Human Factors and Culture

Human Factors and Culture

Carrison K.S. Tong (Pamela Youde Nethersole Eastern Hospital, HK) and Eric T.T. Wong (Hong Kong Polytechnic Institute, Hong Kong)
DOI: 10.4018/978-1-59904-672-3.ch014
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Abstract

Human factors engineering (HFE) is the science of designing systems to fit human capabilities and limitations. These include limitations in perception, cognition, and physical performance. HFE involves the application of specific methods and tools in the design of systems. Human information processing is influenced by multiple factors: • Attention: May be limited in duration or focus, especially if attention to several things is necessary. • Memory constraints: Working memory is limited, especially when active processing of information is required. • Automaticity: Consistent, over learned responses may become automatic, and completed without conscious thought. • Situation awareness: A person’s perception of elements in the environment may affect their processing of information. Humans have certain tendencies and biases that can predispose them to error. These heuristics are usually very useful and successful, but at times can get us into trouble. The objectives of this chapter are to provide practical Human Factors guidance to professionals concerned with PACS operation and management and to introduce the non-specialist to Human Factors issues in PACS operation and management. It is intended to show how human capabilities and limitations can influence field performance and quality within the PACS environment. This chapter also discusses the quality improvement likely to result from the provision of a proper work environment. First the importance of communications and information exchange among PACS users, maintenance staff, manufacturers, suppliers, and so forth, is discussed. The need to introduce self-paced computer-based PACS training for hospital staff is stressed. Then a comparison of the western and eastern cultural dimensions is illustrated through a case study. Finally a feasible PACS HF model is suggested. Obviously, a PACS environment that works for one hospital does not necessarily work for another; hence it is imperative that the organizational culture must be considered when a PACS project is being planned.
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Background

Human factors engineering (HFE) is the science of designing systems to fit human capabilities and limitations. These include limitations in perception, cognition, and physical performance. HFE involves the application of specific methods and tools in the design of systems.

Human information processing is influenced by multiple factors:

  • Attention: May be limited in duration or focus, especially if attention to several things is necessary.

  • Memory constraints: Working memory is limited, especially when active processing of information is required.

  • Automaticity: Consistent, over learned responses may become automatic, and completed without conscious thought.

  • Situation awareness: A person’s perception of elements in the environment may affect their processing of information.

Humans have certain tendencies and biases that can predispose them to error. These heuristics are usually very useful and successful, but at times can get us into trouble. The objectives of this chapter are to provide practical Human Factors guidance to professionals concerned with PACS operation and management and to introduce the non-specialist to Human Factors issues in PACS operation and management. It is intended to show how human capabilities and limitations can influence field performance and quality within the PACS environment.

This chapter also discusses the quality improvement likely to result from the provision of a proper work environment. First the importance of communications and information exchange among PACS users, maintenance staff, manufacturers, suppliers, and so forth, is discussed. The need to introduce self-paced computer-based PACS training for hospital staff is stressed. Then a comparison of the western and eastern cultural dimensions is illustrated through a case study. Finally a feasible PACS HF model is suggested. Obviously, a PACS environment that works for one hospital does not necessarily work for another; hence it is imperative that the organizational culture must be considered when a PACS project is being planned.

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Communication And Information Exchange

Communication is probably the most important Human Factor issue in PACS operation and management. Without communication among referring clinicians, radiologists, technologists, nursing staff, maintenance engineers and suppliers, high PACS quality standards would be difficult to maintain. In the PACS environment, there is an enormous volume of information that must be created, conveyed, assimilated, used and recorded in delivering quality medical imaging service. A frequently quoted example in the aviation sector is the paper stack, supposedly exceeding the height of Mt. Everest, that the Boeing Aircraft Company produces annually in order to support its aircraft operators. Airlines literally have warehouses full of paper that contain the historical records of maintenance of their aircraft.

As part of a national program in the Department of Veterans Affairs to improve communication within the healthcare environment, a Medical Team Training questionnaire was developed to assess organizational culture, communication, teamwork, and awareness of human factors engineering principles (Mills et al. 2008). First, the Medical Team Training questionnaire was pilot tested with 300 healthcare clinicians. The final version of the Medical Team Training questionnaire was administered to an interdisciplinary group of 384 surgical staff members in 6 facilities as part of the Medical Team Training pilot project in the Department of Veterans Affairs. The results revealed a pattern of discrepancies among physicians and nurses in which surgeons perceive a stronger organizational culture of safety, better communication, and better teamwork than either nurses or anesthesiologists do. It was concluded that the Medical Team Training questionnaire was helpful in identifying hidden problems with communication before formal team training learning sessions, and it would be useful in focusing efforts to improve communication and teamwork in the operating room.

