Human factors in Obstetrics

and Gynaecology

Dr Sunbal Mukhtar ST5

17/12/2020
What are Human factors:

Human factors refer to environmental,

organisational and job factors, and
human and individual characteristics,
which influence behaviour at work in a
way which can affect health and safety

Clinical Human factors are the way in

which we as individual behave and
interact with others in our workplace
 The study of human factors
 

Science behind why we make mistakes

and
How we can apply this knowledge to help prevent
these mistakes
OR
To reduce their potential harms
 Human behaviour

Significant factor in
medical errors.
 Barriers and Safeguards

 Physical
 Procedural
 Humans

Reason’s Swiss cheese model hypothesis

 Categories

•Organisational

•Supervision

•Precondition

•Specific act or active failure

Accidents are usually caused by failure of these

defences
Stages of Error Happening

No study leave

Inadequate supervision

Tired , busy night shift

Rushed to complete procedure

Never event
Category Elements

Situation awareness  Gathering information

 Understanding information
 Projecting and anticipating future state

Decision making  Considering options

 Selecting and communicating option
 Implementing and reviewing decisions

Communication and Teamwork  Exchanging information

 Establishing a shared understanding
 Co-ordinating team activities

Leadership  Setting and maintaining standards

 Supporting others
 Coping with pressure

Task management Planning and preparing

Prioritising
Maintaining standard
Utilising resources
Situation awareness
https://www.youtube.com/watch?v=882nzxb_oqQ

https://www.youtube.com/watch?v=2pK0BQ9CUHk
 Gathering information

• Hand overs
• SBAR
• Review notes ( things might have
been missed if shift was busy).
• NEWS/MEOWS
• Fresh eyes
• Patients
 Barriers to Situational awareness

Fatigue
stress
hunger
illness
language or cultural factors
hazardous attitudes
New environment
Poor communication
 
 
 
 Decision Making

Skills for diagnosing the situation and reaching a judgement

in order to choose an appropriate course of action.

 Assess the problem

 Establish your goals
 Gather and filter information
 Identify options
 Anticipate consequences
 Inform others of decision and rationale
 Act on the decision
 Evaluate results
Balanced discussion and opinion of
colleagues and communicating decision.
Barriers to good decision making:

Time
Ambiguous data
Pressure to perform
Rank difference
Personal attitudes
 Teamwork

The ability to cooperate and

communicate effectively with others
to achieve common goal.

Skills for working in a team to ensure

that the team has an acceptable
shared picture of the situation and
can complete tasks effectively.
Check lists (theatre huddle, sign in,
time out, debrief).
LW board updates
Communicate with the wider team:
SCBU, Anaesthetist
Staffing
Breaks
Raise concern
Listen to concerns
 Leadership

Leading the team and providing

direction, demonstrating high standards
of clinical practice and care, and being
considerate about the needs of individual
team members.
 Leaders Qualities

 Up to date with knowledge, guidelines.

 Supportive
 Calm under pressure
 Take responsibility and steps forward in
emergency
 Constructively criticise
 Establishes good rapport with team members
When things go wrong:
Just a routine operation

https://m.youtube.com/watch?v=VndU2zap_Rg
Areas of Focus

• Multidisciplinary
• Training for Safety
• Increase awareness and education
• Observational work in obstetric theatres
• Identify areas for development
• Prompt Cards
• Emergency Transfer Directive
• Human Factors Train The Trainer
Errors are inevitable:
 
There are situations that can increase
the likelihood of error
Attention to human factors principles can
lead to a reduction in error or its
consequences.
 References
Anaesthetic Non-Technical Skills
http://www.abdn.ac.uk/iprc/ANTS

A human factors video, “Just a routine operation” and other information on the
concepts can be found at:
https://m.youtube.com/watch?v=VndU2zap_Rg

Royal college of surgeons Edinburgh. (NOTSS , non technical skills for surgeons)
https://www.rcsed.ac.uk/professional-support-development-resources/learning
-resources/non-technical-skills-for-surgeons-notss
.