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Human factors and ergonomics and quality improvement science: integrating approaches for safety in healthcare
  1. Sue Hignett1,
  2. Emma Leanne Jones2,
  3. Duncan Miller3,
  4. Laurie Wolf4,
  5. Chetna Modi5,
  6. Muhammad Waseem Shahzad5,
  7. Peter Buckle6,
  8. Jaydip Banerjee7,
  9. Ken Catchpole8
  1. 1Loughborough Design School, Loughborough University, Loughborough, UK
  2. 2College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
  3. 3Department of Quality Improvement, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  4. 4Department of Operational Excellence, Barnes-Jewish Hospital, St Louis, Missouri, USA
  5. 5Health Education East Midlands, Leicester, UK
  6. 6Helen Hamlyn Centre for Design, Royal College of Art, London, UK
  7. 7Department of Emergency Medicine, Leicester Royal Infirmary, Leicester, UK
  8. 8Department of Surgery, Cedars-Sinai Medical Centre, Los Angeles, California, USA
  1. Correspondence to Professor Sue Hignett, Loughborough Design School, Loughborough University, Ashby Road Loughborough LE11 3TU, UK; s.m.hignett{at}lboro.ac.uk

https://doi.org/10.1136/bmjqs-2014-003623

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    Introduction

    In this paper, we will address the important question of how quality improvement science (QIS) and human factors and ergonomics (HFE) can work together to produce safer solutions for healthcare. We suggest that there will be considerable advantages from an integrated approach between the two disciplines and professions which could be achieved in two phases. First, by identifying people trained in HFE and those trained in QIS who understand how to work together and second, by developing opportunities for integrated education and training. To develop this viewpoint we will:

    1. Discuss and explore how QIS and HFE could be integrated by building on existing definitions, scope of practice, knowledge, skills, methods, research and expertise in each discipline.

    2. Outline opportunities for a longer-term integration through training, and education for healthcare professionals.

    History and perspectives of QIS and HFE

    The disciplines and professions of QIS and HFE developed from similar origins in the 20th century to engage workers in the identification of problems and development of solutions.1 ,2 They diverged with QIS focussing more on process issues (eg, production quality control) and HFE focussing on wellbeing (occupational health and safety) and performance. Both have been used in healthcare for many years, with several recent papers discussing confusion about jargon in one or both disciplines.3–7 We will offer a simple outline of our perspectives for each before suggesting an approach for integrated working.

    We are using the term QIS to include both quality improvement and improvement science.8 QIS is used, defined and explained in the literature in many different ways, for example, ‘the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge’;9 ‘better patient experience and outcomes achieved through changing provider behaviour and organisation through using a systematic change method and strategies’ …

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