Dr. Ken Catchpole is a human-factors scientist. He is the SmartState Endowed Chair in Clinical Practice and Human Factors and a professor at the Medical University of South Carolina, where he leads the Human Factors and Clinical Safety Science Laboratory. His career has focused on studying healthcare as a sociotechnical system: people, equipment, tasks, environment, workflow, and organization interacting with one another.
Dr. Ken Catchpole’s work highlights:
He is particularly drawn to work in medical patient safety because it connects emotionally and philosophically difficult experiences for family, patients, and clinicians and complex systems.
Formula 1 pit stops have evolved extensively over the years. See here
Pit stops need to be done very reliably and very quickly which clearly has applications in many fields including medicine.
Analyzed the Formula 1 pit-stop process and applied to a patient handover process for moving pediatric cardiac surgery patients to the intensive care unit
Emphasized clearly defined roles, sequencing, leadership and structuring communication.
Recent work on radiofrequency identification (RFID) surgical sponges highlights the importance of research in patient safety interventions as opposed to spending more resources on any patient safety device. His recent study found that RFID sponges had only a marginally acceptable benefit.
Recent work looking at surgical counts. In the operating room, counting is also accounting (ie. how people place objects in space as opposed to a simple count of them).
The current barriers to developing aviation-structured CRM in medicine are based around lack of training from healthcare workers, a focus on individuals versus teams, and cultural resistance to system change.
Healthcare workers don’t have to demonstrate their ability to effectively communicate before being licensed
Failure to properly train healthcare professionals on new protocols, checklists, procedures, etc.
Healthcare is very focused on the performance of individual people rather than team performance.
There remains cultural resistance to system change potentially driven by the fact that healthcare workers still believe their actions alone have an outsized role in the safety of their patients
People don’t necessarily change their behaviour based solely on evidence.
Usage of ideas from other industries takes research, adaptation, and training.
When using ideas from other industries in medicine, the idea can’t simply be a transplantation from one industry to another or an outright rejection of the idea; it has to be an adaptation.
“Work as imagined"—What we think goes on in a work environment versus “work as done"—What actually goes on in a work environment is vitally important in engineering system solutions. One must actually see how a protocol works “in the field” to properly design it.
While Crisis Resource Management works primarily to improve the performance of frontline workers, moving “beyond” CRM focuses on human factors in the intentional design of systems that help patient safety.
Human factors in system design emphasizes how human behaviour and the limitations of human performance can be understood to enhance system performance.
Human factors research initially started in the 1940’s in aviation, when focusing on pilot confusion between flaps and landing gear (two similar levers) in a basic airplane. The initial solution was to change the shape of the levers.
Situational awareness looks very different in different contexts (ie. a cardiac anesthesiologist versus an orthopedic surgeon)
Generic training on CRM or human factors doesn’t necessarily work given that each context is so different.
“Understanding human behaviour allows us to design the world to suit them better.”
User-centred design incorporates designing a product for the everyday user as opposed to the world expert (designing a ventilator for rural physicians and respiratory therapists as opposed to the most specialized ICU doctor).
Employment of a human factors scientist in healthcare institutions may improve patient safety.
Human factors scientists can improve healthcare design through:
Incident analysis
Developing standards of practice
Architecture and design of actual spaces
Observation and understanding of different clinical environments
Disseminating information to healthcare workers
Dr. Catchpole’s current suggestions for improving safety in hospitals today through:
Procurement of devices (effort spent to determine functionality before it is purchased)
Clinical incident analysis (how harm comes from financial and staffing-related decisions, not just clinicians)
Human factors scientists spending time in clinical environments to find where the real pain points are.
Safety intervention worth mentioning
Human factors or user-centred design, particularly when implementing new equipment or processes.
Forcing functions engineer out error, such as the change to epidural catheters to no longer accept Luer lock syringes.
Other resources
The Design of Every Day Things by Don Norman
The Field Guide Human Error by Sidney Dekker
Still Not Safe by Robert Wears (need to put in patreon amazon link)
Google Scholar, Dr. Kenneth Catchpole
Institute for Healthcare Improvement: Certified Professional in Human Factors in Healthcare
Random recommendations
Ken: Go and do some art. It doesn’t need to be good. Whether it’s sculpture, gardening, cooking etc.
Amir: The Podcast Hard Fork on The AI mob that attacked hugging face (free on YouTube, audio behind paywall)
Adam: The Rescue streaming on Disney+ in Canada, which is about the rescue of a Thai Boys Soccer Team that got trapped deep in a cave that flooded.
Thanks to Carter Ponce at VoV Media for his work in producing and promoting the show, and our intern, Dr. Sam Seshadri, a rural family medicine resident in Canada, for his research and help with post-production.