SEIPS WORK SYSTEM FACTORS EXAMPLES OF LATENT RISKS IN GENERAL WORK ACTIVITY IN OxCRF
People
Barrier: Diverse group of healthcare professionals involved in study, some had trained in different healthcare cultures, some did not have English as a first language. Barrier: Some newer members of study team were uncertain about aspects of tasks. Facilitator: Inclusive and supportive teams with a visible focus on collaborative teamwork.
Environment
Physical environment: Barrier: Groundworks underway outside OxCRF causing restricted access to both entrances during observation period. Unclear what measures were in place for access in emergency or if go/no-go criteria described. Barrier: Facilities for research teams not optimal yet e.g. no designated area for overnight rest; lights come on automatically with movement; no handwashing facilities in coffee room. Facilitator: Large, well-lit spaces which could be adapted Barrier: Visibility and communication into participants room hampered by room design. Socio-organisational environment: Barrier: Communication required between different teams (e.g. OxCRF team and study teams); areas on site (e.g. OxCRF and laboratory); areas in different organisations (e.g. OxCRF and hospital scanner). Communication about certain aspects of tasks unclear (e.g. route to be taken to CT scanner) Facilitator: Recognition of the importance of clear communication and observation of regular closed-loop communication between team members Barrier: Use of checklists not routine. Barrier: Training for emergency situations (e.g. anaphylaxis, cardiac dysrhythmia) available (BLS is mandatory for all staff) but not “low dose – high frequency” model. Facilitator: Strong desire within OxCRF and the COV-CHIM study team to improve checklists and training.
Task
Barrier: No explicit go-no-go criteria in trial protocol or OxCRF SOPs to highlight criteria for halting specific task/trial. Barrier: Communication difficult from participant’s room to outside. Facilitator: Options available to modify communication systems in OxCRF
Tools/ Technology
Barrier: Paper record keeping common. Barrier: Signage for procedures which may incur risk (e.g. inoculation) not standardised or clearly visible and in paper form. Barrier: Communication between areas variably supported with modern telecommunication tools. Facilitator: Options available to modify communication systems in OxCRF