Taking organizational design seriously
Prof. Pierre Falzone (Chaire d’ergonomie ET neurosciences du travail, Conservatoire national des arts ET métiers, Paris) reflected on how to design an organisation.
After the definition of an organization, one has to think about the goals of organizational interventions. The goal of ergonomist is to propose manageable and interesting difficulties. Work is not only a source to constraint; it may be an opportunity for development.
Work is a constant trade-off between: work as prescribed and work as performed. The workflow is often accompanied by unforeseen events, variability, ineffective prescriptions etc.
Organizations result from the interaction between their members. Agents play an important part. Organizations have two faces: the static, formal face with rules, prescriptions and procedures and a dynamic, living face made of the social dynamics of their members (see also «Organizational work, De Terssac and «Organizing» by Weick).
Interventions that target organizational re-design should be based on principles and should set up dynamics. Falzone described the re-designing of hospital units by a development-centered methodology.
This meant an on site observation of several units, interviews with staff members at all levels and with patients. The results were: work is structured by inpatient practice, inaccurate opinions of patient wishes, discordant representations of outpatient surgery and inefficient teamwork.
The redesign process was set in a participatory way with a steering committee, intervention on 2 units and rules for agent’s participation, regardless of functions.
Changes in Ergonomics und technology
Prof. Thomas Alexander (Chair of IEA Standing Committee on Science, Technology and Practice, Frauenhofer Institute, Germany).
Today you have access to information everywhere and anytime. We do have an increasing need for information. The trends are a change in demographics, globalization, future markets. Everything depends on resources. We live a highly dynamic technical evolution. This leads to a global society of knowledge, a shared global responsibility, new techniques and innovation, trends resulting out of technology that is made available.
This whole development is the base for new products and forms of work; we speak of Industrie 4.0 as well as Human/Robots collaboration.
We have analyzed how many sources men needs for the solution of a task. Men can absorb five and one to two additional tasks. If he walks and puts text into his smartphone the chance that he is overloaded with his abilities and has an accident is very high. One needs cognitive and technological ergonomy.
A similar sample is the maintenance on distance. The technical limit is the bandwidth for a videoconference where also only 5 and ±2 tactical positions can be worked on. The limits in presentation text information are on 8 to 9 points. Men need 12 sec. to recognize the text.
Other aspects that play a role in using modern technology are: body positioning while using a tablet, or a head mounted display usw. There is a high change for information overload and additional stress factors. These lead to known diseases as for example burnout.
Creativity in Practice for Patient Safety
Ms. Elena Beleffi (Center of Patient Safety, Tuscany, Italy) described the clinical risk management and ways on how to improve patient safety.
The goal of patient safety aims to involve the organization that guides planning, delivery and evaluation of health care. Together with patients and family the center of patient safety aims to improve the outcome of care, the experience of care, the work experience for caregivers and the outcome of care for all patients.
On the way to patient safety there are patient and family barriers. The citizen’s academy offers trainings to improve the patient centered care. After three editions 100 patient advocates were trained. A network of expert patients and citizens promotes the safety and duality of care.
The patient engagement also includes an introduction for the point of view of the citizen-patient design of user-centered methods and interventions. The method includes participation to a SEA Audit, and to a multidisciplinary safety walk around and a dedicated reporting system.
To promote patient safety the academy has produced four youtube films on patient safety, medical error, prevention of fall and prevention of infections.
Patients, families, their representatives and health professionals work in active partnership at various levels across the health care system – direct care, organizational design and governance, and policy making – to improve health and health care.
Recent developments in the training of occupational health and safety specialists in Switzerland
Dr. Maggie Graf SECO.
She gave an overview of the new education for health and safety specialists. She reviewed the history of different offers for higher education in Health and Safety over the last years and mentioned the areas of lack in the actual educations offered.