This thesis describes original research that examines the extent to which organisational culture, and psychosocial aspects specifically, relate to individuals??? ???normal??? performance within Australian Defence Force (ADF) aviation. The primary rationale for the research relates to the ???safety record??? of ADF aviation, whereby more than fifty ???peace time??? fatalities have occurred in ADF aviation accidents since 1990 and many of these have links to organisational culture attributes. The secondary rationale relates to a more general perspective: previous research identifies human functioning in military aviation ??? more than any other aviation domain ??? as being dependent upon psychosocial attributes including interpersonal collaboration, communication and coordination. However, the depth to which such qualities impact the safety of a sociotechnical system remains substantially uncharted. This thesis firstly examines both scientific and Australian military literature on organisational behaviour, culture and human factors. Subsequently, it describes the design and implementation of a new 45-item questionnaire ??? the Australian Defence Force Aviation Questionnaire (ADFAQ). More than four hundred ADF aircrew and engineers completed the ADFAQ. The data analysis involved quantitative and qualitative consideration of survey responses and comparisons between numerous demographic criteria. Following this, the thesis describes the design and implementation of an interview study that was designed to both cross-examine key ADFAQ results and explore more deeply other issues that were only superficially identified by the (largely psychometric) composition of the ADFAQ. The research results offer three main contributions to scientific knowledge. These relate to: (1) the efficacy of triangulated and contextualised methodology in building an understanding of organisational culture; (2) the nature of the safety culture concept and its relationship with organisational culture; and (3) rank-based homogeneity of attitudes. This research shows that survey methodologies are not a panacea, but they can illuminate the nature of attitudes to safety and provide empirical guidance for other methods to explore more deeply the cultural roots of such attitudes and associated behaviours.

The aim of the present research was to examine the impact of mental workload on conflict resolution decision making in air traffic control (ATC). While previous studies have examined the effect of workload on performance (Averty, 2004; Kopardekar & Magyrits, 2002) and conflict detection (Mogford, 1997; Seamster, Redding, Cannon, Ryder & Purcell, 1993), limited research examines the effect of workload on conflict resolution decisions. The aim of the first study was to gain an initial understanding of how controllers manage their airspace. Results demonstrated that controllers scan repetitively, in a clockwise and top-bottom pattern; group aircraft with similar characteristics and use at least five lateral and eight vertical conflict resolution heuristics. Study two examined the effect of conflict type on conflict resolution under different levels of workload. Under moderate workload controllers used a mix of solutions, while under high workload, solutions became more conservative. Study three examined the effect of other contextual factors on conflict resolution. Results again suggested conflict type affects conflict resolution decisions and also that other contextual parameters, such as aircraft performance may play a role in solution preferences. Study four examined the effect of workload on conflict resolution using a realistic ATC task. Workload not only impacted on controllers’ performance scores, but interacted with conflict type to determine whether an efficient solution was preferred over a less efficient solution. This research identifies some of the heuristics experts use when competing priorities are present and provides an understanding of how conflict type, contextual factors and workload affect decisions. Findings contribute to the naturalistic decision making (NDM) literature by demonstrating how the situation can influence decision making.

<p>Being able to keep your balance is something most of us take for granted. People with inner ear problems due to an accident or surgery or other dizziness have to live with this problem on a chronic basis. A balance prosthesis, worn around the torso, giving feedback about their upright position via tactile vibrators has been shown to help these people keep their balance.</p><p>The goal and purpose for this thesis has been to conduct research on how to improve the existing balance prosthesis and adapt it to fit the user. The research has been conducted with the focus on human factors, meaning with the users’ experience as the premier aspect.</p><p>To be able to reach a good solution with a prototype that would be an improvement compared to the existing device, a vest, several stages have been passed. At first twelve criteria were set up to establish human factors and hedonomic requirements. To fulfill these requirements, surveys with users were conducted. An extensive phase of prototyping and material research informed the design of a final concept.</p><p>The final concept was a prototype balance belt that contains six vibrators, called tactors, and models of the other electronic components. The belt has an elastic band as a base and then a black spandex fabric that covers all components. A Velcro band and a buckle are used to open and close the belt. Finally the belt has a beige spandex cover that can be pulled on and off. This cover makes the belt easy to keep clean because the cover can be washed.</p><p>The prototype is made in three different sizes so it can fit most people in the US population.</p><p>In the near future it will be important to make an evaluation of the balance belt with users. It needs to be tested if the vibrators are possible to feel and how it feels to wear the belt for a longer time. An aid to help pulling the cover onto the belt also has to be developed because putting on the cover is a bit difficult right now.</p>

