Human Factors and Hernia Repair - What you were not told......

 

I have written about hernia repair and recurrences previously.

A fairly common surgical procedure such as hernia repair involves a number of human factors.

Pause now, think and imagine the human factors involved in a successful routine primary inguinal hernia repair.

 

So I asked AI (ChatGPT)

What are the human factors involved in a successful primary inguinal hernia repair?

Chat GPT answer was:

The human factors behind a successful repair can be summarised as:

Preparation → situational awareness → effective communication → teamwork → appropriate challenge → cognitive flexibility → ergonomic working → fatigue management → reliable checking → reflection and learning.

Claude gave this answer to a similar question:

The dominant human factors challenge is therefore data capture, audit culture, and willingness to have practice scrutinised, rather than technical dexterity alone.

 

If you were a surgeon, or an anaesthetist, or a theatre nurse, or any member of the surgical team, that is exactly what you would have been taught as human factors.

Those would be true for variables that do not have a technology based physical design solution.

One of the important crucial end points of a successful primary inguinal hernia repair is the recurrence rate.

Historically, the recurrence rate was 30% to 40%.

Currently the recurrence rate is 1% (in some research publications) and up to 10% in practice.

Were the surgeons of the past technically incompetent? Has the groin anatomy changed? Were the surgical teams of the past not paying attention to the human factors listed above by Chat GPT?

I don’t think you would say yes to any of those questions.

What made the difference was the introduction of a physical technology based design in the repair of an inguinal hernia – a MESH.

That reduced the recurrence rate.

Every behaviour based  point mentioned above and repeated here, namely Preparation → situational awareness → effective communication → teamwork → appropriate challenge → cognitive flexibility → ergonomic working → fatigue management → reliable checking → reflection and learning; are important as an additional layer on top of the physical design but unlikely to make a significant impact on their own.

 

Healthcare Human Factors is so distorted that we do not readily consider physical technological design as a component, never mind the main component of human factors.

 

I address this issue extensively in my book : “Look for the design – Clinical Human Factors – Humans execute and ‘machines’ guard.” https://www.amazon.co.uk/dp/B0HC4M1ZBT

The above example is not in the book but is a bonus for the readers of my blog.

Give the book a read and let me know what you think.

 

 

https://www.amazon.co.uk/dp/B0HC4M1ZBT