories: “Challenging organizational work environment” and “Changing external work environment.” The second main category comprised factors related to paramedics themselves and were divided into three generic categories: “Issues linked to personality,” “Personal experiences”, and “Factors resulting from personal features.” The third main category described that paramedics have difficulties in understanding and describing human factors.

Conclusion

This study revealed numerous factors that can affect paramedics’ work in the EMS setting. Increased knowledge about human factors in the EMS setting provides organizations with the opportunity to develop procedures that can support paramedics’ cognitive and physical work. Human factors in different situations can be addressed to improve occupational and patient safety.

The barriers and opportunities to support the early career academics and professionals in human factors/ergonomics - revisiting reflections from IEA2015, IEA2018 & IEA2021

BACKGROUND: The Early-Career Community (ECC) comprises researchers, practitioners, and professionals in their “early-career” stages in the Human Factors/Ergonomics (HFE) profession. Early-career HFE professionals are essential to both current industry decision making and future growth of our profession. OBJECTIVE: This paper provides detailed insights into the barriers and suggestions to support engagement with ECC within the International Ergonomics Association (IEA) and its Federated Societies. METHODS: This report integrates key findings from the formal and informal discussions that occurred with diverse groups of stakeholders (n > 100) at IEA2015, IEA2018 and IEA2021 guided by the participatory inquiry paradigm, cooperative action-inquiry and participatory ergonomics approaches. RESULTS: Barriers to support ECC include: a lack of employment opportunities, poor general awareness and integration of HFE in existing university-courses, financial constraints, inclusivity challenges and a lack of Influence in decision-making. While some of the more systemic challenges are context-specific and cannot be overcome, ECCs suggested that: the IEA and its Federated Societies include ECC members as part of their boards; a Standing Committee for the ECCs be established as part of the IEA; make use of social-media more effectively to engage the ECC. More mentorship, networking, knowledge sharing, training and education, combined with financial-support will ensure that the ECC can participate. CONCLUSION: ECC members experience complex and dynamic challenges that affect their development and involvement in the broader HFE profession. It is therefore critical that appropriate, global, national and local strategies are developed to continue to support and develop the ECC to ensure the continued growth of and demand for HFE.

Vocal ergonomics with sports coaches: Co-devised approaches to occupational voice

BACKGROUND: Work-system participation and factors are associated with occupational vocal health for vocally reliant workers, such as sports coaches. However, there is limited use of systems approaches and worker collaboration to address occupational voice. OBJECTIVE: The current research aimed to cooperatively consider coaches’ vocally reliant systems participation, including addressing vocal ergonomic factors that can create barriers for occupational vocal health and voice use. METHODS: Collaborative action inquiries explored vocal ergonomics with coaches (n = 24) from nine professional basketball teams. Across three basketball seasons, coaches and a subject matter expert identified what influenced coaches’ voices and trialed approaches to optimize vocally reliant coaching participation. Nine action inquiry methods were used, including search conferences, ergonomic approaches to enhance systems participation, and focus groups. Multi-level analyses were also undertaken. RESULTS: Participants cooperatively generated, implemented, and evaluated different strategies. A cumulative total of 57 strategies were explored within teams (team mean = 6.33, SD = 3, range = 4–14). Cross-case analysis identified 25 different strategy types. Overall, participants appraised 31.58% (18/57) strategies as supportive (i.e., enhanced facilitators for voice), 61.40% (35/57) strategies as somewhat supportive (i.e., some enhanced facilitators and some ongoing barriers), and 7.02% (4/57) strategies as unsupportive (i.e., pervasive ongoing barriers not mitigated by strategies). Further, factors across coaches’ work-systems continued to influence coaches’ voices in dynamic and complex ways. CONCLUSIONS: Collaboration with coaches enriched vocal ergonomic approaches by providing novel, context-anchored insights. Collaboration should form ‘part’ of broader mechanisms to support coaches’ voice use and vocal health at work.

Ergonomic work analysis and training: Past, present and future

BACKGROUND: The Ergonomic Work Analysis and Training (EWAT) network celebrated its 30th anniversary in 2021. OBJECTIVE: THE EWAT focuses mainly on how activity analysis in real work can contribute to the training situations. Over the years, two lines of thought evolved: i) training in ergonomic work analysis, and ii) the use of the work analysis for the improvement or design of training interventions. Both share a common theoretical and methodological background based on three pillars: the focus on real work, the adoption of a systemic and participatory approach, and the intentional emphasis on a multidisciplinary approach. METHODS: The design of training courses that are adequate both for workers and for supervisors who are concerned with the development of the worker’s skills and health at work is challenged by major changes at work. Such challenges were the driving force behind the discussion within this network at the IEA 2021 congress. RESULTS: The authors who contributed to this congress maintain the network’s characterizing principles. At the same time, they introduce research updates and new intervention methodologies. In addition, the authors have been called upon to provide novel answers to the issues of organizational transformation and digitalization of work and training. CONCLUSION: The permanence of this network involves leveraging its 30 years of collective expert experience to continue to respond to present and emerging challenges, concerning work and training sustainability. The network’s research contributes to growing evidence about how training can impact on healthier workplaces where individual and group development is improved.

