Taking forward human factors and ergonomics integration in NHS Scotland: Progress and challenges

Abstract

The failure of healthcare systems leads to multiple problems including avoidable patient harms, poor care experiences, psychological impacts on the workforce and costly medico-legal litigation. The urgent need for HFE to be routinely embedded in national healthcare systems is strongly advocated by leading international institutions to better inform solutions to these issues, but policy progress is limited. NHS Scotland has a significant track record in HFE-related research and development, particularly in embedding related principles in education, non-technical skills assessment and training, system-wide hazard identification, learning from safety incidents, measuring safety climate, and integration with quality improvement. However, this work has evolved on an ad hoc basis with no strategic plan for national integration of HFE in priority areas of healthcare policy and practice. To address this gap, four stakeholder workshops with 144 participants representing 27 organisations led to agreement on five priority areas where HFE could ‘add value’: 1. Building workforce capacity and capability by embedding HFE in education and training; 2. Integrating systems thinking into how teams learn from ‘significant events’; 3. Ensuring buildings and workspaces are designed for safety and wellbeing; and adhering to design principles in healthcare technology procurement; 4. Embedding HFE in the design of national safety and improvement programmes; and 5. Exploring the role of a future national HFE expert advisory board to support NHS Scotland. Next steps include engagement with strategic decision-makers (e.g. medical directors, chief executive officers, board members) to inform, influence and ultimately broker the formal integration of HFE in NHS Scotland policy.