I do human factors.
As an airline pilot, I sit at the front of an aircraft that passes through the upper atmosphere at close to the speed of sound. My immediate thoughts are about 100 miles ahead. My longer-term thoughts may be many thousands of miles ahead. All the time I can only do what I do because of an amazingly complex aviation system that somehow ‘understands’ the nature of humans within it. It understands how to make my job easier. It understands how to present me with information. It understands how not to distract me up until I need distracting. It understands, in simple terms, how to make it easy to do the right things.
I am supported by colleagues who understand how to make it easy for us to do the right things, as well as understanding the ways to get the best out of us and the best out of the system. And if it all starts to go wrong, they, I, and the system as a whole understand how we can manage ourselves and all the complexity in a way that ultimately is more likely to deliver us safely back to our homes.
Do the passengers that I fly understand human factors and ergonomics (HF/E)? I’m not sure, but I bet they’d really appreciate the preceding paragraphs. Do I understand human factors and ergonomics? I’m not sure either, but I still do it and live with it every day of my life.
Sadly, I was to discover that not all safety critical work in other domains has benefitted from understanding human factors and ergonomics. In 2005 my wife was admitted to hospital for a routine elective procedure. It took just over 20 minutes for people and a system that didn’t do human factors to leave my wife brain dead. It would be another 13 days before she really was dead.
I was shocked, not just be the tragedy that had befallen me and my children, but as an independent report and Inquest revealed, the system that had inadvertently killed my wife seemed to be so far behind in its practices. When it came to safety and human factors, it was as if it was stuck in the 1930’s.
Since then I’ve worked, in a voluntary capacity, to try and understand the healthcare system. I discovered there had been some theoretical discussion around the topic at senior levels, and a few very local frontline projects, but in a workforce of 1.4 million people in the UK alone, HF/E was regarded as a niche research topic that wasn’t terribly relevant to the real world.
It became clear very early on that I was out of my depth, I needed specialists in HF/E to work with. Since then I’ve been delighted to have received the support of so many in your community, far too many to name.
As an outsider, I’ve been enveloped in the HF/E profession, and I’ve begun to appreciate just how much HF/E can do for the world. Whether the simple pleasing design of my phone that allows me milliseconds faster access to my contacts, to the safety critical seconds that a good system might buy me, which can make the difference between life and death. HF/E is just too important to confine to a lab or research article. Whatever research articles might exist on the issues relevant to the events on that day, they are wasted unless HF/E touches practice – in the broadest sense of the term.
As clinicians the world over have reviewed my late wife’s case, in a quiet break room perhaps, they have all, with very few exceptions stated clearly: “I wouldn’t have done what they did”. Yet place those same people in a simulated scenario with the same real world disorder, which deteriorates into the same challenging moment, most actually do. This gap illustrates the difference between human performance as imagined and human performance in the real world. Of course this gap exists in other industries as well.
To help close this gap requires the sort of insight that you can provide.
I have no doubt that the most influential HF/E specialists are those who can ‘mix it’ with the front-line employees, CEOs, senior policy makers, even politicians. These people understand the complexity of HF/E and can also explain it in relatively simple terms. They can balance the need to do things in the ‘best’ way, with the real financial, practical and cognitive limitations of those who have to implement ideas into reality.
You might be surprised that I talk about cognitive limitations when we’re discussing a target audience who make up some of the most intelligent people in the world. But I’ve also observed that in complex systems nurture wins over nature almost always, and introducing even the simplest concept, that ‘human error’ is normal, is for many a stretch of the imagination a little too far.
This has been my challenge, but here’s a challenge for you:
Do you move the profession forward or do you move the world forward?
Moving the world forward involves some trade-offs and compromises in order to include the wider world. The danger of the purist academic, theoretical world is that it is neat and defined. This is not the messy real world occupied by the frontline in any industry. To change the real world, you have to be in the real world, whatever part you play.
This book has been expertly crafted by Steven Shorrock and Claire Williams. It features many human factors experts and ergonomists who have exposed their work to the real world and who have become my own heroes. I know it will inspire you to make a difference for the benefit of not just those of us at the frontline, but everyone who depends on us.
Airline Captain & Founder of the Clinical Human Factors Group (CHFG), UK