Perception towards nursing profession: A comparative study between Sudanese, Yemeni and Egyptian communities.. [DOI: 10.21203/rs.3.rs-2119216/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: Communities’ perception is one of the most important factors in the development of the nursing profession. The purpose of this study is to identify the perception of Arabic communities (Sudan, Yemen, and Egypt) towards the nursing profession. Methods: A descriptive comparative study was used to identify the perception of Arabic communities (Sudan, Yemen, and Egypt) towards the nursing profession. The study was conducted in three Arabic countries (Sudan, Yemen, and Egypt) using an online approach by sending the link of questions to the targeted population using emails, WhatsApp, and social media. There were 529 participants from the three Arabic countries. Results: Almost 75.6% of the participants were less than 40 years, and most respondents (82.9%) were between 21 to 30 years old. There was a generally positive perception towards the nursing profession among these communities: 97.6% of Sudanese, 94.9% of Yemenis, and 96.1% Egyptian. There was a borderline statistical significance between the Sudanese and Egyptians' age and their perception toward their profession. Conclusions: Overall, the perception of Sudanese, Yemeni, and Egyptian communities towards the nursing profession is acceptable. The only influencing factor on the level of perception was Egyptian females who have high positive perception towards the nursing profession and Sudanese males who have high positive perception towards nursing profession We recommend further research to assess the perception towards nursing from different sociocultural backgrounds and on a larger sample size.

Exploring the nature of adaptive capacity for resilience in healthcare across different healthcare contexts; a metasynthesis of narratives

Adaptive capacity has been described as instrumental for the development of resilience in healthcare. Yet, our theoretical understanding of adaptive capacity remains relatively underdeveloped. This research therefore aims at developing a new understanding of the nature of adaptive capacity by exploring the following research questions: 1. What constitutes adaptive capacity across different healthcare contexts? and 2. What type of enabling factors support adaptive capacity across different healthcare contexts? The study used a novel combination of qualitative methods featuring a metasynthesis of narratives based on empirical research to contribute understanding of adaptive capacity across different healthcare contexts. The findings show that adaptive capacity was found to include four forms: reframing, aligning, coping, and innovating. A framework illustrating the relatedness between the identified forms, in terms of resources, change and enablers, is provided. Based on these findings, a new definition of adaptive capacity for resilience in healthcare is proposed.

Quantifying the qualitative: exploring epistemic network analysis as a method to study work system interactions

Studying interactions faces methodological challenges and existing methods, such as configural diagramming, have limitations. This work demonstrates Epistemic Network Analysis (ENA) as an analytical method to construct configural diagrams. We demonstrated ENA as an analytical tool by applying this method to study dementia caregiver work systems. We conducted 20 semi-structured interviews with caregivers to collect caregiving experiences. Guided by the Patient Work System model, we conducted a directed content analysis to identify work system components and used ENA to study interactions between components. By using ENA to create configural diagrams, we identified five frequently occurring interactions, compared work system configurations of caregivers providing care at home and away from home. Although we were underpowered to determine statistically significant differences, we identified visual and qualitative differences. Our results demonstrate the capability of ENA as an analytical method for studying work system interactions through configural diagramming. Practitioner summary: A new methodology, Epistemic Network Analysis (ENA), was presented to better support the study of work system interactions through configural diagramming. ENA was applied to qualitative data to demonstrate the capabilities of this method to construct configural diagrams of the work system. This study successfully demonstrated that ENA can visually represent and describe work system configurations.

