Peter W Buckle

Imperial College London | Imperial · Division of Surgery

Introduction Technological advancements have increased the scope and range of home-use medical devices. These have allowed development of care at home. This requires appropriate understanding of patient's needs with regards to such devices for safe use of medical technology at home and minimise usability errors. This study sought to investigate pat...

This study describes an evidence-based Clinical Pathway Mapping (CPM) visualisation method that can be used to enhance healthcare quality in the face of complex systems and constrained resources. The CPM visualisation method we are proposing highlights the connection among the key components of the healthcare work system – individuals, tasks, tools...

This paper presents a human factors qualitative study on an AI application for managing sepsis in Intensive Care Units (ICUs). The study involved semi-structured interviews with nine ICU clinicians and nurses across three London hospitals. It consisted of two parts: the first applied methods to understand sepsis resuscitation processes and establis...

Objectives: This study aimed to develop the actual pathway to reporting and information transfer in operating theatres in relation to medical technology malfunction/failure. This with the aim of understanding the differences with the pathway published by NHS Improvement and identification of points for improvement. Design: This is a qualitative...

The emergence of severe acute respiratory syndrome 2 (SARS-CoV-2) variants of concern (VOCs), with mutations linked to increased transmissibility, vaccine escape and virulence, has necessitated the widespread genomic surveillance of SARS-CoV-2. This has placed a strain on global sequencing capacity, especially in areas lacking the resources for lar...

Background Home care medical devices are the fastest-growing segment of the medical device industry with associated safety and usability challenges. Human factor studies in the home environment present many difficulties resulting in limited knowledge of device use in this setting. This systematic review aims to identify usability challenges reporte...

Introduction The current under-reporting of medical device malfunctions, difficulties with the current system and absence of continuous good-quality data has removed the possibility for constant data interrogation and trend recognition to identify evolving issues. This research used end user experiences aiming to understand causes for the lack of d...

Background In response to the global COVID-19 pandemic, many in vitro diagnostic (IVD) tests for SARS-CoV-2 have been developed. Given the urgent clinical demand, researchers must balance the desire for precise estimates of sensitivity and specificity against the need for rapid implementation. To complement estimates of precision used for sample si...

Background The purpose of this study is to develop a theory-driven understanding of the barriers and facilitators underpinning physicians’ attitudes and capabilities to implementing SARS-CoV-2 point-of-care (POC) testing into primary care practices. Methods We used a secondary qualitative analysis approach to re-analyse data from a qualitative, in...

Background NG (nasogastric) tubes are used worldwide as a means to provide enteral nutrition. Testing the pH of tube aspirates prior to feeding is commonly used to verify tube location before feeding or medication. A pH at or lower than 5.5 was taken as evidence for stomach intubation. However, the existing standard pH strips lack sensitivity, espe...

Introduction Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunof...

Introduction Antigen-based lateral flow devices (LFDs) offer the potential of widespread rapid testing. The scientific literature has primarily focused on mathematical modelling of their use and test performance characteristics. For these tests to be implemented successfully, an understanding of the real-world contextual factors that allow them to...

Introduction Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs). Methods An evaluation of a SARS-CoV-2 LFD based testing protoc...

Artificial Intelligence (AI) systems could improve system efficiency by supporting clinicians in making appropriate referrals. However, they are imperfect by nature and misdiagnoses, if not correctly identified, can have consequences for patient care. In this paper, findings from an online survey are presented to understand the aptitude of GPs (n =...

COVID-19 has devastated care homes. Point of care tests (POCTs), mainly using Lateral Flow Devices (LFDs), have been deployed hurriedly without much consideration of their usability or impact on care workflow. Even after the pandemic POCTs, particularly multiplex tests, may be an important control against spread of SARS-CoV-2 and other respiratory...

Background Improving the design of technology relies in part, on the reporting of performance failures in existing devices. Healthcare has low levels of formal reporting of performance and failure of medical equipment. This paper examines methods of reporting in the car industry and healthcare and aims to understand differences and identify opportu...

Background There is little empirical evidence to inform implementation strategies for introducing SARS-CoV-2 point of care (POC) testing into primary care settings. The purpose of this study is to develop a theory-driven understanding of the behavioural determinants underpinning the implementation of SARS-CoV-2 POC testing in primary care. This wil...

Background: There is little empirical evidence to inform implementation strategies for introducing SARS-CoV-2 point of care (POC) testing into primary care settings. The purpose of this study is to develop a theory-driven understanding of the behavioural determinants underpinning the implementation of SARS-CoV-2 POC testing in primary care. This wi...

Introduction Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of contextual and usability factors that affect test results and minimise biosafety risks. This paper presents findings from a scoping-usability and test performance study of a microfluid...

Introduction: Reliable rapid testing for COVID-19 is needed in care homes to reduce the risk of outbreaks and enable timely care. This study aimed to examine the usability and test performance of a point of care polymerase chain reaction (PCR) test for detection of SARS-COV2 (POCKITTM Central) in care homes. Methods: POCKITTM Central was evaluat...

