Human factors is a science that combines psychology and engineering to understand the interaction between humans and the systems in which they operate. Our team uses human factors methods to address the complexity of human behavior and create a safer, more effective healthcare system.

Guiding Philosophy

Systems perspective

Healthcare workers are trained to deliver the best possible care, but training is not the only factor at play. Their behaviors are also shaped by the broader context of the healthcare system in which they work. Understanding these factors and how they intersect leads to more effective solutions.

User centered

Healthcare workers and other key stakeholders are central to our approach. They are both the focus of our work and active collaborators in study design and implementation. Placing users at the center keeps our priorities on target and ensures that solutions will meet their needs.

Design-based improvement

We believe that the most effective way to change behavior is to re-design the systems that shape it. Improving equipment, processes, and environments creates a safer, more effective healthcare system that enables healthcare workers to perform at their best.

Our Work
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Project Firstline

Strengthening infection prevention and control practices among nurses.

The COVID-19 pandemic has revealed gaps in many areas of healthcare, but one acutely felt has been the systemic shortcomings of infection prevention and control (IPC) training…

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CHAMPIONS

Preventing MDRO transmission in skilled nursing facilities.

Over half (57%)1 of residents in skilled nursing facilities (SNFs) are colonized with multi-drug resistant organisms (MDROs). Contact between residents and healthcare personnel during resident care…

Elastomeric Respirators Project

Reusable Respirators

Assessing reusable elastomeric respirators in healthcare delivery.

Early in the COVID-19 pandemic, the demand for disposable N95 respirators quickly exceeded the supply. Other respiratory protection devices, like reusable elastomeric respirators, can serve as…

Cloth Face Masks Study

Cloth Face Masks

Designing better cloth face masks for source control.

Despite the widespread use of face coverings spurred by the COVID-19 pandemic, there has been limited research to fully evaluate cloth masks for source control. In collaboration with Georgia State…

Our Approach

We seek to improve healthcare by combining innovative science with human factors evaluation and design.

Research

Our team utilizes a unique combination of laboratory and field research methods to study complex healthcare scenarios in a structured setting. With this approach, we can develop a deep understanding of healthcare workers and the systems with which they interact safely and efficiently.

Evaluation

Evaluations can assess medical equipment or processes for usability, efficiency, user satisfaction, and safety. We conduct usability evaluations to help healthcare partners make evidence-based procurement decisions and develop recommendations for best practices.

Design

Findings from research and evaluation are translated into potential solutions. These ideas are tested, revised, and refined in collaboration with users and other key stakeholders. The aim is to quickly identify and correct issues before building out a full solution.

Translation

Embedded within Emory University Hospital, we are uniquely positioned to rapidly implement solutions, be it a demonstration study or formal roll-out. In addition, we are developing training and fellowship programs for healthcare workers to teach them how to use human factors methods to solve everyday clinical problems.

Learn more about the science
that drives our work

Project Firstline

The COVID-19 pandemic has revealed gaps in many areas of healthcare, but one acutely felt has been the systemic shortcomings of infection prevention and control (IPC) training among healthcare workers. In collaboration with the CDC, we are developing the scientific foundation for Project Firstline, a sweeping initiative to transform IPC training for all 6 million+ US healthcare workers. Our Lab is conducting high-fidelity patient care simulations with registered nurses to identify gaps in IPC practices (e.g., failure modes for personal protective equipment and medical devices). Simulations include interactions with lifelike patient manikins and contamination tracking with viral surrogates, harmless bacteriophages that mimic pathogens. Our findings will inform the development of an evidence-based IPC competency assessment and, ultimately, a training program for routine IPC practices.

Methods include:

• High-Fidelity Simulation

• Bacteriophage Contamination Tracking

• Failure Modes and Effects Analysis

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CHAMPIONS

Over half (57%)1 of residents in skilled nursing facilities are colonized with multi-drug resistant organisms (MDROs). Contact between residents and healthcare personnel (HCP) during resident care tasks contributes to MDRO transmission. As part of the Prevention Epicenter of Emory and Collaborating Healthcare Facilities, we are identifying HCP-led interventions that could reduce the transmission of MDROs in skilled nursing facilities. Utilizing a mixed-methods approach, we seek to identify common barriers to performing critical resident care tasks (e.g., bed bathing and toileting) and strategies to manage them. Simulations will be used to assess gaps in infection prevention and control practices and identify targets for intervention.

Methods include:

• High-Fidelity Simulation

• Failure Modes and Effects Analysis

1Mody, L., Foxman, B., Bradley, S., McNamara, S., Lansing, B., Gibson, K., … & Min, L. (2018). Longitudinal assessment of multidrug-resistant organisms in newly admitted nursing facility patients: implications for an evolving population. Clinical Infectious Diseases, 67(6), 837-844.

Elastomeric Respirators

Assessment of elastomeric respirators in healthcare delivery. Early in the COVID-19 pandemic, the demand for disposable N95 respirators quickly exceeded the supply. Other respiratory protection devices, like reusable elastomeric respirators, can serve as an alternative and increase the total supply of respirators available to healthcare personnel during future crises. In collaboration with the National Institute for Occupational Safety and Health, University of Texas-Houston, and Wayne State University, our Lab is studying the feasibility of using elastomeric half-face mask respirators (EHMRs) in healthcare settings. Initial research revealed that training and fit testing healthcare personnel for EHMRs was no more challenging than for N95 respirators.

Buoyed by these results, we are moving forward with additional work to evaluate methods of disinfection and demonstrate the use of EHMRs in routine patient care. Our findings will inform recommendations on how to best deploy elastomeric respirators in everyday healthcare delivery and during future pandemics.

Cloth Face
Masks

Assessment of cloth face coverings as source control under laboratory and simulated field conditions despite the widespread use of face coverings spurred by the COVID-19 pandemic, there has been limited research to fully evaluate cloth masks for source control.

In collaboration with Georgia State University and the Georgia Institute of Technology, our Lab is testing the effectiveness of different mask materials and designs to reduce the spread of pathogens, like SARS-CoV-2. Optimal mask candidates identified in laboratory testing with our cough simulator, “Gene Hackman,” will be evaluated under real-world conditions to assess mask usability, comfort, and fit. Our findings will inform public and private sector strategies for effective mask use during this pandemic and in the future.

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