Human Factors in Healthcare Blog
A Blog by John Gosbee & Laura Lin Gosbee of Red Forest Consulting
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We are now to the final two sets of characteristics to look for in a HFE and healthcare specialist. We have covered the first three in previous posts:
- Bartender
- Bean-packing plant safety manager
- Lifeguard
- Set designer
- Wilderness survival expert
In a slightly famous scene in the comedy “Seinfeld”, George Costanza puts together a table-top recreation of a meeting room where he thinks “Susan-Memorial” board members have damaged his brief case on purpose… He was trying to audio record them while they said unkind things about him behind his back. You might not want the work ethic of George, but you need the insight and talent to recreate enough realism to do simulations and usability testing.
Simply put, you need someone who can put the most effective and efficient level of realism to do usability testing during product development. Early on, with low-fidelity testing, it could be items purchased at a hardware store that stand in as medical tubing or devices, and B&W screen prints pasted to cardboard boxes for computers or device displays. They don’t need the talent or tools to do it all, but they will often have to be the pioneering leader to nudge or push others to get it done. You need someone to buy the 9-drawer tool chest as a prop for medication storage cart – and worry about justifying the expense report after the prop has proved effective. 
Later in the design process, this person needs the savvy to choose between a “well dressed” usability testing lab versus a $$$/hr ICU room set-up at a medical simulation center. I cannot imagine they will hire David Rockwell (set designer for the Oscar ceremony), but they need to lead or build the expertise to effectively create healthcare props and back-drops. During interviews, one good screening question is to ask them what kind of healthcare props they already have in their portfolio (basement office). Another is to ask them what do they think of “paper prototyping”, and when did they last use it.
Next, the fifth and final key to hiring or developing a HFE & Healthcare professional.
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In my last posting, I began a thread about how to hire someone for a human factors engineering and design/safety job. These were the five jobs that contained attributes helpful for an HFE and Medicine specialist:
- Bartender
- Bean-packing plant safety manager
- Lifeguard
- Set designer
- Wilderness survival expert
In his many years at a green bean packing plant, my uncle had a large role in worker safety. Sure, there were some efforts that were typical (XX days since finger has been sliced off), and some that went askew (200 winter coats emblazoned with the misspelled slogan “Saftey First!” However, many efforts involved involvement… No, that’s not double talk.It means that they closed the plant down one or more days per year and everyone in the plant met to talk about injuries and ways to prevent them. Everyone, meant that they hired temps to cover reception. The supervisors had the job of safety and had to weave the lessons they learned in these “retreats”…it meant they needed skills and patience to translate the lessons into concrete actions and expectation. It meant they needed to be flexible enough to weave stories of caution with verbal “kicks in the butt” to keep summer workers from loafing. Knowing the goal of the plant is clean, tasty food that is packed quickly and as efficiently as possible…and knowing that one finger tip that a consumer finds in a can will be on the nightly news for 9 weeks (maybe even a “60 Minutes” Special!).
Humor surely helps. Softening the harshness of zero tolerance for not wearing hard hats is an art. A person needs good timing of when to tell the story of the temp worker who was nearly boiled when they bypassed the safety system Knowing when to get real and when to be one of the gang is a balancing act. All of these seemingly “natural” skills aren’t. If you find an HFE & Medicine candidate who has some or most of them, HIRE THEM ON THE SPOT.
Next Posting: Lifeguard skills – how to disarm a drowning man!
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New software may require subscribers to actively pick all the categories – or they don’t get email notices of new postings (sigh!).
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Years ago, the most common question I got was, “where do I go to learn more about human factors engineering?” The the length and breadth of my answer did evolve as more workshops and books (including our own) came on the scene. Funny, very few people thought it was funny when I said that they could go back to school and get a masters degree in HFE in just a few short years! I was only partially kidding, since I knew that some of the design or safety questions they would tackle could easily be major essay questions on graduate level tests – or even research theses.
Many people now ask different questions: who should I hire? where can I find them? [These are harder questions, so I reminisce about the old days of the easier questions above.] The question arises frequently enough, that we devoted part of a chapter in our recent book to this.
Simply stated, it is only a small problem to find people with masters degrees or PhDs in human factors engineering. That is not enough. They need one or more other qualities. Below, and in the next 4 postings, I will describe and give examples of some of those needed qualities for an HFE and Medicine specialist:
- Bartender
- Bean-packing plant safety manager
- Lifeguard
- Set designer
- Wilderness survival expert
Skills of a bartender (or, if you will, ombudsman) are key! Your HFE will need to be able to listen, and listen, and listen. Those 40 minutes of seemingly irrelevant stories are the needed lead-in for a patient to reveal the real problem they have with the device or medication delivery system. The HFE needs to be trusted by the usability test participant clinicians when they see “interesting” usage of devices or medications. They should have a ready supply of (NON-ALCOHOLIC) drinks and other pleasantries to set the stage for stressful design meetings. Sometimes, especially during “last call”, they need to summon jaw-dropping honesty about bad things that might happen if the product goes “out” - and be willing to stand up to peer pressure. Finally, be prepared to help out with lots of jobs, clean up messes, and know how to fix things on “the fly”.I also propose that many of these qualities are needed for many people involved in patient safety or HFE in healthcare delivery settings. I proposed this at one national meeting on a panel and the response was mixed! From my frontline view of many device design and safety events, the qualities above are often needed and not necessarily taught in academic programs.Next: Bean-packing plant safety manager