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0010 Clarification and application of human factors and ergonomics in frontline healthcare
  1. Nick Woodier,
  2. Adrian Kwa,
  3. Malcolm Chambers,
  4. Clare Barrow,
  5. Bryn Baxendale
  1. Trent Simulation and Clinical Skills Centre, Nottingham, UK


Background Human Factors and Ergonomics (HFE), although a term now more familiar,1 remains poorly understood in healthcare. This is partially due to inadequate models that are too complex and not applicable, and a lack of engagement from frontline staff due to jargon-based terminology from other industries.2 We aimed to create a new HFE model appropriate for frontline healthcare use; designed by frontline staff for use by frontline staff.

Methodology An initial model was devised by a medic with a background in clinical care. This model, based on a hierarchical structure, was disseminated to staff and students in various disciplines and environments for feedback. They were asked questions considering key model attributes based on published literature.3 Feedback was used to create a final “onion” model considering the patient, individual staff, team, task (environment, protocols and equipment), organisation and government.

This final model was shown to participants on a multiprofessional simulation day with a short education workshop and examples of its application in a simulation setting. Participants were asked to then apply it to their own clinical systems on return to their workplace and provide feedback.

Results/outcomes (recorded to date) 15 multiprofessional staff and 10 students provided feedback identifying that the model was concise (92%), easy to understand (76%), easy to remember (68%) and applicable (96%). To date it has been shown to 32 medical and 8 nursing staff on the simulation day. They have been able to use the model in their own systems to identify such issues as: poor handover, difficult equipment and inhibitory environmental design.

Potential impact This model is well received and applicable to frontline healthcare for use by multiprofessional staff. It provides a clarification of the system-wide applications of HFE and allows identification of system issues for improvement practice.


  1. Human Factors in Healthcare. A National Quality Board concordat. November 2013

  2. Civil Aviation Authority. Fundamental Human Factors Concepts. 2002. CAP 719

  3. Sheridan TB. Evaluating models in systems ergonomics with a taxonomy of model attributes. Appl Ergon. 2014;45:78e–84

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