Benefits of Implementing Human Factors Considerations Early in Laparoscopic Technology System Design

When a system engineer designs, there are many things to consider: budget, organization goal, and end-user goal. As Locatelli et al. (2014) name, the iron triangle of system design includes time, budget, and customer specifications. What is missing is often the operator's needs. Because the human factor is seemingly far from impacting more "important" things when compared to organization goals or budget, it is often not considered. However, in cases where the system is used in a highly hazardous environment, the operators' needs often contribute to the end receiver's goal. Additionally, as Vincent et al. (2014) comment, once the system has been deployed, it is not easy to update or modify it. Therefore, it is essential to consider the users early in the design stage for economic, error prevention, and operator psychology reasons. This paper explains the three reasons using the human factor concerns observed in laparoscopic surgery.

The importance of human factors from a cognitive perspective

Before discussing the benefits of implementing human factors considerations early in the design process, human factors considerations' benefits should be discussed. In medicine and other fields, the purpose of implementing human factors consideration is to provide operators with complete information to make informed decisions. As Way et al. (2002) comment, when the brain does not have all the information to decide, it relies on heuristic probabilities to make any judgments. During laparoscopic surgery, when the bile ducts are visually obstructed by connective tissues, instead of confirming with haptic or other anatomical structures, which are also unavailable, physicians take educated guesses (Way et al., 2002). This is because humans make decisions based on a mixture of inputs from perception, including visual, auditory, haptic, and long-term memory. When all forms of perception are blocked, physicians can only rely on prior knowledge. This is where established mental models guide human behavior (Wilpert, 2007). However, as imagined, with even the subtle anatomical structure differences, such acts can contribute to severe errors in both medical fields and any other high-risk settings.

Economic reasons

Designing is an expensive process, involving both time and money. The main idea of a design process is to incorporate human factors early in the development cycle before designing and validation (Locatelli et al., 2014). The earlier implication of optimal design prevents further iterations, testing, and saving time and resources. Additionally, Way et al. (2002) note that although the common understanding is that physicians can control and prevent these errors. After understanding how human cognition and decision-making function, the reality is that the path to these errors is expected, suggesting the lack of efficiency and effectiveness in excessive training. It is best to consider and implement preventative and corrective strategies within the system processes or technology early in the design process (Way et al., 2002).

Safety reasons

Another reason to consider human factors early in the design phase is to reduce any safety concerns and improve the activity's outcome: surgery's success and the patient's well-being. As Locatelli et al. (2014) state, poor performance is mainly due to poor planning and initiation. They suggest planning should start early to increase the performance. For example, according to Way et al. (2002), laparoscopy technology lacks human factors considerations for the physicians to make correct and inclusive judgments. There are known complications. As a result, accidents occurred. When human factors are considered early in the process and implement necessary cues or perceptual aid for physicians, errors could be avoided, hence, not risking patient lives (Way et al., 2002). Therefore, addressing any human factors concerns and implementing early in the design phase can reduce errors' occurrence and consequences (Vincent et al., 2014).

Operator psychological reasons

The last reason concerns the operator's psychology and enhances operators' performance and attitude, which also influences the overall outcome. Derksen (2014) claims, when treating human operators in the system as humans and considering human factors, the system can benefit from more responsible and productive workers, building positivity. From a psychological view, because human factors indicate that the system appreciates the operators' expertise, operators will take more responsibility and measures of self-determination and self-expression (Derksen, 2014). When operators have the necessary and suitable tools to perform their duty, they can focus on their job and feel positively towards the task. For example, when physicians operate, they will feel more in control, more positive, and less frustrated when they can use a tool more smoothly, which also contributes to lessening error occurrences. 

Conclusion

The importance of human factors considerations in a system goes without saying. When implementing these considerations early in the design process, the benefits can be enhanced. In the case of laparoscopy technology, the company will save money and time by avoiding unnecessary iterations and training. The hospital will reduce the chances of risking patient lives or physicians' careers for eliminating accidents early. Lastly, physicians will work more responsibly, which also enables them to make better judgements and work towards reducing errors. When physicians can rely on the technology and system to provide the information they need at that very moment, they can make the best decision for their patients.

References

Derksen, M. (2014). Turning Men into Machines? Scientific Management, Industrial Psychology, and the “Human Factor.” Journal of the History of the Behavioral Sciences, 50(2), 148–165. https://doi.org/10.1002/jhbs.21650

Locatelli, G., Mancini, M., & Romano, E. (2014). Systems Engineering to improve the governance in complex project environments. International Journal of Project Management, 32(8), 1395–1410. https://doi.org/10.1016/j.ijproman.2013.10.007

Vincent, C. J., Li, Y., & Blandford, A. (2014). Integration of human factors and ergonomics during medical device design and development: It’s all about communication. Applied Ergonomics, 45(3), 413–419. https://doi.org/10.1016/j.apergo.2013.05.009

Way, L. W., Stewart, L., Gantert, W., Liu, K., Lee, C. M., Whang, K., & Hunter, J. G. (2002). Causes and Prevention of Laparoscopic Bile Duct Injuries. ANNALS OF SURGERY, 237(4), 460–469. https://doi.org/10.1097/01.SLA.0000060680.92690.E9

Wilpert, B. (2007). Psychology and human factors engineering. Cognition, Technology & Work, 10(1), 15–21. https://doi.org/10.1007/s10111-007-0073-0