Ergonomic Maturity Model: A tool for integrating ergonomics/human factors into organizations

BACKGROUND: Currently, there is a need for models, methods, and tools that allow ergonomics/human factor (E/HF) practitioners to assess the level of E/HF integration into organizations from a macroergonomics perspective. OBJECTIVE: This paper aims to propose the Ergonomic Maturity Model (EMM) and the tools for its application as a framework for integrating E/HF in organizations. METHODS: The EMM is a macroergonomic tool that allows stakeholders to evaluate the degree of development and integration of E/HF in the organization based on a participatory and macroergonomic approach. The EMM classifies organizations into five gradual levels of maturity: Ignorance, Understanding, Experimentation, Regular use, and Innovation. RESULTS: In this paper, we provide a three-stage procedure for guiding the application of the EMM: preparation of the evaluation, evaluation, and improvement plan and implementation. We include four tools developed specifically for applying EMM in organizations: evaluation matrix, weighting questionnaire, quick questionnaire, and prioritization matrix. Also, we present a Colombian floriculture company’s case study to exemplify the use of the EMM. CONCLUSIONS: The EMM provides a framework for integrating E/HF into organizations from the macroergonomics approach. E/HF practitioners can find in the EMM a tool to help them channel the actions taken by the different organizational actors to improve the safety, health, well-being, and performance of work systems. Finally, it should be noted that further studies on the reliability and validity of the EMM are needed, which would contribute to demonstrating that the EMM can effectively and successfully guide change in E/HF maturity levels in organizations.

Examining the relationship between human factors related quality risk factors and work related musculoskeletal disorder risk factors in manufacturing

This study addresses the relationship between human factors (HF) related quality deficits in manufacturing and work-related musculoskeletal disorder (WMSD) risk factors in production staff. A recent systematic review identified 60 HF-related quality risk factors (QRFs) in manufacturing related to product, process and workstation design stages. We investigate the extent to which these identified QRFs are also WMSD risk factors. Each QRF was examined for its relationship with WMSD using a 0 (no relationship) to 10 (strong relationship) scale rubric. The authors rated each QRF separately and then discussed and adjusted their ratings in a review session. Results showed that average median ratings were the highest for QRFs related to product design (8/10), intermediate for QRFs related to workstation design (7/10) and the lowest for QRFs related to process design (5/10). This emphasises the significant role of HF in system design in reducing both quality deficits and risk of developing WMSDs for manufacturing personnel. Practitioner summary: This study investigates whether human-related risk factors for product quality are also risk factors for work-related musculoskeletal disorders in manufacturing. Results showed a substantial relationship between quality risk factors and WMSD risk factors. This indicates the significant role of human factors in operations design in improving both system performance and human wellbeing.

Visual ergonomics, performance and the mediating role of eye discomfort: A structural equation modelling approach

The purpose of this study was to model the visual ergonomic factors affecting the performance in human computer interaction. A cross-sectional study using structural equation modelling was performed with a sample of 200 participants. The measuring instruments included Office Lighting Survey Questionnaire, performance assessment questionnaires, visual ergonomics assessment, and an eye discomfort assessment. The hypothetical model evaluated workplace lighting status and visual ergonomics as precursors, performance as the output, and eye discomfort as a mediator. The results showed that eye discomfort directly affected performance. Visual ergonomics also had a significant direct effect on eye discomfort. The final model suggested a significant new path between the quality of lighting and visual ergonomics. Also, the quality of lighting had an indirect effect on eye discomfort and performance, and the effect of visual ergonomics on performance was the same. Improving the lighting quality and visual ergonomics can reduce eye discomfort and increase performance.

Design considerations for protective mask development: A remote mask usability evaluation

The design of N95 filtering facepiece respirators (FFRs) continues to pose usability concerns for healthcare workers, which have been exacerbated by the COVID-19 pandemic. The aim of this study was to develop a holistic model to guide mask design improvement. Dental students (n = 38) with experience wearing N95 FFRs participated in a randomized wear trial of three alternative protective masks. A mixed methods survey was used to examine usability of individual mask design components, the relationship of facial/head area to mask features, and overall mask design. Survey results indicated MNmask v1 demonstrated higher usability in seal confidence (M = 3.46), while MNmask v2 performed higher in satisfactory fit (M = 3.50). Design components of nose wire and head/neck bands were the most problematic, while conditions of skin irritation and tight/loose fit created an unfavorable wear experience. To consider healthcare workers' needs in improving the usability of protective masks, a model is presented to consider characteristics of fit, comfort, material, and design.

Human Factors and Ergonomics (HFE) applications in responses to the COVID-19 pandemic: Lessons learned and considerations for methods

Human Factors and Ergonomics (HFE), with the goal to support humans through system design, can contribute to responses to emergencies and crises, like the COVID-19 pandemic. In this paper, we describe three cases presented at the 21st Triennial Congress of the International Ergonomics Association to demonstrate how HFE has been applied during the COVID-19 pandemic, namely to (1) develop a mobile diagnostic testing system, (2) understand the changes within physiotherapy services, and (3) guide the transition of a perioperative pain program to telemedicine. We reflect on methodological choices and lessons learned from each case and discuss opportunities to expand the impact of HFE in responses to future emergencies. The HFE discipline should develop faster, less resource intensive but still rigorous, methods, increase available HFE expertise by growing the field, and proactively enhance individual and public perception of the importance of HFE in crisis response.