Situationsmedvetenhet (Eng. Situational Awareness), (SA), handlar om att ha koll på läget och vara medveten om vad som händer. Redan då ett komplext system utvecklas får vi en möjlighet att påverka vilken SA en framtida användare av systemet kan komma att få. Det gäller att ta tillvara på detta tillfälle! Ibland uppträder skillnader i SA, beroende på en rad olika orsaker. Denna avhandling handlar om SA och hur man kan använda de skillnaderna vid utveckling av komplexa system. Detta är relevant vid utveckling av en rad olika typer av komplexa system, även om de flesta exempel i denna avhandling kommer från flygdomänen. Avhandlingen innehåller beskrivningar hämtade från litteratur inom området och förslag på utveckling av SA-teori utifrån fokus på just skillnader. Skillnaden mellan vad du behöver vara medveten om och vad du verkligen är medveten om föreslås ge en indikation om individens SA. Vidare föreslås skillnaden mellan vad du är medveten om och vad du tror dig vara medveten om också ge en indikation om individens SA. SA kan skattas för en grupp av människor som arbetar tillsammans, genom variationerna i hur samstämmiga deras uppfattningar är. Termen situationshantering (Eng. Situation Management), (SM), föreslås med en vidare mening än SA, inkluderande SA, men också varje del av perceptionscykeln, hantering av mentala resurser och hantering av situationen genom extern påverkan. SM är en väl lämpad term vid utveckling av komplexa system då fokus här är på situationen och hur den kan hanteras, snarare än fokus på vad en individ eller en grupp uppfattar. Att skatta skillnader i SA och att kunna särskilja olika typer av skillnader är viktiga förutsättningar för att kunna hantera skillnader i SA vid utveckling av komplexa system på ett bra sätt. I avhandlingen gås flera sätt att skatta sådana skillnader igenom och speciellt tas för- och nackdelar med ögonrörelsemätning upp. Med referens till litteraturen och till de bilagda artiklarna beskrivs skillnader i SA beroende på a) designalternativ, b) roller i processen från utveckling till användning c) kontext och d) analysnivå. Skillnaderna i SA föreslås ses som både kvantitativa (dvs. hög eller låg SA) och kvalitativa (tex. olika aspekter av en situation). Ansatser såsom SM, realtidsvärdering, mätning och analys av SA på flera nivåer samtidigt samt simulatorbaserad design föreslås för att hantera skillnader i SA vid utveckling av komplexa system. / What’s up, Doc? Situational awareness (SA) is about being aware of what is going on. Already when a complex system is developed there is an opportunity to help a future user of the system to form a better SA. Let us make the best out of this opportunity! When assessing SA, differences in SA will sometimes appear. This dissertation is about SA, and how to manage differences in SA in development of complex systems. This topic is highly valid for development of a variety of complex systems, although most examples in this dissertation are from the aviation domain. Framed by state of the art literature, suggestions are made on theoretical improvements of SA theory, with a focus on differences. The difference between what you are required to be aware of and what you are aware of is suggested as a SA-indicator. Also, the difference between what you are aware of and what you think you are aware of is suggested as another SA-indicator. Further, differences within a team such as variations in degree of agreement could be used for team SA assessment. Also, the term situation management (SM) is suggested, with a proposed wider meaning than SA, including SA and every part of the perception action cycle, the management of mental resources, and external means of managing the situation. SM is a suitable term when developing complex systems due to the focus on the situation and how that could be managed, instead of only focusing on what is perceived by an individual or team. Assessing differences in SA and to differentiate between various types of differences are recognised as important prerequisites to effectively manage differences in SA in development of complex systems. Several assessment techniques are reviewed and especially advantages and disadvantages of the use of eye movements for SA assessment are described. With reference to the literature as well as to the appended papers differences in SA due to a) design alternatives, b) roles in the design-use process, c) context, and d) level of analysis, are described. Differences in SA are suggested to be regarded as both quantitative (i.e. high or low SA) and qualitative (e.g. various aspects of a situation are regarded). Approaches such as, SM, on-line evaluation of SA, simulator based design, as well as measuring and analysing SA on multiple levels simultaneously, are suggested as means to manage differences in SA in the development of complex systems.