Objective: There is a lack of evidence addressing several important human factors questions pertaining to the quality of supportive information provided by commercial manufacturers that can affect the adoption and use of lateral flow serology assays in practice. We aimed to: (1) identify and assess the quality of information that commercial manufac...

Introduction Care home residents are at high risk of dying from COVID-19. Regular testing, producing rapid and reliable results is important in this population because infections spread quickly, and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care test...

Introduction: Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs). Methods: An evaluation of a SARS-CoV-2 LFD based testing prot...

Background: The purpose of this study is to develop a theory-driven understanding of the barriers and facilitators underpinning physicians' attitudes and capabilities to implementing SARS-CoV-2 point-of-care (POC) testing into primary care practices. Methods: We used a secondary qualitative analysis approach to re-analyse data from a qualitative, i...

Introduction Reliable rapid testing on COVID-19 is needed in care homes to reduce the risk of outbreaks and enable timely care. Point-of-care testing (POCT) in care homes could provide rapid actionable results. This study aimed to examine the usability and test performance of point of care polymerase chain reaction (PCR) for COVID-19 in care homes....

Introduction Care home residents are at high risk of dying from COVID-19. Regular testing producing rapid and reliable results is important in this population because infections spread quickly and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests...

Background Point-of-care (POC) tests for COVID-19 could relieve pressure on isolation resource, support infection prevention and control, and help commence more timely and appropriate treatment. We aimed to undertake a systematic review and pooled diagnostic test accuracy study of available individual patient data (IPD) to evaluate the diagnostic a...

Background Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successfull...

Background: Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successful...

Background: Recruitment of research participants poses challenges in socioeconomically deprived areas. The Awareness and Beliefs About Cancer (ABACus) phase 3 Randomised Control Trial recruited adult participants from socioeconomically deprived areas using a combined healthcare/community engagement model. We report the strategies used to successful...

Introduction: Health technology assessments (HTA) are tools for policy making and resource allocation. Early HTAs are increasingly used in design and development of new technologies. Conducting early HTAs is challenging, due to a lack of evidence and significant uncertainties in the technology and the market. A multi-disciplinary approach is consid...

https://iii.hm/1119

Objective: To ascertain the reliability of a standardised, short-scale measure of satisfaction in the use of new healthcare technology i.e., the LITE version of the usability metric for user experience (UMUX-LITE). Whilst previous studies have demonstrated the reliability of UMUX-LITE, and its relationship with measures of likelihood to recommend...

Every day people use multiple technologies to perform complex tasks, such as buying products online, informing their decision making, or supporting their work activities. In many cases, as in healthcare, high risk processes are dependent on the technology to deliver the appropriate service - e.g. diagnostics outcomes, deliver treatments to patients...

Patient and public involvement (PPI) in research is defined as 'research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them'. A knowledge transfer event (KTE) was planned to share the experience of organizations who carry out medical technology research. The KTE was attended by organizations with an inter...

Patient and public involvement (PPI) in research is defined as ‘research being carried out “with” or “by” members of the public rather than “to”, “about” or “for” them’. A knowledge transfer event (KTE) was planned to share the experience of organizations who carry out medical technology research. The KTE was attended by organizations with an inter...

The reliability and clinical utility of a medical device are required to demonstrate its impact and to enhance its success in the market. To fully establish these attributes it is necessary to investigate the context of use and the needs of the users. In healthcare, there is a growing use of human factors and health economics methods to generate ev...

Introduction. The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to re...

Aims (1) To model the process of use and usability of pH strips (2) to identify, through simulation studies, the likelihood of misreading pH strips, and to assess professional’s acceptance, trust and perceived usability of pH strips. Methods This study was undertaken in four phases and used a mixed method approach (an audit, a semi-structured inte...

Semi-structured interview—Results of standardised questionnaire. (DOCX)

Online survey—Results of standardised questionnaire. (DOCX)

Questionnaires and evaluation scales. (DOCX)

Preliminary graphic representation of NG-tube and pH strips use. (TIF)

Revised graphic representation of NG-tube and pH strips use. (TIF)

Workshop presentation

Use of in-vitro point of care devices - intended as tests performed out of laboratories and near patient - is increasing in clinical environments. International standards indicate that interaction assessment should not end after the product release, yet human factors methods are frequently not included in clinical and empirical studies of these dev...

Unlabelled: Medication safety and errors are a major concern in care homes. In addition to the identification of incidents, there is a need for a comprehensive system description to avoid the danger of introducing interventions that have unintended consequences and are therefore unsustainable. The aim of this study was to explore the impact and un...

Unlabelled: Accurate comprehension and analysis of complex sociotechnical systems is a daunting task. Empirically examining, or simply envisioning the structure and behaviour of such systems challenges traditional analytic and experimental approaches as well as our everyday cognitive capabilities. Computer-based models and simulations afford poten...

