BMJ Qual Saf doi:10.1136/bmjqs-2011-000476
  • Editorial

Systems human factors: how far have we come?

  1. Beverley J Norris1,2
  1. 1National Patient Safety Agency, London, UK
  2. 2Helen Hamlyn Centre for Design, Royal College of Art, London, UK
  1. Correspondence to Beverley Norris, National Patient Safety Agency, 4-8 Maple Street, London W1T 5HD, UK; beverley.norris{at}

The paper by de Korne et al in this issue presents a design solution to an infection control problem in the operating room. Specifically, they sought to achieve consistency in the correct positioning of equipment in the operating room for eye surgeries in order to derive the intended benefits of laminar air flow ventilation in reducing bacterial air contamination.

Korne et al used co-creation between surgical staff and tarmac operators at Schiphol airport and a work analysis to develop a design solution to an issue that had traditionally been approached through training and technical issues. This is an approach firmly rooted in human factors. Many people in healthcare will now be familiar with the term ‘human factors’, but how far have we come in applying this approach in healthcare?

What progress have we made?

One of the earliest references to human factors in the healthcare literature dates back to 1957 and calls for equipment to be designed in terms of human capabilities and limitations.1 Presenting data on physical and perceptual abilities (including the effects of excessive cigarette smoke in the cockpit on pilots' performance!) the paper made a plea to the medical community to use the ‘principles of human engineering’ to improve safety. We now hear of human factors being used to design better medical devices, equipment and information systems,2 3 but this is an exception rather …

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