Complete Chapter List

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Table of Contents
Chapter 1
Introduction  (pages 1-27)
Carrison K.S. Tong, Eric T.T. Wong
Picture archiving and communications system (PACS) is a filmless and computerized method of communicating and storing medical image data such as... Sample PDF
Introduction
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Chapter 2
Carrison K.S. Tong, Eric T.T. Wong
The protection of information for a healthcare organization, in any form, while in storage, processing, or transport, from being available to any... Sample PDF
ISO 27000 Information Security Management System
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Chapter 3
Carrison K.S. Tong, Eric T.T. Wong
PACS disasters can, and do, appear in a variety of forms including storage hard disk failure, file corruption, network breakdown, and server... Sample PDF
High Availability Technologies for PACS
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Chapter 4
Carrison K.S. Tong, Eric T.T. Wong
Fundamental to ISO 27000 (ISO/IEC 27001:2005, 2005) is the concept of an information security management system (ISMS). The information security... Sample PDF
Implementation of Information Security Management System (ISMS)
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Chapter 5
Carrison K.S. Tong, Eric T.T. Wong
Filmless hospital is transforming at an unprecedented rate. Physicians, nurses, clinicians, pharmacists, radiologists, emergency departments, local... Sample PDF
Planning for a Filmless Hospital
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Chapter 6
Carrison K.S. Tong, Eric T.T. Wong
More rapidly than any technological advance in medical history, filmless hospital is changing the clinical and business aspects of radiology... Sample PDF
Design of a Filmless Hospital
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Chapter 7
Carrison K.S. Tong, Eric T.T. Wong
A PACS has tremendous benefits (Bryan, Weatherburn, Watkins, Buxton, 1999) and values outside of radiology as well as internally. The biggest... Sample PDF
Implementation of Filmless Hospital
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Chapter 8
Carrison K.S. Tong, Eric T.T. Wong
As PACS gains widespread use, the importance of Quality Control (QC), Quality Assurance (QA), and Business Continuity Plan (BCP) in PACS is rising.... Sample PDF
Quality Control, Quality Assurance, and Business Continuity Plan in PACS
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Chapter 9
PACS Quality Dimensions  (pages 140-153)
Carrison K.S. Tong, Eric T.T. Wong
A large number of studies have attempted to identify the factors that contribute to good PACS quality, such as that shown by Reiner et al (2003).... Sample PDF
PACS Quality Dimensions
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Chapter 10
Customer Oriented PACS  (pages 154-169)
Carrison K.S. Tong, Eric T.T. Wong
During the early development phase of PACS, its implementation was mainly a matter of the radiology department. This is changing rapidly, and PACS... Sample PDF
Customer Oriented PACS
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Chapter 11
Carrison K.S. Tong, Eric T.T. Wong
Nowadays it is hard to think of any applications in modern society in which electronic systems do not play a significant role. In aerospace and... Sample PDF
Design for PACS Reliability
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Chapter 12
Carrison K.S. Tong, Eric T.T. Wong
There are some medical errors for which preventability is rarely questioned. These include medical errors such as wrong site surgery, wrong... Sample PDF
PACS Failure Mode and Effects
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Chapter 13
Carrison K.S. Tong, Eric T.T. Wong
Economically speaking, it is interesting to see that over the years, the question as to whether PACS is cost-justifiable has not been easier to... Sample PDF
PACS Network Traffic Control
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Chapter 14
Human Factors and Culture  (pages 225-243)
Carrison K.S. Tong, Eric T.T. Wong
Human factors engineering (HFE) is the science of designing systems to fit human capabilities and limitations. These include limitations in... Sample PDF
Human Factors and Culture
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Chapter 15
PACS Monitoring  (pages 244-263)
Carrison K.S. Tong, Eric T.T. Wong
The present study advocates the application of statistical process control (SPC) as a performance monitoring tool for a PACS. The objective of... Sample PDF
PACS Monitoring
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Chapter 16
Carrison K.S. Tong, Eric T.T. Wong
To illustrate the benefits of implementing QM in PACS, a successful case based on the Six Sigma approach is given below. It involves a project... Sample PDF
Quality Management Benefits
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Chapter 17
Epilogue  (pages 288-297)
Carrison K.S. Tong, Eric T.T. Wong
Today’s filmless radiology through PACS provides greater speed and superior image quality. However, when workflow is encumbered by inefficiencies... Sample PDF
Epilogue
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Appendix A
Appendix B
Appendix C
About the Authors