Emergency services
Developing a Data-Driven Fatigue Management System Dashboard for Paramedic Services
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Author Marcus Yung, Amin Yazdani |
| Abstract Paramedic Fatigue is linked to poor work performance, including increased medical errors, and adverse health outcomes for the paramedic, such as increased accident risk, musculoskeletal disorders, and burnout. Currently, there are no effective and practical risk assessment tools that consider the various fatigue factors attributed to work tasks, work arrangement, and personal demographics. This presentation describes findings from a large prospective cohort fatigue study with a rural paramedic service in Ontario, Canada. Research data informed the development of a Fatigue Management System Dashboard (FMSD) to support a Service’s critical decision making for enhancing service efficiency, improving paramedic health and wellbeing, and maintaining patient safety. |
Prevalence of Physical Health Symptoms in Police Officers
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Author Kenisha V. NELSON |
| Abstract This study reports on the prevalence of physical health symptoms in Jamaican police officers (N=134) and examines associations between these and gender, age, rank and years of service. The relationships between number of reported symptoms and sickness and doctor visits were also examined. Participants completed a questionnaire using a cross-sectional design. Over 50% of participants reported backache, frequent headaches, heartburn or indigestion, and sleeping problems. Few significant relationships were found with demographic variables and symptoms. Significant relationships between number of symptoms, sickness absence and doctor visits were observed. Implications of the findings and suggestions for future studies are discussed. |
Needs for resilient fire safety management on land and sea
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Author Helene Degerman and Staffan Bram |
| Abstract Fires are associated with potentially large consequences for life, environment and property and are therefore an important aspect in workplace design. This article summarises two case studies, examining the preconditions for a well-functioning fire safety system on land and at sea respectively, applying a systems perspective on work and safety. Today’s fire safety management is mainly focused on technical installations, constructional and building measures, control plans and evacuation routines. Fire safety installations could meet all regulative requirements and still create problems for production, sometimes to the point where fire protective routines or installations are bypassed. A common answer to such issues is to strengthen administrative barriers such as rules, safety information and training. However, in tightly optimised organisations like heavy industries or shipping, more checks and routines will only run the risk of aggravating the problem at hand. The problem could instead be viewed as an effect of poor design. Flaws in fire safety design can be traced to the processes of ship and industrial workplace design, building and revision. In the observed fire safety design processes, there are no established ways to ensure that end-user needs are taken into account, and the construction project's main incentive is to keep the construction cost down. Instead, costs are pushed to the operational phase in the form of reduced production and lower safety levels. Safety management in general, and fire safety management in particular, needs to be further developed from a systems perspective. |
Examining cognitive tasks in the emergency department
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Author Nick Woodier, Paul Davis, Laura Pickup, Kathryn Whitehill & Robert Hutton |
| Abstract Applied Cognitive Task Analysis is an appropriate method to investigate challenging cognitive tasks and the role of expertise in healthcare contexts. Healthcare needs to support the accelerated development of decision-making skills in its novices and also create the optimum conditions in which to make decisions. |
Human factors in emergency management
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Author Weixuan Li, Glyn Lawson & Gary Burnett |
| Abstract Good emergency management is essential when human beings face natural disasters. However, there are many human factors challenges in this area, in particular teamwork amongst those involved with the response efforts, but also communication, navigation, and workload. This article presents the findings from nine interviews with emergency management practitioners based in China, with an emphasis on the potential use of Virtual- and Augmented-Reality to address the aforementioned human factors issues. |
Mountain guides’ everyday work: Articulating safety and service relationship
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Author Antoine Girard, Sandrine Caroly and Pierre Falzon |
| Abstract With a worrying accidentology (ten fatal accidents per year for approximately 1700 professionals in France), a culture that promotes a high level of performance and a profession based on the craft-type approach, the practice of mountaineering with a guide can be considered as an unsafe system (Amalberti et al., 2005; Morel et al., 2009). This practice has two particular characteristics. Firstly, it is currently undergoing a deep transformation not only in terms of its environmental context (with global warming), but also because of the media, legal and regulatory pressure that weakens the sustainability of the profession, due to low safety standards. Secondly, it belongs to the service situations. The client is present and involved in the production phases (Falzon and Cerf, 2005): they may be a novice or more experienced and may themself be a victim of accidents. For instance, fifteen clients died in 2018 in France. If, for the guide, clients are a variable to be monitored in a dynamic situation (Hoc, 2001), they are also participants, with their own goals, in the interactive process of the service relationship (Falzon and Cerf, 2005). This service situation, where a professional applies specific skills to provide the service requested by the client, should be distinguished from situations of cooperation between two operators (Falzon and Cerf, 2005; Flageul-Caroly, 2001). According to these elements, this study examines the way the guides build safety with their clients, in a hazardous, dynamic environment and in this particular socio-professional context. |
