human factors and medicine safety
TRANSCRIPT
Human FactorsOptimising the usability of processes and technology in Pharma R&D
Andrew Alexander ParsonsMSc, PhDwww.reciprocalminds.com
5th Annual Pharmacovigilance Forum
2 March 2017Berlin
A dilemmaAffordability vs Availability?
Medicines Life Cycle – Traditional View
Discovery
Preclinical Phase 1 Phase 2 Phase 3 Phase 4
• Described as a linear process
• High attrition
• High costs in Operation
• Sales drive further innovation • (high cost due to attrition)
• Long cycle times - 10-20 years
• Many Risks and uncertainties
Favourable Scientific
and Regulatory Environme
nt
Cost effective use of
Medicine Societal
Value
Innovative New
DrugsR&D
Adequate cash Flow
Sales
Changing Times and New Directions
• Stem cell therapies
• Gene therapies
• Epi-genetic modulation
• Focus on Orphan Disease• Limited Patient Numbers• Parallel development (e.g. cancer)
• Disaggregation of the industry• Small R&D companies supported by CRO and CMOs • Several Stakeholders in managing supply and operations
A linear model no longer describes the system!
• Andrew A Parsons
• Allison Morgan
• Simon Whiteley
• Crystal Ruff
• Ralph Hibbard
Education and Training
Human Centred Organisations
• Brian Edwards
• Fiona Day
• Julia Mironova
Pharma HuF has several Teams
Systems Mapping Sub Team Pharma Huf
Considerations
• Increasing usability and productivity
• Reducing errors
• Human Centred Organisations
• Safety
Human Factors – what are they?
What are Human Factors?
• Capability depends on combination of interacting elements
• Operation of equipment and systems in circumstances of fatigue, hunger, stress and even fear
• Usability in demanding circumstances will determine success
• Named roles in Human Factor integration in product life cycle
Learning from Ministry of Defence UK
Human Factors
• Is a risk management process – particularly around usability engineering
• Proactively manages all elements of the process• Application description• Requirements specifications• System design• Implementation
The Process & Environment: Where conditions matter…
ChemistryReagent 1 + Reagent 2 Product 1 + Product 2
Innovation
People + Technology Product + Value
Catalyst
Process Conditions
Socio-Techno Process(e.g. Safety, Quality, Usability)
Investment
Buying
Delivering
Doing
“What’s the benefit?”
“How will we provide that benefit?”
“What will we produce?”
3 Levels of Customer Value
System Control Points
Quality
Safe and Effective Medicines
Organisation focus
Product or Medicine focus
ValueCost
Individual focus
Team focus
Safety
Buying
Delivering
Doing
High Level System Control Points
Clinical Safety
Clinical Effective
ness
Management and Process
use-ability
Health and
Safety
Distribution
/ supply of Product
Manufacture
Product Use-
ability
Commercial Value
Payer Value
HCP Value
Product or Medicine focus
Individual focus
Patient Value
Societal Value
Management and Process Effectiveness
Compensation and reward
ProcessExtrinsic Motivatio
n
Intrinsic Motivatio
nAbilities
Autonomy
Political factors
Environmental
factors
Financial factors
Societal factors
Management and Process
use-ability
Health and
Safety
Team focus
Management and Process Effectiveness
Compensation and reward
Process
Political factors
Environmental factors
Financial factors
Societal factors
Perception
Bias / Heuristi
cs
Organisation focus
Safe and Effective Medicines
Illustrative Example: Weighting of decisions in each phase
clinical safetyclinical effectivenesspayer valuemanufacture
product userbaiitycommercial value
patient value
HCP valuesocietal value
Distribution/Product supplyHealth and SafetyMangement and Process usebabilitypolitical factorsfinancial factorsmanagemnt and process effectiveness
compensation and reward processenvironmental factors
societal factors
intrinsic motivation
extrinsic motivationperception
abilitiesautonomybias/heuristics
0
5
preclinical
clinical safetyclinical effectivenesspayer valuemanufacture
product userbaiitycommercial value
patient value
HCP valuesocietal value
Distribution/Product supplyHealth and SafetyMangement and Process usebabilitypolitical factorsfinancial factorsmanagemnt and process effectiveness
