There is a trend in modern organisations to ban the use of TLAs (three-letter abbreviations) in work communications. In human factors terms, this is a Good Thing: abbreviations are divisive – separating and excluding those who don’t happen to be familiar with them; they are inefficient – causing time to be wasted deciphering them; and worst of all, they can be ambiguous.
So, always at the head of the curve, the NHS (sorry, National Health Service) has met this challenge with an innovative solution: five-letter abbreviations.
We have PSIRF and GIRFT, which sound like minor Tolkien characters, but by far the most egregious is SEIPS. No-one can spell it, literally no-one knows what it stands for, and when you find out you are no closer to knowing what it is.
At the Patient Safety Congress in Manchester in mid-September, the CHFG stall was very busy, mostly with people asking us about SEIPS and what on earth they were supposed to do with it.
This is all a shame, because SEIPS is a powerful and underappreciated resource.
SEIPS (Systems Engineering Initiative for Patient Safety) is the tool chosen by NHSE (National Health Service England) to replace RCA (Root Cause Analysis) for investigation processes as part of PSIRF (was this an elf in the Hobbit? No, it’s the Patient Safety Incident Response Framework). We approve of this, because SEIPS is based on sound human factors foundations, and looks at the whole system rather than just one person who made a mistake.
But a quick dip into the history of SEIPS reveals some interesting details. Firstly, the name: this was lifted wholesale from the title of an academic paper, written by ergonomics experts for other ergonomics experts, and nobody thought of rebranding it before it was used on civilians. Second: it was never designed as an investigation tool.
It’s easy to assume that a working knowledge of SEIPS is only required for that small minority of health workers who conduct incident investigations. But originally, it was intended to be a quality improvement tool, and it’s still very useful for that purpose.
An understanding of SEIPS, even in its most basic form, allows useful analysis of clinical environments before an incident has happened. It can help anyone at the coal face to identify how to make their own work processes safer and more efficient, by understanding the elements of the system and how they interact.
And once you get your head round the idea that you are part of a much wider system, it will help if you do get caught in an error. If you understand why it happened, you are less likely to blame yourself, and more likely to report the incident. You are less likely to blame others for their mistakes – ‘Just Culture’ is as much about treating each other fairly as it is about the attitudes of senior management.
This is why Clinical Human Factors Group is working with national bodies to make SEIPS easier for healthcare staff to understand and use. Yes, it has a terrible, clunky name but despite this, it’s a tool for everyone: the more it’s used, the more safe, efficient and just the NHS will be. Give SEIPS a chance.
Peter Hambly – CHFG Trustee
If you are looking for an introduction to SEIPS in healthcare then try one of our workshops https://chfg.org/chfg-events/
