Ergonomics management model based on good practices of large industrial companies: Structured elements through the fuzzy set theory.

BACKGROUND: Most organizations perceive the concept of ergonomic actions as a local tool used to improve workplace issues. Ergonomics however is not included in global management systems. The paradigm of ergonomics action in large organizations proposed by this study is that of management systems whose primary objective is the pressing need for continuous performance improvement, acquisition of excellence, and integration into all aspects of the business. OBJECTIVE: The general objective of this work is to draw a frame presenting a model of ergonomics management based on good practices in managing this discipline in large industrial companies. METHOD: In this study, we describe a strategy based on the fuzzy set theory to aggregate a group of good practices expressed by experienced ergonomists attached to large industrial companies for handling the lack of ergonomics in an organization. RESULTS: A set of good practices was compiled as a basis for application in ergonomics in large companies. CONCLUSION: This study shows that ergonomics should not be considered an isolated phenomenon but in a strategic, proactive, integrated, and perennial way as one of the management subjects.

Complex systems design based on actual system functioning: Coping with variability in a national water ambulances service.

BACKGROUND: In Brazil, the Mobile Emergency Medical Service (SAMU) is a model of mobile assistance and care for emergencies standardized throughout the country. The water ambulance service within the SAMU operates in riverside and coastal areas, and faces challenges and peculiarities that increase the complexity of providing a high-quality and safe emergency care service. OBJECTIVE: To develop organizational design guidelines aiming to improve resilient performance of complex systems, with an application to riverine and coastal mobile emergency care in Brazil. METHODS: Data collection followed an ethnographic approach. Fieldwork was carried in a participatory way, based on worksite technical description, semi-structured interviews with managers and emergency care teams' professionals, and work observation whenever possible. Five regional SAMU coordinations were visited. Data coding employed content analysis and grouped data excerpts according to concepts of capacity and demand. Interfaces were identified between demand and capacity elements and adaptations led by system agents, orienting the proposal of guidelines for organizational design as solutions to face the verified gaps. RESULTS: Design guidelines produced spanned composition and training of both intervention teams and dispatch central teams, uniforms and personal protective equipment (PPE), decentralized water bases, means of communication, intervention protocols, biosafety and inter-sector actions. CONCLUSION: The approach enabled framing and assessment of specific design elements according to resilience engineering concepts, which in turn showed paths for improving the service and reconciling work-as-imagined and actual system functioning.

Community health workers' non-technical skills for delivering primary healthcare in low-income areas.

BACKGROUND: To overcome the poor conditions of low-income areas in developing countries like Brazil, Community Health Workers (CHWs) are required to exceed the regular set of formal skills they are used to employ. OBJECTIVE: In this study, we aim at identifying the non-technical skills CHWs must develop to cope with the extraordinary situations that occur in vulnerable communities. METHODS: 41 CHWs based in two primary healthcare clinics in Brazil underwent two rounds of in-depth interviews. The analysis was carried out using the Analytical Hierarchy Process, resulting in the prioritization of social skills according to their calculated importance to house calls. RESULTS: Among the ten higher-scored skills, we find communication and advocacy skills being of high importance. Civility was found to be the most important attribute, confirming that community action relies strongly on the relationship between health professionals and the community. CONCLUSION: The results of our study contribute primarily to the improvement of community-based primary care programs as it helps to identify major skills required for community action.

On the brink of disruption: Applying Resilience Engineering to anticipate system performance under crisis.

As COVID-19 spread across Brazil, it quickly reached remote regions including Amazon's ultra-peripheral locations where patient transportation through rivers is added to the list of obstacles to overcome. This article analyses the pandemic's effects in the access of riverine communities to the prehospital emergency healthcare system in the Brazilian Upper Amazon River region. To do so, we present two studies that by using a Resilience Engineering approach aimed to predict the functioning of the Brazilian Mobile Emergency Medical Service (SAMU) for riverside and coastal areas during the COVID-19 pandemic, based on the normal system functioning. Study I, carried out before the pandemic, applied ethnographic methods for data collection and the Functional Resonance Analysis Method - FRAM for data analysis in order to develop a model of the mobile emergency care in the region during typical conditions of operation. Study II then estimated how changes in variability dynamics would alter system functioning during the pandemic, arriving at three trends that could lead the service to collapse. Finally, the accuracy of predictions is discussed after the pandemic first peaked in the region. Findings reveal that relatively small changes in variability dynamics can deliver strong implications to operating care and safety of expeditions aboard water ambulances. Also, important elements that add to the resilient capabilities of the system are extra-organizational, and thus during the pandemic safety became jeopardized as informal support networks grew fragile. Using FRAM for modelling regular operation enabled prospective scenario analysis that accurately predicted disruptions in providing emergency care to riverine population.

Designing for Risk Assessment Systems for Patient Triage in Primary Health Care: A Literature Review.