GENESISS 1-Generating Standards for In-Situ Simulation project: a scoping review and conceptual model

BACKGROUND

In-Situ Simulation (ISS) enables teams to rehearse and review practice in the clinical environment to facilitate knowledge transition, reflection and safe learning. There is increasing use of ISS in healthcare organisations for which patient safety and quality improvement are key drivers. However, the effectiveness of ISS interventions has not yet been fully demonstrated and requires further study to maximise impact. Cohesive programmatic implementation is lacking and efforts to standardise ISS terms and concepts, strengthen the evidence base and develop an integrated model of learning is required. The aim of this study was to explore the current evidence, theories and concepts associated with ISS across all areas of healthcare and develop a conceptual model to inform future ISS research and best practice guidance.

METHODS

A scoping review was undertaken with stakeholder feedback to develop a conceptual model for ISS. Medline, OpenGrey and Web of Science were searched in September 2018 and updated in December 2020. Data from the included scoping review studies were analysed descriptively and organised into categories based on the different motivations, concepts and theoretical approaches for ISS. Categories and concepts were further refined through accessing stakeholder feedback.

RESULTS

Thirty-eight papers were included in the scoping review. Papers reported the development and evaluation of ISS interventions. Stakeholder groups highlighted situations where ISS could be suitable to improve care and outcomes and identified contextual and practical factors for implementation. A conceptual model of ISS was developed which was organised into four themes: 1. To understand and explore why systematic events occur in complex settings; 2.To design and test new clinical spaces, equipment, information technologies and procedures; 3. To practice and develop capability in individual and team performance; 4. To assess competency in complex clinical settings.

CONCLUSIONS

ISS presents a promising approach to improve individual and team capabilities and system performance and address the 'practice-theory gap'. However, there are limitations associated with ISS such as the impact on the clinical setting and service provision, the reliance of having an open learning culture and availability of relevant expertise. ISS should be introduced with due consideration of the specific objectives and learning needs it is proposed to address. Effectiveness of ISS has not yet been established and further research is required to evaluate and disseminate the findings of ISS interventions.

Development of Natural Fibre-Reinforced Polymer Composites Ballistic Helmet Using Concurrent Engineering Approach: A Brief Review

In this decade, all researchers and industry players compete to develop sustainable product design by exploring natural fibre composites in product design development. One of the essential methodologies in creating composite products is concurrent engineering (CE). Industrial design and production engineering should be involved in the development of ballistic helmets. This publication aims to provide a quick overview of the evolution of natural fibre composite ballistic helmet designs. This manuscript is still in its early stages, but it already includes a summary of the progress of ballistic helmet design from 1915 to the present. Renewable materials, such as natural fibre, should be highlighted as an alternative to synthetic composites in developing a sustainable ballistic helmet design. Furthermore, launching the design development process for a ballistic helmet demands a CE strategy that includes multi-disciplinary knowledge. Computational modelling aids in the development of ballistic helmet designs, reducing the time and cost of manufacturing ballistic helmets. The ergonomic component of ballistic helmet design is also crucial, as is the thermal comfort factor, which can be handled using natural fibre composites with thermal solid insulating characteristics. The development of natural fibre composite ballistic helmets can be used as a consideration in the future as a revolution to create a sustainable design. Finally, this review can be used as a guide for industrial designers. In conclusion, this review might be utilized as a reference for industrial designers due to a shortage of studies, especially in producing product-related natural fibre.

Collaboration Between Humans and Robots in Organizations: A Macroergonomic, Emotional, and Spiritual Approach

The new managerial challenges are related to finding solutions for complex problems, inside some more and more complex management systems, in a continuously changing organizational context. Competitivity and progress imply a continuous positive change and the need to accept, respond, and adapt to the organization’s internal and external environments changes. This brief research report aims to point out the organizational ergonomics’ contribution to employees’ wellbeing through a systemic, emotional, and spiritual approach to man’s interaction with technology, systems, and organizational environment. The research methods used were the multidisciplinary bibliographic study and the interview. Three semi-structured interviews were taken to explore today’s challenges and new 4.0 technologies’ impact, especially robots, on the company and on employees’ wellbeing and spiritual fulfillment. The novelty comes from the analysis of new technologies’ impact on the human factor from the spiritual point of view. Our main results have to do with the shaping of a model for human capital’s valorization and with suggesting a list for monitoring human capital valorization in the company. This article’s main conclusion shows that the organizations’ management must be prepared to manage future challenges by improving the employee’s abilities, adaptability to change, and collaboration with robots.