Handling production scheduling is increasingly difficult for manyenterprises, and human involvement is necessary. The overall objective ofthis research was to gain further understanding of planners’ and schedulers’work within the manufacturing industry, to elucidate how their worksituation is formed, and to explain their significance to other employees’work and company activities. Scheduling work was studied in fourcompanies in the Swedish woodworking industry; a sawmill, a parquet floormanufacturer, a furniture manufacturer and a house manufacturer. Themethod used was activity analysis which is based on the analysis of workactivities in real work situations. Data collection included 20 days’observations and 65 interviews. Cross-case analysis with British cases onplanning work was also included.The findings revealed that the schedulers’ tasks lead to many activities. Twothirds of these are what can be expected. The remaining third constitutesactivities that depend on the schedulers’ individual attributes and the contextin which they work. The schedulers serve as problem solvers in a number ofdomains and constitute efficient information nodes, making them animportant service function. Furthermore, they have an alignment rolebetween different organizational groups. This role is specifically remarkablein dealing with production enquiries that must be aligned with productioncapability. Here, both planners and schedulers play an essential role inlinking the manufacturing and the commercial sides and their differentfunctional logics.Planners and schedulers in daily work exert strong influence on others. Theydo not hold legitimate power. Instead their influence emanates mainly fromaccess to and control of information and their ability to apply expertise tointerpret this information and examine the impact of decisions made acrossdifferent areas of the business. Personal power related to social skills is alsosignificant.Furthermore, they facilitate others’ work in continuous personalinteractions, serving the technical scheduling software system, and aligningdifferent organizational functions. In combination with expert knowledgeand developed social skills, they significantly contribute to quality operationsperformance. Finally, the schedulers influence the decision latitude of otheremployees and may indirectly promote job satisfaction, thus contributing todeveloping appropriate working conditions for others in the company. / QC 20100624

Failure to recognize changes in a patient’s clinical condition is a barrier to the effectiveness of CCRT outreach programs. The development of a vital signs capture and decision system could alert care providers and CCRTs when a patient’s clinical condition deteriorates. However, point-of-care vital signs capture and documentation is often problematic in clinical practice. Ethnographic research was conducted to understand the difficulties of replacing pen and paper charts and barriers to electronic nursing documentation systems. Analysis of workflows directed the design of two solutions; 1) Apple iPhone facilitated manual vital signs entry, 2) Motorola MC55 enabled automatic data capturing from physiological monitors. Nurses participated in high-fidelity usability testing, comparing the traditional method of paper documentation with the two electronic solutions. As a result of user-centered design process, both solutions were comparable to the efficiency of paper methods, were found acceptable to nurses, and could be successfully incorporated into current workflows.

Research suggests that interruptions are ubiquitous in healthcare settings and have a negative impact on patient safety. However, there is a lack of solutions to reduce harm arising from interruptions. Therefore, this research aimed to design and test the effectiveness of interventions to mitigate the effects of interruptions during medication administration. A three-phased study was conducted. First, direct observation was conducted to quantify the state of interruptions in an ambulatory unit where nurses routinely administered high-risk medications. Secondly, a user-centred approach was used to design interventions targeting errors arising from these interruptions. Finally, the effectiveness of these interventions was evaluated through a high-fidelity simulation experiment. Results showed that medication administration error rates decreased significantly on 4 of 7 measures with the use of interventions, compared to the control condition. Results of this work will help guide the implementation of interventions in nursing environments to reduce medication errors caused by interruptions.

Designing a software interface for healthcare requires thorough domain knowledge, and effective user research and benchmark analysis. This thesis examines the requirements for an improved patient information management system for emergency medicine and describes the iterative process of designing and evaluating the system. I conducted observational study of Emergency Department (ED) physicians’ workflow and information needs, from which I derived a set of functional requirements, created scenarios, performed hierarchical task analysis, and developed a preliminary user model for the patient information management system. Based on these, I developed an interface prototype and evaluated the design with a sample of ED physicians. I review the user testing and design iterations carried out and report on the design improvements made based on the user feedback.

This thesis investigates the associations between crash outcomes, the existence and type of driver distraction as well as driver’s age. The crash outcomes considered in this thesis consist of the type of crash as well as the injury severity sustained by occupants involved in the crash. An ordered logit model was built to predict the likelihood of severe injuries and a multinomial model was developed to predict the likelihood that a driver will be involved in one of three common crash types: singular, angular, and rearend. In these models, various factors (e.g., weather, driver’s gender, and speeding) have been statistically controlled for, but the main focus was on the interaction of driver’s age and distraction type. The findings of this thesis have implications for policy making and prioritizing capabilities of distraction-related safety systems.

Secondary infusions are a common and convenient method to administer intermittent infusions unattended through a single IV access using infusion pump technology. Previous studies have indicated that clinicians have a high frequency of committing operation errors while administering secondary infusions, which can cause patient harm. The purpose of this study was to evaluate the safety of secondary infusion practice by identifying and analyzing potential failure modes when delivering secondary infusions on five different smart infusion pumps. Healthcare Failure Mode and Effect Analysis (HFMEA) was used to prioritize potential failure modes that are considered high-risk for each pump. Results showed that four of the five pumps were not able to mitigate physical set-up errors. As well, each pump contributed differently to programming errors due to difference in interface design. Recommendations from this study focused on outlining desired infusion pump features and mitigation strategies to help alleviate high-risk secondary infusion failure modes.