A design research project was conducted in London to investigate the issues experienced by people with vision impairment around street works and to generate and evaluate improvements to the manner in which street works are signed and guarded. A qualitative, ethnographic approach was taken to achieve a multifaceted understanding of street works equi...

In this paper, we will address the important question of how quality improvement science (QIS) and human factors and ergonomics (HFE) can work together to produce safer solutions for healthcare. We suggest that there will be considerable advantages from an integrated approach between the two disciplines and professions which could be achieved in tw...

A recent initiative in the National Health Service (NHS, UK) has led to an increased interest in Human Factors & Ergonomics (HFE). As part of initial discussions there have been questions about the similarities and differences between HFE and Quality Improvement (QI).We believe that there are considerable advantages from a more structured relations...

Manufacturers are well informed about the role of human factors in managing risk and in identifying problems in the use of medical devices. However, there are many myths and conceptual misunderstandings that act as barriers toward a full integration of assessment methods in the product life cycle. The difficulty of balancing costs, the necessary ac...

Unlabelled: The past decade has seen an increase in the application of human factors and ergonomics (HFE) techniques to healthcare delivery in a broad range of contexts (domains, locations and environments). This paper provides a state of science commentary using four examples of HFE in healthcare to review and discuss analytical and implementatio...

The Francis report identified multiple problems relating to the safety culture of Stafford Hospital during 2005-09.1 In a safe culture, system leaders are sensitive to the unintended consequences of policy, and staff at every level share responsibility for safety.2 The aviation industry began to recognise 30 years ago that certain behaviours were...

The Use of Work Place Physiological Measurements to Establish the Minimum Fitness Standards Required for Entry into the United Kingdom Police Service The use of pre-entry fitness tests as a means of screening recruits has been adopted by the United Kingdom Police Service. However, validating the minimum standard for such tests has proved to be chal...

Obesity within today's workforce is increasing. This paper shows, through an overview of the current literature, how and where obesity is impacting on the workplace and how the health of the workforce is being affected. Associations have been found with musculoskeletal health, stress and physiological cost. Implications for ergonomists concerned wi...

Unlabelled: Human factors/ergonomics (HFE) has great potential to contribute to the design of all kinds of systems with people (work systems, product/service systems), but faces challenges in the readiness of its market and in the supply of high-quality applications. HFE has a unique combination of three fundamental characteristics: (1) it takes a...

The placement of nasogastric (NG) tubes is known to be prone to error and may lead to serious issues for patient safety and wellbeing. In some instances these have been catastrophic and resulted in the death of the patient. This study sought to explore the potential risks associated with this procedure through the use of systematic prospective risk...

Systems approaches and their relevance to risk assessment are considered through an examination of a number of recent applications in England. The importance of visual mapping of systems is emphasised. This approach encourages participation from those within the system with less technical knowledge but with important information to add to a risk as...

Obesity within today's workforce is increasingly recognized as a challenge for both public health professionals and ergonomists. The two disciplines share a scientific, evidence-based approach to practice and now have the opportunity to address a common health issue, namely obesity. This paper shows, through an overview of the current literature, h...

Firefighting is known to be demanding, but low retirement age in this field means the capacity of the older worker to fight fires is less understood. In the Royal Fleet Auxiliary (RFA), firefighting is a critical secondary task that all personnel must be capable of. Heart rate (HR), work ability index and subjective work demand were obtained from 4...

The relationship between research and practice in ergonomics and human factors has rarely been addressed in the literature. This presents specific problems for researchers when seeking to relate their work to the research community. Equally, practitioners are often frustrated by the lack of appropriate research to meet their needs. This paper seeks...

Systems mapping workshops have been applied to the problem of medication errors in healthcare. The workshops were designed using experiential group work principles. They involved a range of stakeholders from within the health service as well as those who supply the health sector, including designers who may be able to enhance the safety of products...

In the light of a number of serious incidents in the UK resulting from accidental overdoses of methotrexate, this study investigated how the design of methotrexate packaging can influence patient safety, and aimed to collect evidence to provide a basis for the development of new concepts for revised designs by the pharmaceutical industry. The resea...

Care home residents are at particular risk from medication errors, and our objective was to determine the prevalence and potential harm of prescribing, monitoring, dispensing and administration errors in UK care homes, and to identify their causes. A prospective study of a random sample of residents within a purposive sample of homes in three areas...

The disciplines of public health and ergonomics share scientific concepts and often address similar health issues. However, the potential for a significantly greater engagement with public health priorities now exists. Problems to be tackled include the ageing population (and workforce), obesity and patient safety. Priorities may be set using publi...

Although methods for investigating safety in complex systems have been widely applied, few studies have made explicit comparisons of two or more methods used to study one system problem. This paper presents a comparison of two methods that were used to analyse medication errors identified in UK care homes namely, The London Protocol and Work Domain...