University Health Network (UHN) is in the process of implementing an electronic system for managing all documentation completed by its anesthesiologists. This represents a dramatic shift in their workflow as their current practice of documenting on a tri-fold paper form, will be replaced with electronic systems at the point of care. Selecting a system that doesn’t take into consideration anesthesiologist workflow, needs and limitations, not only runs the risk of poor adoption, but could also have patient safety implications if the system is difficult to understand and use.

The Chemotherapy Daycare (CDC) Pharmacy of Princess Margaret Hospital approached the Healthcare Human Factors Team for an assessment of their workflow and workspace.  The impetus for this assessment was rooted in the growing need to accommodate more chemotherapy patients in the CDC via an alternate day patient booking model and therefore to improve the efficiency of the pharmacy within its limited space.  The objectives of this assessment were: 1) to identify issues of safety and efficiency, and 2) to recommend practical solutions for improving the efficiency and safety of the unit’s workflow and workspace.

The University Health Network (UHN) has an electronic reporting system that allows hospital staff to report incidents and near misses. Like most institutions, however, they did not have a means for staff to proactively identify and communicate hazards in their environment. Hazards are anything that increases the potential of an incident or near miss and may include things such as problems with the physical setting (lighting, noise, organization of materials), technology that is difficult to use, work patterns and procedures, forms, medication administration and many other issues.

The Healthcare Human Factors Group was approached to support the potential procurement of new manual defibrillator for use at University Health Network (UHN). The objective was to assess the possibility of integrating a newer version of the manual defibrillator device with its predecessor in the existing clinical environment. It was important to ensure that the two technologies could co-exist at UHN without negatively affecting the user’s workflow or mental model.  A procurement decision needed to be made between: 1) purchasing a small number of devices for supplementation, and 2) replacing all existing devices and standardizing the manual defibrillator technology used across UHN.

The Healthcare Human Factors Group was engaged in the evaluation of a mobile intensive care unit designed for use by military medics in helicopters. Although it was designed specifically for the military, the unit is also valuable to other emergency transport care services because of its mobility. The unit was designed such that medics interact with it via a small visual display and audio/visual outputs. Given that users are expected to effectively control and monitor this safety-critical system, it is paramount that the user interface be well-designed to facilitate correct actions and prevent or discourage actions that could result in errors.

The full potential for electronic health records (EHRs) can only be realized if readily adopted by users. Yet the usability of these systems, while recognized as critical for successful user adoption, continues to be a challenge. Furthermore, despite significant technical efforts towards EHR interoperability, there has been minimal consideration of the impact of combining disparate applications on the end user experience in terms of ease of use and adoption. Through the eHealth Collaboratory, a joint initiative between Canada Health Infoway and the Centre for Global eHealth Innovation, human factors methods were used to evaluate EHR solutions for effectiveness, efficiency and ease of use.

The Healthcare Human Factors Group was engaged to improve usability and accessibility of a smoking cessation website. Although the website was very rich in content and contained a number of useful tools only a small portion of these visitors signed up for the program that was offered despite the high website traffic that the website received.

Telecommunication technologies can be an effective way of enabling the management of diabetes and other chronic diseases.  Issues of usability however, have hindered the widespread success of such technologies and have thus emphasized the importance of user-centric design.  This project assessed the usability of a diabetes hypertension telemanagement (DHT) system being developed by the Medical Device Informatics group at the University Health Network.  The objective was to make design recommendations regarding the system’s two user interfaces in order to improve its ease and adherence of use, as well as user satisfaction.

Smiths Medical is developing a new ambulatory patient-controlled analgesia (PCA) pump with a dose error reduction system. In addition to delivering analgesic medications accurately and reliably, the pump is intended to be safe and easy to use. To ensure that the risks associated with use-errors are minimized, the Healthcare Human Factors Group worked closely with Smiths Medical throughout the iterative design process to evaluate each design phase and provide recommendations for improving the user interface of both the hardware and the software.