compensation and reward processenvironmental factors
societal factors
intrinsic motivation
extrinsic motivationperception
abilitiesautonomybias/heuristics
0
2
4
phase 1
phase 1
clinical safetyclinical effectivenesspayer valuemanufacture
product userbaiitycommercial value
patient value
HCP valuesocietal value
Distribution/Product supplyHealth and SafetyMangement and Process usebabilitypolitical factorsfinancial factorsmanagemnt and process effectiveness
compensation and reward processenvironmental factors
societal factors
intrinsic motivation
extrinsic motivationperception
abilitiesautonomybias/heuristics
0
5
phase 2phase 2
clinical safetyclinical effectivenesspayer valuemanufacture
product userbaiitycommercial value
patient value
HCP valuesocietal value
Distribution/Product supplyHealth and SafetyMangement and Process usebabilitypolitical factorsfinancial factorsmanagemnt and process effectiveness
compensation and reward processenvironmental factors
societal factors
intrinsic motivation
extrinsic motivationperception
abilitiesautonomybias/heuristics
0
5
phase 3phase 3
clinical safetyclinical effectivenesspayer valuemanufacture
product userbaiitycommercial value
patient value
HCP valuesocietal value
Distribution/Product supplyHealth and SafetyMangement and Process usebabilitypolitical factorsfinancial factorsmanagemnt and process effectiveness
compensation and reward processenvironmental factors
societal factors
intrinsic motivation
extrinsic motivationperception
abilitiesautonomybias/heuristics
0
5
phase 4phase 4
Steering CtteParty A Party B
Program TeamDevelopmen
t Project Team
Define and DecideWhere, What, HowWho DecidesTransparency of RisksCommunicateAlignment of Purpose Meaning rather than perceptions
Governance and Commissioning
• Tracking lag measures – reactive and ‘out of control’. • Focus on the process (Lead) measures• Ensure Congruence of lag and lead measures
Performance Measures
Use failure and effects analysis
• Lots of different risk management plans for when stuff does not work
• Focus of human safety analysis is SAFETY
• Process of assessment is
• 1 – task analysis
• 2 – PCA analysis (Perception, cognitive and action)
• 3- use error analysis
• Protocol evaluation
Managing usability risks
• Task analysis - to each user error and how it is linked to PCA
Risk mitigation is
• Design – changes made to the design
• Protection – protective barrier put in place
• Information – changes to the instructions for use (training) – seen as weakest
HF focus: how to ensure the system can adapt to the human error
Being Human Centred
Recognition that organisations have impact on customers and employees, their families and the wider community
It is an approach to integrate a social-technical methodologies and manage the complex risks of business today e.g.
• Wasted effort, poor efficiency, effectiveness and satisfaction
• Errors and system failures, product recalls…
• Absenteeism, presenteeism, poor recruitment and retention
• Litigation, reputational damage
• Etc….
Putting Human Factors First – Principles
• Capitalise on individual differences as an organisational strength
• Make usability and accessibility strategic business objectives
• Adopt a total systems approach
• Ensure health, safety and wellbeing are business priorities
• Value employees and create meaningful work environments
• Be open and trustworthy and act in socially responsible ways
ISO 275000 Human Centred Organisations
Can you help?
• Led by safety and HF Professionals Lee Allford and Shama Didla
• Aim to create “best practice” stories for the industry
• Can you share?
• Would you like to learn more?
Pharma Huf ISO27500 Workstream
• Use design thinking
• Think systems and human factors
• Describe the solution state
• Remember you get what you measure• Lead and Lag measures• What we do• How we do it
Clear strategy, tactics and operations
How to change effectively
In Life
Adaptability is Key
Andrew A Parsons [email protected]+44 7854 029 268
Drag picture to placeholder or click icon to addThank You
Thanks to Colleagues in Pharmaceutical Human Factor SIG