Principles for the conduct of human factors/ergonomics in healthcare: a scoping study of the published evidence.

Abstract

Background: There is a need for guidance to support human factors/ergonomics (HFE) practitioners to conceive and design HFE interventions that live up to the fundamental principles underpinning the discipline of HFE. The principles are that HFE has a systems focus, is design driven and focuses on both performance and well-being outcomes.

Objectives: The objectives of this scoping review are to: identify studies that meet these principles in order to discover how commonly HFE studies meet the principles for the practice of HFE; the scope and characteristics of studies that meet the principles; and the learning that can be gleaned from these studies.

Eligibility criteria: The principles were operationalised into four criteria that were used to select studies: (1) The intervention acts on more than one aspect or element of the system; (2) a context-relevant needs assessment or systems analysis phase is undertaken to design the intervention; (3) the intervention has an active element that is designed to enhance safety, quality, efficiency, effectiveness or well-being and (4) the intervention is evaluated.

Sources of evidence: The review considered all studies published in peer-reviewed journals between 2010 and July 2024 in which an HFE or related intervention is presented and evaluated. Electronic searches were conducted across five databases plus Google Scholar.

Charting methods: Data extraction was done by consensus using extraction forms and following two stages: (1) data extraction and (2) data interpretation.

Results: A total of 13 intervention studies met the inclusion criteria, suggesting that adherence to core HFE principles is rare. All included studies self-identified as HFE intervention studies. All interventions had a clearly defined scope and most targeted at least four system elements, that is, person, tools, technology, task, process, organisation, environment. The 'people' element was the one most commonly targeted. A wide range of organisational level and patient outcomes were measured, but no employee safety or well-being outcomes were measured in the included studies. In all cases, the intervention team included healthcare providers working with HFE/systems engineering/improvement experts, who often led the project.