Comp 15 Usability and Human Factors Unit 4

Comp 15 - Usability and Human Factors Unit 4 a - Human Factors and Healthcare This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1 U 24 OC 000003.

Overview • Introduction to human factors principles • Applied cognitive psychology/selective attention • Patient safety • Understanding human errors • A Systems-centered approach to human errors • Mental workload • Medical devices Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 2

Human Factors & Health Care Health Devices Component 15/Unit 4 a Electronic Health Record Systems Health IT Workforce Curriculum 2. 0/Spring 2011 Version 3

Human Factors and HCI Redux • Differences: – Histories, journals, academic and professional • societies Histories, journals, academic and professional societies – HCI focused on computing and innovative • design HCI focused on computing and innovative design – HF focused on any system and greater • HF focused on any system and greater emphasison onwork/workplaceand andon ondevices – Safety is a core issue in HF devices • Safety is a core issue in HF Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 4

Human Factors and HCI Redux Similarities: • User-centered and systems approach • Draws on cognitive psychology and other social sciences • Similar methods with regards to usability evaluation • Cognitive task analysis • Usability testing Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 5

History of Human Factors 1900 -1945: • Industrial efforts to increase worker productivity 1945 – 1960: • Formal beginning of the profession – military 1960 – 1980: • Rapid growth and expansion – space program, product design, workplace design 1980 – 1990: • Human computer interaction, safety/human error 1990 – Present expansion • e. g. , healthcare, aging, aviation safety, standardization Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 6

Why is Human Factors Increasingly Important • • • Diversity of user groups Complexity of systems Increased use of technology Increased “costs” of human error Societal emphasis on well-being and quality of life Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 7

Human Factors Objective Focus: Goal: • Human beings and their interactions with products/equipment, tasks, environments • (Micro, macro, ambient) • Design systems and system components to match the capabilities and limitations of humans who use them • Optimize working & living conditions Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 8

Examples of Application Areas • Military • Highway systems – e. g. readability and comprehensibility of signs • • Automobile design and driver behavior Human-computer systems Healthcare and patient safety Aging and accessibility Nuclear power Workplace layout and furnishings Airline industry – e. g. pilot workload, aircraft design, automation, aircraft maintenance • Quality control Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 9

Nuclear Power Plant Control Room Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 10

Airplane Cockpit Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 11

Human Factors in Medicine • • • Infusion pumps Anesthesia equipment Medication errors Effects of fatigue on resident’s performance Judgmental limitations in medical decision making • Inadequate infection control • Unintended consequences of automation Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 12

Human Factors/Ergonomics (Carayon, 2007) • Scientific discipline concerned with understanding interactions – Among humans – Other elements of a system • Profession that applies theory, principles, data, methods to design to optimize: – human well-being – overall system performance • System can be a technology, device, person, team, organization, policy, etc. Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 13

Human Factors Ergonomics: 3 Major Domains • Physical Ergonomics Physical Cognitive • Cognitive Ergonomics • Organizational / Macroergonomics Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 14

Physical Ergonomics Concerned with physical activity • Topics: Repetitive movements, workplace layout, safety and health • Application to Health: Reducing and preventing injury, designing workstations and work rooms for optimal human performance • Examples: • Designing a patient room to facilitate and support patient care • Designing medical labels so that they are readable and understandable Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 15

Organizational Ergonomics Concerned with sociotechnical systems • Topics: communication, teamwork, participatory design, quality management • Application to Health: Reducing stress and burnout, improving satisfaction and retention, implementing improvement activities • Examples: • Management training in surgery teams • Designing work schedules for reduced fatigue and enhanced performance Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 16

Cognitive Ergonomics • Concerned with mental processes – Topics: mental workload, decision making, skilled performance, HCI, work stress, Topics: mental decision making, skilled – • Application toworkload, Health: usability, designing performance, HCI, work stress, training systems, usable interfaces • Application to Health: usability, designing training – Examples: systems, usable interfaces • Event report systems • Examples: • • Event report systems Implementing incident analysis system • Implementing incident analysis system Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 17

Human Factors & Applied Cognitive Psychology • Applies knowledge about human strengths and limitations to design of interactive systems, equipment, and their environment to ensure their effectiveness, safety, and ease of use • Perception, attention, memory, mental models and decision making are central to human factors research and analysis Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 18

Human Attention • Selective Mechanism • Resource needed for information processing • Limited • Sharable Flexible Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 19

Selective Attention • Ability to ignore extraneous information and focus on relevant inputs and focus • Performance typically declines asofthe typically declines as the number sources of number informationof increases sources of information increases can only information at a finite rate at a • Humans canprocess only process finite rate overload contributes to errors • Information overload contributes to errors Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 20

Information Overload Speed Stress Load Stress Speed/Accuracy Tradeoff Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 21

Selective Attention Four factors drive the selection of channels to attend (and the filtering of channels to ignore): Salience: • Events or stimuli that are salient capture attention (this represents a bottom-up process) Expectancy and Value: • We tend to “sample” the world where we expect to find information, and attend to channels based on how valuable it is to look or costly to miss Effort: • Selective attention may be inhibited if it is effortful Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 22

Divided Attention or Time Sharing • Time-sharing: – ability to perform more than one cognitive task by attending to both at once or rapidly switching back and forth between them • Because cognitive resources for attention are relatively limited, time-sharing often results in a drop in performance for one or both tasks • People can also “modulate” the resources given to one task or the other Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 23

Human Factors Design Implications • Reduce the number of competing channels of information • Make sources of information as distinct as possible • Provide feedback • Use redundant cues • Work/rest scheduling • Training Component 15/Unit 4 a Health IT Workforce Curriculum 2. 0/Spring 2011 Version 24