HEALTH FOUNDATION: CLOSING THE GAP IN PATIENT SAFETY PROGRAMME

SAFER CARE PATHWAYS IN MENTAL HEALTH PROJECT

Frequently Asked Questions (FAQ) on the Human Factors Approach

What is safety culture?

Safety culture is defined as ‘the product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organization's health and safety management’ (Health and Safety Commission of Great Britain, 2003.

Organizations with a positive safety culture are characterized by communications founded on mutual trust, by shared perceptions of the importance of safety, and by confidence in the efficacy of preventive measures.

What is ‘Human Factors’ (HFs)?

Human Factors (HFs) is a discipline that studies all those factors that can influence people and their behaviour. In a work context, human factors are the environmental, organisational and job factors, and individual characteristics which influence behaviour at work (CHFG, 2013).

In a clinical setting, HFs has been can be defined as follow: “Enhancing clinical performance through an understanding of the effects of teamwork, tasks, equipment, workspace, culture, organisation on human behaviour and abilities, and application of that knowledge in clinical settings.” Catchpole, 2013

Why are ‘Human Factors’ is important?

Human Factors can reduce harm and improve both patient and staff safety (CHFG, 2013). HFs research has shown that technical skills are necessary, but not sufficient to ensure patient safety (Carthey et al., 2003, Catchpole et al., 2008; Mishra et al., 2008). Technical and process errors are reduced by delivering human-factors based team training to operating theatre staff (McCulloch et al., 2009; Ricci, 2012). Also, recent studies have found that the greater the proportion of staff who report working in teams with clear objectives, who work interdependently with team colleagues, and who take time out regularly to review their performance and how it can be improved, the lower the levels of patient mortality (Schippers, 2013).

Why are we receiving this HFs training now?

The project proposes to address the severe criticisms of safety culture in the NHS as highlighted in the Francis report (Francis R, 2013 ‘Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry’) and the Berwick report commissioned by the National Advisory Group on the Safety of Patients in England and published in August 2013. Both reports draw attention to the importance of ‘the growth and development of all staff, including their ability and support to improve the processes in which they work ‘(Berwick, 2013) and ‘to integrate the essential shared values of the common culture into everything they do’ (Francis, 2013).

Further, the CQUINN priorities for 2012/2013 include the improvement of the patient experience in primary care and mental health (NHS Institute for Innovation and Improvement, 2012).

What does the HFs training involve?

The HFs training will focus on current teamwork and communication issues amongst healthcare professionals, from a theoretical and practical point of view. The main components of the training include:

  • The delivery of training on HFs theories and improvement methodology to enhance communication and teamwork in selected primary care, mental health and acute care settings to a critical mass of front line staff
  • Development of a smaller number of HFs leaders and trainers within each participating trust
  • Development of service improvement projects as part of the training process

What is the evidence base for the HFs training?

The evidence base derives from work undertaken by the by Human Engineering Limited and the NHS Institute for Innovation and Improvement’s Safer Care team. The study identified HFs training appropriate for different staff groups in the National Health Service (NHS Institute for Innovation and Improvement, 2010).

Our HFs training has been tested and evaluated at the Luton & Dunstable hospital in 2008 and has now been implemented across the region through the Health Science Network (HSN). Training outcomes included improvements in patient safety culture, job satisfaction and implementation of effective service improvement projects within the participating Trusts.

What are the benefits of participating to the HFs training?

Human Factors training can reduce harm and improve both patient and staff safety.Many healthcare organizations in the acute sector and emergency teams have implemented human-factors-based team training, in order to:

  • Tackle variation and improve the reliability in clinical practice
  • Support staff to work interdependently, even if working in new and different teams every day.
  • Improve compliance with clinical care policies and procedures
  • Implement proven strategies and interventions that reduce harm; and sharing them rapidly across the system.

July 2014

Safer Care Pathways in Mental Health – Project Team