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G612 Changing a culture: Raising awareness of human factors and ergonomics within a paediatric department to improve patient safety
  1. EM Forbes
  1. Organisational Development, Torbay and South Devon NHS Foundation Trust, Torquay, UK


Aims To increase awareness of Human Factors and Ergonomics (HFE) throughout the paediatric multi-disciplinary team using a range of different educational strategies and approaches, in order to improve patient safety and well-being for staff.

Methods In 2012, critical incident reporting and a number of serious adverse events involving management of critically ill children identified the need for education in HFE across the paediatric department. Working closely with the Clinical Director and the Lead for Acute Care, Quality and Safety specific areas for improvement were developed and prioritised in order to be introduced slowly and with buy in from all staff groups.


  • Weekly Safety huddles were introduced with CD, Acute Lead, Matron and Clinical; Governance Lead to highlight challenges of the weekend, incidents, complaints and discuss any areas for prioritisation for the week;

  • Nursing team brief to emulate medical briefs;

  • Introduction of Management Critically Ill Child study day for paediatric staff, ITU and Emergency Department and to include simulation training; we were also able to undertake this whilst undertaking a project within Africa using clinicians to observe debriefing techniques;

  • Increased multi-disciplinary paediatric simulation training;

  • Moving the location of paediatric High Dependency Unit within the acute children’s ward;

  • Development of a half day study day for senior multi-professionals on HFE;

  • Improved collaboration with Intensive Care Unit and Emergency Department and development of clear escalation plan for critically unwell children.

Conclusion Over a 3 year period, we were able to demonstrate an increase in reporting of incidents; a safer environment for staff to work in; improved communication and escalation of critically unwell children. Further work is being undertaken using similar approaches in other departments within the acute organisation with a hope to disseminate to community partners. This work has also been instrumental in providing the groundwork for joint project with the Quality Improvement Team, and in informing work for the Human Factors and Ergonomics Fellow.

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