Ergonomics and Nudging for Health, Safety and Happiness

The most successful human societies are those that have found better ways to promote cooperative behaviour. Yet, cooperation is individually costly and, therefore, it often breaks down, leading to enormous social costs. In this article, I review the literature on the mechanisms and interventions that are known to promote cooperative behaviour in social dilemmas. In iterated or non-anonymous interactions, I focus on the five rules of cooperation, as well as on structural changes, involving the cost or the benefit of cooperation, or the size of the interacting group. In one-shot and anonymous interactions, I focus on the role of internalised social heuristics as well as moral preferences for doing the right thing. For each account, I summarize the available experimental evidence. I hope that this review can be helpful for social scientists working on cooperation and for leaders and policy makers who aim at promoting social cooperation or teamwork.

Technological evolution has made available tools capable of connecting the patient to treating doctors and health facilities for ordinary activities and carrying out medical investigations directly at the patient’s home, thanks to increasingly sophisticated devices.

The restrictions on the movement of people due to the COVID-19 pandemic have encouraged the use of tools already available to doctors and patients but have also accelerated the development of ongoing projects. The Italian Society of Ergonomics and Human Factors SIE has created a multidisciplinary working group that has tried to imagine the shape of home care in the next twenty years. The study is based on integrating the “Human-Centered Design” and “Strategic Foresight” processes. According to their skills, the eight researchers have tried to identify the trends that will most influence the future, designing the possible scenarios in which home care will take place.

The pertussis vaccination in pregnancy represents the main preventive strategy against this disease in the first trimester of life. The purpose of the study is to develop an e-health tool for assessing vaccination attitudes and to evaluate three types of communication for pregnant women, providing efficient information for their vaccination choice. One-hundred-and-five participants were assessed using a psychometric questionnaire implemented on a tablet and subsequently, they were exposed to different communication formats based on the Elaboration Likelihood Model (ELM). The participants in each group receive the same information contents on vaccination and pertussis in a different format (two provided by digital devices and one by leaflet). The difference between the post-intervention scores on vaccination intention showed that a video containing an expert-patient conversation was equivalent to the information provided by a collaborator delivering the leaflet and these two formats were significantly more efficient compared to the information provided through interactive infographics. These results demonstrate the importance of interpersonal exchange as a key factor also in the e-health tool to provide persuasive health information.

Prevention of healthcare related infections requires appropriate hand hygiene before and after procedures. Hand hygiene is one of the main Patient Safety Practices. Compliance and upholding have to be supported by a correct behavioral, organizational and structural approach. A Team expert in Human Factors and Ergonomics (ERGOMeyer) has developed an implementation and support service that collects the contributions of cognitive psychology and the theory of nudging, through point of care and thoughtful communication. An increase in adherence to hand hygiene up to 92.2% in 2021, an increased use of alcoholic gel, both certainly also related to the precautions implemented to cope with the SAR-CoV-2 pandemic, and infection rates close to the standard values were observed. It also ensured an appropriate management of critical issues due to the pandemic. By planning a good architecture of choices, it is possible to act on the behavior of operators and users, encouraging the correct actions and increasing patient safety.

Increased complexity in healthcare environments, together with scientific and technological advances, require advanced research and resource support, and need an approach based on human factors and ergonomics. Meyer Children’s Hospital has instituted a Strategic Operational Unit called “ERGOMeyer”, to support Risk Management for the safety and wellbeing of healthcare workers and patients, to improve the performance of the organization and to achieve international standards of safety and quality of care. The ERGOMeyer Team operates in the areas of Human Factors and Ergonomics, Clinical Risk Management, Simulation in paediatrics, Health, Safety and Environment. In the four years of activity, important projects have been carried out regarding prevention of infections, patient identification, safety in surgery, and the re-organization of healthcare environments.

The newborn hospitalized in a health facility, to receive the best care, must also be able to count on a global comfort of the rooms. As it is now the case in the workplace, the assessment of the causes of discomfort must simultaneously consider the various aspects. The control of noise, brightness and microclimatic and air quality parameters all contribute to the achievement of the well-being of the subject as well as health treatments. The environment contributes to strengthening the body’s response to treatments and improves the endurance of pain. This condition is even more evident in premature subjects or subjects affected by pathologies in the first months of life. The health care worker must therefore take care of the environmental aspects or be assisted by the technical services of the health facility to achieve the best patient comfort. The quality of the environment will also affect the psychophysical state of health workers who are called to guarantee high standards of care and to whom it is necessary to guarantee safety conditions in the workplace.

