Presentation
The Power of Guerrilla: Human Factors Implementation
SessionPoster Session 1
DescriptionThe healthcare environment presents several challenges for human factors (HF) practitioners due to many constraints. For example, healthcare as a field was not systematically designed unlike aviation but rather emerged from the need to holistically care for and heal sick and injured people. Thus, with a plethora of evolving goals needing to be achieved with variable resource availability, knowledge transfer between healthcare organizations is difficult, making standardization difficult to achieve. Furthermore, there is a dearth of knowledge amongst healthcare professionals on how the science of human factors can impact workflow and critical aspects of healthcare delivery. For these reasons, the work of human factors practitioners needs to be strategically implemented to gain buy-in from healthcare administrators and decision makers.
The human factors team at Carilion Clinic approach human factors work in the healthcare environment using the incremental buy-in approach. Specifically, the team takes on smaller (low stakes) projects, apply human factors methods (ethnographic observations, task analyses, cognitive walkthroughs, workload assessments, etc.) and generate data-driven solutions to address problems existing in the patient care environment. These solutions have engendered trust between the human factors team and clinician stakeholders and have oftentimes snowballed into high stakes projects that have transformed healthcare delivery.
An example of a smaller project that snowballed into a system-wide implementation of a human factors-recommended solution was the problem of behavioral health patients tailgating and elopements. The human factors team performed a series of consultations which included observation of clinical space design, signages, and workflow and recommended stopgap solutions such as activation of badge access, installing sally port entrances etc . The implementation of these recommendations was needed to provide an extra layer of protection against elopements in addition to the existing human vigilance. The success of these recommendations resulted in the team eventually being invited to consult on monitor placements for geofencing targeted at real-time notification of clinicians on attempted elopements for prompt interventions. This has the potential to reduce elopement by a significant percentage.
In another consultation, HF support was requested to optimize electrocardiogram (EKG) lead workflow in a cardiovascular Progressive Care Unit (PCU). The success of this intervention generated goodwill within the department, leading to additional collaborations across other cardiovascular units and eventually led to HF integration into planning and workflow design for a new cardiovascular tower. Through this collaboration, HF designed the room numbering system for a new emergency department (ED). The positive reception of the work prompted the team to develop temporary wayfinding signage, which proved effective, resulting in the hospital’s graphic design team recreating and formalizing the signage for the ED. This momentum ultimately led to HF engagement in wayfinding design for the new cardiovascular tower. Both cases demonstrate how targeted, practical HF solutions can generate organizational trust, snowball into larger initiatives, and embed HF expertise into major healthcare infrastructure projects.
Finally, the HF team used heuristic evaluation methods and iterative feedback from end users to identify multiple inconsistencies and barriers to safe, efficient vaccine identification. Using rapid cycle prototyping, HF was able to standardize labeling across the hospital system which supported clinicians’ visual scanning and reduced the potential for error. This work demonstrates how pragmatic, resource-constrained (“guerrilla”) human factors interventions can yield system-wide improvements in patient safety with minimal disruption to existing workflows.
The human factors team at Carilion Clinic approach human factors work in the healthcare environment using the incremental buy-in approach. Specifically, the team takes on smaller (low stakes) projects, apply human factors methods (ethnographic observations, task analyses, cognitive walkthroughs, workload assessments, etc.) and generate data-driven solutions to address problems existing in the patient care environment. These solutions have engendered trust between the human factors team and clinician stakeholders and have oftentimes snowballed into high stakes projects that have transformed healthcare delivery.
An example of a smaller project that snowballed into a system-wide implementation of a human factors-recommended solution was the problem of behavioral health patients tailgating and elopements. The human factors team performed a series of consultations which included observation of clinical space design, signages, and workflow and recommended stopgap solutions such as activation of badge access, installing sally port entrances etc . The implementation of these recommendations was needed to provide an extra layer of protection against elopements in addition to the existing human vigilance. The success of these recommendations resulted in the team eventually being invited to consult on monitor placements for geofencing targeted at real-time notification of clinicians on attempted elopements for prompt interventions. This has the potential to reduce elopement by a significant percentage.
In another consultation, HF support was requested to optimize electrocardiogram (EKG) lead workflow in a cardiovascular Progressive Care Unit (PCU). The success of this intervention generated goodwill within the department, leading to additional collaborations across other cardiovascular units and eventually led to HF integration into planning and workflow design for a new cardiovascular tower. Through this collaboration, HF designed the room numbering system for a new emergency department (ED). The positive reception of the work prompted the team to develop temporary wayfinding signage, which proved effective, resulting in the hospital’s graphic design team recreating and formalizing the signage for the ED. This momentum ultimately led to HF engagement in wayfinding design for the new cardiovascular tower. Both cases demonstrate how targeted, practical HF solutions can generate organizational trust, snowball into larger initiatives, and embed HF expertise into major healthcare infrastructure projects.
Finally, the HF team used heuristic evaluation methods and iterative feedback from end users to identify multiple inconsistencies and barriers to safe, efficient vaccine identification. Using rapid cycle prototyping, HF was able to standardize labeling across the hospital system which supported clinicians’ visual scanning and reduced the potential for error. This work demonstrates how pragmatic, resource-constrained (“guerrilla”) human factors interventions can yield system-wide improvements in patient safety with minimal disruption to existing workflows.
Authors
Event Type
Poster Presentation
TimeMonday, March 234:45pm - 6:15pm EDT
LocationRhinelander Gallery
Hospital Environments