Systems Safety: The Critical Role of Human Factors and Ergonomics

Effective workplace safety relies on tailored solutions incorporating human factors and ergonomics to address industry-specific risks and cultivate a proactive safety culture.

• By Megan E. Gregory
• Jul 18, 2024

A door plug blew off Alaska Airlines Boeing 737 Max 9 mid-flight in January 2024. Now the National Transportation Safety Board says it can happen again.

When it comes to safety in the workplace, there is no such thing as “one size fits all.” Every industry has unique risks and requires tailored solutions, rendering Human Factors and Ergonomics (HF/E) crucial. Among other goals, organizational leaders are charged with protecting their staff and customers - but do not always leverage the advantages of HF/E to ensure safety. A robust safety culture entails understanding risk factors and implementing preventative measures from a human factors perspective.

HF/E is an interdisciplinary field that studies how humans interact with the environment (including physical, cognitive, social and organizational aspects) to influence products, processes and systems. Improved safety, reliability, health, comfort and productivity are primary goals of HF/E. It looks at tasks across all industries from construction to data entry, what tools are used, how they should be handled, body postures while performing job tasks and other physical elements such as lighting, air quality and noise levels. 

In addition, it also considers cognitive aspects such as mental workload, workload distribution and decision-making associated with the task. When it comes to ensuring safety and reliability within an organization, a robust safety culture is at the heart, one in which employees perceive that safety is a core value and feel that leadership regularly and continuously prioritizes safety above and beyond potentially competing goals such as productivity.

And the Federal Aviation Administration (FAA) has found a failing safety culture at Boeing, citing a disconnect between senior management and frontline employees. Their latest major incident comes on the heels of Boeing 737 MAX crashes in 2018 and 2019, reportedly due to poor design of the Maneuvering Characteristics Augmentation System (MCAS), allegedly implemented as a cost savings measure to avoid required retraining of pilots.

However, lack of safety culture is not limited to the aviation industry. Dozens of health systems and hundreds of healthcare workers over the past decade have focused on safety and quality in the healthcare industry, finding that healthcare organizations commonly trade off between safety and clinical productivity (e.g., long work hours, high staff-to-patient ratios). While these factors can have positive benefits in that they increase access to care for patients, they can also result in medical error due to associated factors such as staff fatigue and workload. 

Most of the healthcare workers feel such time pressure that they find it impossible to find the time to accommodate any new work tasks, even those intended to improve patient safety. For example, in a study my colleagues and I conducted seeking to implement a patient safety checklist before anesthesia induction, one anesthesia provider lamented, “It only takes 35 seconds, but it is one more thing on top of existing pressure.”

Unhinged

When errors occur, it's easy to point a finger at the human who made the mistake, but this overlooks the broader systemic factors that contributed. These may include poorly designed systems, a culture that rewards productivity over safety, poor communication and inadequate training. In many industries, a hierarchical structure creates power distance between employees at different levels, leading to hesitancy for lower-level employees to speak up (termed low “psychological safety”).

A classic example that appeared time and time again during my research is how particular physicians who earn a reputation for lambasting nurses, resulted in nurses hesitating or failing to notify them when concerned about a patient for fear of the interpersonal consequences. Reducing this power distance, with senior leaders open to feedback from all employees and modeling that it is acceptable to ask questions and be unsure, leads to safer systems. One example of such a flattened hierarchy was when a hospital janitor revealed that the CEO knows his kids’ names and asks about them every time they pass in the hall.

The Nuts and Bolts

An effective safety culture is also proactive instead of reactive. Identifying potential safety hazards in the environment and taking action to eliminate or minimize them can prevent accidents before they have the opportunity to occur. This could mean developing standard processes to double-check that all bolts are properly installed, keeping walkways clear, keeping workspaces well-lit or requiring the use of appropriate safety gear while working with dangerous machinery or materials. Creating a safe environment begins at the fundamental planning and design phase of the organization, including its business objectives, plans to meet those objectives, workflows, policies, practices, training, equipment needs, architectural designs that work for people, and floorplans that ensure optimal equipment placement and accessibility.

Integrating human factors into the design process is an essential component in minimizing safety risks. It involves considering the physical and cognitive abilities, limitations and skills of the end-users. Designers must also consider the environmental factors that could affect the usage of the product or system, for example, noise, temperature, lighting conditions, duration of use and task sequence. Engaging with end-users and stakeholders to get detailed feedback and insight on their needs and requirements is crucial. Finally, testing and evaluation should be carried out throughout the design process to verify that the product or system is safe for use by the end users. Integrating human factors helps ensure that safety risks are minimized at the earliest stages.

Technology—including augmented reality, spaceships, smartphones, self-driving vehicles and even exoskeletons—is increasingly leveraged to improve safety in a variety of industries. From wearable technology to advanced automation systems, the possibilities are endless. During a research study on prevention of healthcare-associated infections, I learned that some hospitals were using sensors to track whether employees washed their hands when entering patient rooms, increasing employees’ motivation to take the time to engage in this safety practice.

Staying Grounded

When HF/E is embraced and practiced correctly, it can have a positive impact on individuals, organizations, communities and society itself. There can be misconceptions that safety and ergonomics require expensive equipment, tools and furniture. However, even simple low-cost solutions such as posture modifications or changing work areas can have a big effect on safety. From beginning to end, employers must remember the human side of their employees and the impact of safety on their end users and customers so that they build their environment accordingly.