The managers of the UOC of Neonatology and Neonatal Intensive Care. S. Giuseppe Moscati Hospital Avellino have decided to improve the care and work environment to avoid the negative effects on the health of newborns, and to improve the psychophysical conditions of workers, preventing them from suffering injuries or making mistakes during assistance.

The Health Department of the Tuscany Region, under the resolution of the regional council, n. 862 of 30th July 2018, approved a MoU between the Tuscany Region and regional Superintendence of Penitentiary Administration, aimed to carry out, with the scientific coordination of the regional Centre for Clinical Risk Management, a series of visits to most of the prisons of the region, with the purpose of evaluating the quality and safety of health assistance provided to people in prison. The method followed was that of Patient Safety Walkarounds adapted to the context. Each visit was conducted by a multidisciplinary team of experts from the field of patient safety and risk management, penitentiary medicine, mental health, primary care and representative of the penitentiary administration. Information were collected in a template that allowed a categorization according to the following factors: technology and work environment; organisational & management, team, communication and training. For the categorization of the information was used the London Protocol by Taylor-Adams S, and Vincent. Preliminary results related to 12/18 prisons showed that main risk factors for safety and quality of care were related to the organization and management followed by team factors and communication.

Safety Walkrounds are a clinical risk management tool originally designed to help healthcare leaders learn “on the job” about safety issues and implement effective solutions. The authors present the results of a project carried out, during the years 2017–2021, in a Local Healthcare Trust to learn about the perception of operators with regard to safety, promote the adoption of patient safety practices (PSPs) and recommendations of the Italian Ministry of health (HMRs), share the results of self-assessments carried out by facilities and a plan for improvement/consolidation of PSPs/HMRs for which critical issues had emerged. Barriers to PSPs/HMRs implementation were then classified according to Vincent’s contributory factor categories, in order to identify priority areas for intervention using a systems approach, which is particularly useful for planning interventions at the strategic level.

In the past decades, research in cognitive science has increasingly improved our understanding of human cognition and decision-making processes. On the one hand, the “heuristics and biases” research program highlighted how human reasoners often fail to conform to normative standards of rationality, falling prey to systematic and predictable “cognitive illusions”. On the other hand, further research explored how to design communication strategies and reasoning tools that are more ergonomic - that is, that make easier and more transparent the processing and evaluation of complex information. Here, we report on a preliminary analysis (including a pilot study) of understanding and communication of statistical information concerning COVID-19-related risks among the public. Our tentative conclusions are as follows: first, in line with previous literature, transparent communication using a “natural frequency” format (instead of percentages or probabilities) does improve understanding; second, many important institutions do not employ cognitively ergonomic communication strategies, leaving much room for further improvement.

This paper aims at discussing the opportunities offered by the perspectives of natural and reality-based interaction design in robot-assisted microsurgery. Specifically, it presents the “Natural Surgeon Interfaces” (NSIs) designed during μRALP (European project on Micro-Technologies and Systems for Robot-Assisted Endoscopic Laser Microsurgery). The goal was to make the experience of controlling a laser similar to handling a scalpel. In terms of cognitive ergonomics and neuroergonomics, the NSI systems in μRALP were based on the enactive coupling of perception and action that occurs when humans handle a tool. Accordingly, μRALP proposed a Virtual Scalpel and a Haptic Scalpel, which became part of a Neurotraining Scalpel setup too. Such exemplary cases of visuo-haptic paradigms of μRALP can truly make a physician a “natural surgeon”.

Industry 4.0 passes through the concept of smart factories, bringing into the industrial context a new vision of production lines and workflows, which can now be designed considering ergonomics and thus the interaction among operators, machines, and tools, in accordance with human-centered design principles. Virtual simulations help in reproducing such interactions and in foreseeing solutions to improve the working conditions before installing tools and equipment. In addition, motion capture techniques have proven capable to guarantee the reproduction of human motion with sufficient accuracy. The present work aims at the development of an integrated tool for ergonomics risk assessment index calculation, using motion capture in 3D environments. With this purpose, starting from motion capture acquisitions, an engine for postural angle calculation, in accordance with international standards, and a Unity-based application have been specifically designed and validated. The work is part of the IM.PR.ES.S.E.D. (IMmersive PRocESs ergonomicS by wEarable Devices) project.