BACKGROUND: This literature review covers original journal papers published between 2011 and 2015. These papers review the current status of research on the application of human factors and ergonomics in risk assessment systems' design to cope with the complexity, singularity, and danger in patient triage in primary health care. OBJECTIVE: This paper presents a systematic literature review that aims to identify, analyze, and interpret the application of available evidence from human factors and ergonomics to the design of tools, devices, and work processes to support risk assessment in the context of health care. METHODS: Electronic search was performed on 7 bibliographic databases of health sciences, engineering, and computer sciences disciplines. The quality and suitability of primary studies were evaluated, and selected papers were classified according to 4 classes of outcomes. RESULTS: A total of 1845 papers were retrieved by the initial search, culminating in 16 selected for data extraction after the application of inclusion and exclusion criteria and quality and suitability evaluation. CONCLUSIONS: Results point out that the study of the implications of the lack of understanding about real work performance in designing for risk assessment in health care is very specific, little explored, and mostly focused on the development of tools.

Support system for management of shares ergonomic.

This article discusses the development of a computerized support to demands for treatment of a wide spectrum and diverse nature. Developed under SPM platform (Situação, Problema e Melhoria), the practitioner seeks to provide an ergonomic aid from the identification and characterization of the processes of analysis demands. The interest of a technological support the practice of ergonomics is a domestic origin, which already features a wide universe. For purposes of this article will be drawn the line defined by the universe in the Federal Public Service occupations within the guidelines set Subsystem Integrated System for Health Care Workers of the Federal Government. The development of this system initially intended to assist the practitioner in ergonomics mapping situations in which the federal public servant has been undergoing for the second time that can classify and then treat them.

Conceptual design pattern for ergonomic workplaces.

In this paper, we analyzed two laboratories of liquid chromatography (LC), separation technique of mixtures and identification of its components, in order to identify projectual gaps relating to the environment and the working station. The methodology used was the ergonomic analysis with interactional and participatory techniques applied during the activity performance. This work incorporated and adapted the concept developed by Alexander (1979)--pattern languages--passing from architectural projects to workstations project and physical arrangement of the work environment. The adaptation of the concept resulted in a list of recommendations, requirements and concepts that have brought design solutions for the problematic aspects observed in the ergonomic analysis. The employed methodology, strongly supported in ergonomics principles, and in interactional and participatory techniques, contributed to achieve our gold that is what we now call Conceptual Standards. The patterns go beyond of a usual model of book a of ergonomics specification, once incorporating the viewpoint of the end user, it is also a set of best project practices and of project management in conception ergonomics.

The RFad Method--a new fatigue recovery time assessment for industrial activities.

This paper presents a study about fatigue recovery time assessment processes in work activities. It came about due to a demand presented by an automotive industry giant, in need of updating existing cycle time sheets and TAKT time parameters. The company decided to hire an Ergonomics Laboratory with ties to a major Brazilian University in order to evaluate current conditions and establish a new method to either calculate recovery times or validate existing assessment criteria, based in the ergonomics evaluation of the work activities. It is clear that there has been evident evolution in the industrial sector in the past two decades. It brought up fast modernization of industrial processes, not only in production but also in terms of management systems. Due to improved computer and robotics systems, combined with overall operational advancements - like the use of lighter hand tools and more effective hoist systems - most work activities have had its physical effort requirements reduced in the past decades. Thus, compensation factors built into production times need to be reviewed in order to avoid unnecessary costs associated to them. By using ergonomics considerations, we prevent simply removing the physical variables built in rest time calculations without taking on account, for example, additional cognitive load represented by the use of more sophisticated pieces of equipment.

A postura sentada e a motricidade humana no contexto da criança escolar: a mochila não é a única responsável pelos problemas posturais / The sitting posture and the human motricity on the school children context: only school bag is not responsible for posture problems

Este trabalho tem por objetivo principal discutir o paradigma do aprendizado escolar formal ocorrer basicamente na posição sentada, considerando atitude crítica porque a postura sentada é extremamente danosa à saúde da coluna vertebral, induz a comportamentos posturais e gera hábitos danosos que se propagam para a vida adulta. É um estudo descritivo acerca da manutenção da postura sentada em crianças escolares, os resultados demonstram a necessidade de treinar os professores e que a manutenção da postura sentada por longos períodos produz fadiga muscular no aluno. É conclusiva a necessidade de ampliar as aulas de educação física e mudar o paradigma didático da educação.

The main objective of this work is a discussion about the paradigm that the formal school apprenticeship occur on sitting posture, considering critical attitude about this because the sitting posture is too dangerous for the spine and can induce the adoption of bad postures and bad habits retain into the adult life. This is a descriptive study about the long periods sitting posture maintenance on school children, and the results show that teachers should be trained and the maintenance of the same posture for prolonged periods produces muscles fatigue in children. The necessity to enlarge the physical education discipline is conclusive and is necessary to change the didactic education paradigm.