Laura Pickup

Fundamental examination of mental workload in the rail industry

In recent years there has been a resurgence of interest in rail human factors. The sometimes conflicting requirements of safety, reliable performance, quality of operations and effective use of limited capacity have meant that managers and engineers across all companies in the rail network have realized the importance of understanding and designing for human factors in train driving, signalling and control, maintenance, planning, etc. One key concern has been with workload, particularly mental workload, and especially in signalling and driving. This paper is concerned with a fundamental examination of what workload means in relation to the railways and especially signalling work and with a need to develop an appropriate suite of tools for the practical assessment of workload. In order to do this, the basic literature has been revisited in order to propose a conceptual framework of mental workload in the rail industry. Subsequently, a suite of workload tools has been proposed and is being used in practice; this is also described in this paper.

The Operational Demand Evaluation Checklist (ODEC) of workload for railway signalling.

This paper is concerned with the interpretation and assessment of mental workload, and in particular assessment of the load imposed by the work system. It highlights a framework created to direct the development of workload assessment tools capable of assessing the dimensions most relevant to the population being studied, in our case railway signallers. A tool to capture the operational demands on the rail signaller was required to evaluate the load from the system they operated. This paper justifies the need for, and describes the development of, the Operational Demand Evaluation Checklist (ODEC), using techniques like repertory grid with active signallers. The practical experience of the development, evaluation, live use and validation of ODEC is discussed and the paper concludes by suggesting that the approach could be adopted to interpret the concept of workload in other work domains.

Blood sampling - two sides to the story

This study aimed to investigate why there is variability in taking blood. A multi method Pilot study was completed in four National Health Service Scotland hospitals. Human Factors/Ergonomics principles were applied to analyse data from 50 observations, 15 interviews and 12-months of incident data from all Scottish hospitals. The Functional Resonance Analysis Method (FRAM) was used to understand why variability may influence blood sampling functions. The analysis of the 61 pre blood transfusion sampling incidents highlighted limitations in the data collected to understand factors influencing performance. FRAM highlighted how variability in the sequence of blood sampling functions and the number of practitioners involved in a single blood sampling activity was influenced by the working environment, equipment, clinical context, work demands and staff resources. This pilot study proposes a realistic view of why blood sampling activities vary and proposes the need to consider the systems resilience in future safety management strategies.

More holes than cheese. What prevents the delivery of effective, high quality and safe health care in England?

Abstract What prevents the delivery of effective, high quality and safe health care in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 years (staff shortages, finance and patient complexity) but other challenges raise questions about the commitment of the NHS to patient and staff safety. For example, Organisational Culture leading to ‘stifling bureaucracy’, ‘odds stacked against smooth […] working’ and Workload resulting in ‘firefighting daily’ and ‘perpetual crisis mode’. The role of Human Factors/Ergonomics professional input (engagement with safety scientists) is discussed in the context of success stories and examples of Human Factors Integration from other safety critical industries (Defence, Nuclear and Rail). Practitioner Summary: 760 challenges to the quality, effectiveness and safety of health care were identified at Human Factors/Ergonomics taster workshops in England. These are used to challenge health care providers to think about a Human Factors Integration (HFI systems) approach for safety, well-being and performance for all people involved in providing and receiving health care.

The dichotomy of the application of a systems approach in UK healthcare: the challenges and priorities for implementation

Abstract There is increasing demand for a systems approach within national healthcare guidelines to provide a systematic and sustainable framework for improvements in patient safety. Supported by this is the growing body of evidence within Human Factors/Ergonomics (HFE) healthcare literature for the inclusion of this approach in health service design, provision and evaluation. This paper considers the current interpretation of this within UK healthcare systems and the dichotomy which exists in the challenge to implement a systems approach. Three case studies, from primary and secondary care, present a systems approach, offering a novel perspective of primary care and blood sampling. These provide practical illustrations of how HFE methods have been used in collaboration with healthcare staff to understand the system for the purpose of professional education, design and safety of clinical activities. The paper concludes with the challenge for implementation and proposes five roles for systems HFE to support patient safety. Practitioner Summary: healthcare is classified as a complex and dynamic system within this paper and as such HFE system methods are presented as desirable to understand the system, to develop HFE tools, to deliver education and integrate HFE within healthcare systems.

Human factors in general practice – early thoughts on the educational focus for specialty training and beyond

In the third article in the series, we describe the outputs from a series of roundtable discussions by Human Factors experts and General Practice (GP) Educational Supervisors tasked with examining the GP (family medicine) training and work environments through the lens of the systems and designed-centred discipline of Human Factors and Ergonomics (HFE). A prominent issue agreed upon proposes that the GP setting should be viewed as a complex sociotechnical system from a care service and specialty training perspective. Additionally, while the existing GP specialty training curriculum in the United Kingdom (UK) touches on some important HFE concepts, we argue that there are also significant educational gaps that could be addressed (e.g. physical workplace design, work organisation, the design of procedures, decision-making and human reliability) to increase knowledge and skills that are key to understanding workplace complexity and interactions, and supporting everyday efforts to improve the performance and wellbeing of people and organisations. Altogether we propose and illustrate how future HFE content could be enhanced, contexualised and integrated within existing training arrangements, which also serves as a tentative guide in this area for continuing professional development for the wider GP and primary care teams.