Review of SEIPS Course on HFE and Patient Safety

This summer I wrote about the SEIPS Course on HFE and Patient Safety and that I thought it would be a useful. I was unable to attend it but one of my readers, Satish, did attend it and he was gracious enough to provide a review for us. Satish Duryodhan works as Assoc. VP at Hexaware Technologies Limited and leads Hexaware’s Healthcare Practice. I met Satish during my recent trip to India. He was one of the “bright guys” I talked about. Hexaware is working with Providers and Payers and providing some pretty nice healthcare focused IT-BPO solutions that are worth checking out. I worked with them on SOA, legacy technology management, Independent Testing and BPO at a recent engagement and they seem to know their stuff. Enough on introductions — In this guest posting Satish provides an overview of the course he and several others from Hexaware attended in July. If you attended as well, please drop some comments here and share your thoughts with us as well.

The 2006 Systems Engineering Initiative in Patient Safety (SEIPS) Course on Human Factors Engineering (HFE) and Patient Safety was organized on August 14-18, 2006 at The Pyle Center, University of Wisconsin-Madison. The Course was jointly sponsored by the University of Wisconsin Center for Quality and Productivity Improvement (CQPI) and the University of Wisconsin School of Medicine and Public Health, Office of Continuing Professional Development in Medicine and Public Health. The program was organized in two parts:

Part I The Basics of HFE & Patient Safety – August 14-16

Part II HFE and Healthcare Information Technology (HIT) – August 16-18

The course was attended by over 30 professionals including Physicians, Senior Nursing staff, Pharmacists, patient safety officers and IT professionals etc.

The five day course for professionals was conducted by nationally recognized speakers discussing a variety of Patient Safety topics and Human Factors Engineering(HFE) including:

• Human Factors Engineering                                                   
  • Design of the Physical Environment and Ergonomics
    • Cognitive Ergonomics 
      • Job and organizational Issues
        • Technology Design and Usability
          • HFE principles of HIT design
            • Usability of CPOE Technology

              • Impact of HIT on Patient Care Process

                • A Provider’s Conversion Experience
                The course was designed to provide an understanding of human factors and systems engineering and how this approach to patient safety can improve performance, prevent harm when error does occur, help systems recover from error, and mitigate further harm.

              The Key principles of HFE and patient safety were extremely well presented through over 20 sessions covered by different speakers, case studies, group exercises and group presentations. The course was very interactive with participants sharing their experiences and examining how each principle presented would be relevant in their work environment.

              The Part I course started with clarifications on misconceptions about HFE and clearly laying out HFE principles from the perspective of Patient safety. Scope of HFE involves Different levels of study and intervention:

              – Human: Information Display

              – Human: Machine

              – Human: Environment

              – Human: Job

              – Human: Organization

              – Human: Community

              Each of these interactions was analyzed in detail from conceptual and practical perspective. For example the “Human: Environment” was presented through research findings that relate improved physical environment (Light, Sound, Climate, Arrangement of space etc) to patient and staff in four areas:

              1. Reduce staff stress and fatigue and increase effectiveness in delivering care

              2. Improve patient safety

              3. Reduce stress and improve outcomes

              4. Improve overall healthcare quality

              A model for analyzing organizational accident causation was presented.

              Similarly cognitive (e.g., attention, memory) factors affect the way people process information and make decisions, therefore affecting their cognitive performance (e.g., errors, safety). Models and principles for improved cognitive performance were presented.

              The course presented the Donabedian’s framework (for assessing the quality of health care), and the “work system model” (how an individual performs a range of tasks using various tools and technologies). Assessing patient safety can be accomplished by integrating Donabedian’s Structure-Process-Outcome framework and the work system model. Several case studies were presented to illustrate how these frameworks can be effectively utilized for improved patient safety. This part also focused on HFE method of usability testing and how it fits in proactive risk assessment.

              This course also presented Rasmussen’s dynamic model of risk and safety to illustrate how it can used to understanding current conditions in modern healthcare delivery and the way these conditions may lead to accidents.

              The course enabled participants to acquire skills in the HFE method of usability testing and pro-active risk assessment and developing decision making strategies to determine when to use usability testing for patient safety activities.

              The part II presented several topics related to HFE in HIT (Healthcare Information Technology):

              · A holistic model of Information System Architecture for Healthcare System

              · Overview of systems such as Hospital information system, Electronic Health records, EHealth Portals, CPOE and context of patient care in implementing these systems

              · A very interesting case study on how HFE was used to improve usability of CPOE technology.

              · Analysis model for assessing impact of HIT on patient care processes and tasks. The group exercise focusing on applying on these principles in live environment provided a great leering value.

              Throughout the course many practical exercises were provides including:

              · The classic practical model to illustrate that a practical process is extremely complex to document completely with no ambiguity.

              · Usability testing using usability principles of Alaris^TM system

              · Usability testing with Fat measurement meter

              · Usability of injection system under panic situation

              Overall the course environment was kept informal and participative. This provided great learning value not only from the sessions conducted by various experts but also from interaction among participants.

              — written by Satish Duryodhan, Assoc. VP at Hexaware Technologies Limited