Using Human Factors Engineering to Enhance New Trauma Bay Effectiveness

Spatial design can contribute to patient harm and healthcare inefficiencies if the design process does not consider how workers interact with each other and their environments. Human factors engineering (HFE) applies human-centered design assessment to the built environment to evaluate implications for patients and staff. HFE assessment was applied to a proposed trauma-bay design prior to construction. We hypothesized that HFE evaluation would produce significant changes to a new trauma-bay layout that would improve provider safety and decrease errors and costs.

A cardboard mock-up of the proposed trauma bay was created. Mock scenarios were performed with two interdisciplinary teams. An iterative process whereby the architectural plans were adapted by the trauma medical director and then each subsequent team was used with changes made in real time. We utilized a mixed-methods analysis including pre/post surveys as well as video analyses, including link analysis, bump analysis, and crossover analysis. Our results were integrated into layout design change recommendations provided to the architects.

Mock-up cost was $2986 and required 10 h of labor. Two teams completed six scenarios. Staff simulation time was 70 h, while analysis took 36 h. Survey data indicated improvements in "ability to do your job" from 3.85 to 4.25 (unchanged median 4.0). Link analysis demonstrated areas in certain layouts that created work inefficiencies. Bump analysis demonstrated a decrease in bumps from 47 to 33. Crossover analysis showed a decrease in patient crossovers from 7 to 0. Estimated cost savings were estimated at $333,200.

The opportunity for HFE assessment integration into the construction of new healthcare facilities is rare. We present a structured and iterative approach to testing new physical design changes prior to construction. We identified improvements in staff satisfaction, staff safety, and estimated cost.