Bringing ergonomics to the emergency department

Applying ergonomics in NHS trusts can boost patient safety and staff morale

Applying ergonomics in NHS trusts can boost patient saftey and staff morale, writes Hannah Bryant

Would you consider combining human factors and ergonomics? Picture: Getty Images

Many of us may see human factors as a separate entity to ergonomics. However, if you talk to an ergonomics specialist it becomes clear that they are entwined and most consider them to be interchangeable terms.

Optimising sociotechnical systems

Physical ergonomics is concerned with human anatomical, anthropometric, physiological and biomechanical characteristics as they relate to physical activity. Organisational ergonomics is concerned with the optimisation of sociotechnical systems, including their organisational structures, policies, and processes.

Cognitive ergonomics is concerned with mental processes, such as perception, memory, reasoning, and motor response, as they affect interactions among humans and other elements of a system.

At the Queen Elizabeth Hospital Birmingham (QEHB) emergency department, a human factors’ review of the department process for treating self-presenting chest pain patients was carried out. The outcome was immediate, incurred no extra cost and identified sustainable improvements.

Through observation and targeted focus group discussions a review of the existing process was carried out by the emergency team working in collaboration with two members of the QEHB human factors faculty. This process enabled the human factors team to gain an understanding of the initial chest pain assessment process and identify points within the process where errors and failures could occur. 

Failure modes and effects analysis

To understand and identify further areas where the process might fail, a failure modes and effects analysis (FMEA) was carried out. By awarding scores to each part of the process as in an FMEA, this can help to recognise which parts of the process are most in need of change. 

'The application of human factors and ergonomics in NHS trusts can improve not only patient safety, but staff morale and workforce engagement'

The new process reduced the distance that patients were required to walk. The simpler route reduced the risk of patients becoming lost or not making themselves known to the appropriate staff member. A second FMEA was carried out on the new process, which demonstrated that the risk of the process failing had been reduced.

Few hospitals have access to human factors and ergonomics teams who can help them improve systems and processes in their departments, however, the application of human factors and ergonomics in NHS Trusts can improve not only patient safety, but staff morale and workforce engagement.

About the author

Hannah Bryant is a resuscitation officer at Queen Elizabeth Hospital, major trauma centre, Birmingham.

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