Clinician perspectives around automating the Emergency Department triage process
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Author Katherine L. Plant, Beverley Townsend, & OlTunde Ashaolu |
| Abstract Healthcare has arguably been the sector most impacted by the Covid-19 pandemic, leaving Emergency Department (ED) medical teams overworked and understaffed. An automated system for ED triage has been developed to help alleviate some of these pressures. Eight ED clinicians were interviewed to capture their views of the automated system. Insights were generated around where this system might add value and areas of challenge or concern. These findings will be used to refine the prototype for end-user testing and support the development of training material for clinicians. |
The first empirical test of Human Factors integration in frontline policing
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Author Adam Pace |
| Abstract This study presents the first empirical test of aviation-derived Human Factors (HF) training within frontline policing. Longitudinal surveys of serving police officers and interviews with aviation specialists examined the relevance, transferability and operational impact of HF principles in this context. Findings were consistent with literature indicating that HF has not yet been adopted within policing, and participants reported low baseline familiarity with related concepts. Post-training responses demonstrated substantial gains in understanding, confidence and behavioural application. Most officers (89%) reported using HF operationally, with strong perceived benefits for safety and performance. The results indicate clear potential for HF to strengthen decision-making, safety and organisational learning across policing and the wider emergency services. |
Influence of Information Source and Environmental Cues on Decision-Making During Flood Evacuation
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Author Razan Aldahlawi, Glyn Lawson, Alexandra Lang, Vahid Akbari |
| Abstract This study explored the influence of different information sources and environmental cues on decision-making behaviour at route intersections during flood evacuation. The information sources included traffic police officers, navigation systems, and road signs. The environmental cues involved floodwater on the streets and congestion. The talk-through method developed by Lawson (2011) was employed, in which participants were presented with hypothetical flood scenarios and asked to explain how they would respond. The results showed that receiving routing directions from a traffic police officer to follow the planned route increased the likelihood of complying with the instructions and staying on the planned route the most. In contrast, observing floodwater along the planned route was the strongest factor in decreasing the likelihood of staying on it and switching to an alternative route. Following a within-subject design, these findings were based on nonparametric statistical analysis, in which the Friedman test and the Wilcoxon Signed-Rank test assessed differences in participants’ rating scores across conditions. This research makes an important contribution to understanding how information sources and environmental conditions influence decision-making during floods. |
Human factors: emergency department suspected heart attack process
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Author Frances Ives & Deborah Jackson |
| Abstract Early recognition of a heart attack is essential as delayed treatment can result in death. A Human Factors (HF) review of the process for treating suspected heart attack patients in a busy inner-city Emergency Department (ED) was completed to help decrease risk, improve patient safety, care and patient and staff experience. To provide timely treatment for a heart attack, a diagnostic electrocardiogram (ECG) must be performed within 15 minutes of arrival at ED. However, concerns had been raised by staff relating to patient experience and delayed ECG, due to the number of process steps the patient had to complete from arrival at ED reception to the ECG being taken. Observations of the process were carried out along with multidisciplinary staff focus groups to understand the patient journey. A Hierarchical Task Analysis (HTA) and Failure Modes Effects Analysis (FMEA) were also completed to identify process failures and impact. The FMEA and observations identified that the patient journey was complex due to: the distance they were required to walk; having to enter the department through the ambulance entrance; and the requirement to speak to a specific member of staff in the department to obtain further directions. The process was changed to: reduce the distance the patient had to walk; decrease the likelihood for them to get lost; improve patient visibility for staff; and to facilitate more timely ECGs. As result of the Human Factors review, ED staff felt empowered to make immediate, no-cost and sustainable improvements. |