Technostress, or the inability to deal with information technology (IT) healthily, may have a detrimental impact on employees’ quality of life. The present study had the objective to develop training to facilitate the management of work-related technostress. A sample of 236 voluntary bank employees underwent an initial survey and a training protocol to mitigate and relieve technostress effects. Finally, they filled in the survey again. Within-group analyses were performed comparing pre- against post-training scores.

Furthermore, between-group analyses compared the post-training results of the experimental group to those of a control group that answered the initial survey, but did not perform the training. Results showed that in the experimental group, the post-training levels of technostress were reduced with respect to pre-training scores and were lower than in the control group. Our data showed that a multifaceted approach could stimulate the development of effective screening procedures and intervention strategies to enhance a healthy interaction between individuals and IT.

This work discusses the methodological approach and technical results of a research study aimed at building a model of the cognitive and socio-cultural factors that influence the human performance of Air Traffic Controllers. The proposed model was integrated into an agent-based simulation tool supporting the impact assessment on the performance of alternative operational scenarios in Air Traffic Management. On the base of the specific case study of direct and free routing in southern Europe airspaces, a preliminary scenario analysis and a task-analysis were conducted to describe the environment, procedures and technical systems. After that, a set of Human variables relevant for the tasks accomplishment and Human Behaviour specification were derived. The resulting Human Behaviour model feeding the Agent-Based Simulator combines three types of variables – Personal, Cognitive and Socio-cultural ones – and proposes rules for Human Performances variability to represent a human adjustment to external and contextual conditions such as traffic complexity and pilots’ behaviour in current or future operating scenarios.

Nowadays Remotely Piloted Aircraft Systems (RPASs) represent the new frontier of air vehicle for both transportation of people and goods. The Air Traffic Management (ATM) is a complex socio-technical system relying on cooperation and coordination among human actors and distributed architectures, where all pieces shall fit together to ensure safety performances and smoothness of traffic flows. The introduction of RPASs in controlled airspaces increases the complexity of ATM system and needs to be properly evaluated from a safety and Human Factors (HF) point of view. This article discusses the approach and presents the results of Safety and HF evaluations on the RPASs integration conducted within the INVIRCAT European research project. Several safety and HF validation objectives were identified within the project and assessed through Real Time Simulation (RTS) campaigns executed in Germany, Netherland and Italy addressing different Use Cases, this article presents the INVIRCAT experimental activities conducted in Italy focusing on nominal, contingency and Automatic Take-off and Landing (ATOL) procedures.

The present work focuses on gamification applied to public service innovation, with a specific focus on the commoning paradigm as an alternative form of collaboration among citizens and public administrations.

In the proposed innovation scenario, gamification – the use of game elements for non-game contexts – is proposed and investigated as a strategy to promote the citizens’ active engagement in the co-management and co-creation of novel public services. The paper outlines the core elements of the strategy, co-designed with the stakeholders. Moreover, the implementation of the “Gamification Engine” is presented as a building block enabling an open-ended gamification strategy to be applied to innovative public services.

The synergies and the relevant interdisciplinary existing between Sustainability and Ergonomics (HFE) are paramount to document the cultural evolution of design interventions that can be made when creating innovative artefacts, such as products, services, and product-service systems, since both disciplines aim at investigating the interactions between humans and living ecosystems. However, studies linking Sustainability and HFE mainly tackle the problems at the macro-scales, though several interplays between human behaviours, creative practices, and contexts of use can be identified at the micro-scales within the Human Centred Design domain (HCD). Ergonomic interventions performed under the Sustainability domain should employ design-driven strategies, which means that there is the need to further investigate the interdisciplinary contributions under a HCD lens (e.g.: investigations made at the human dimension). A research agenda for future explorations on Sustainable HCD is proposed in this work. The agenda is composed by six main research themes that employ design-driven scenarios to frame the complex set of open research topics pointed out by HFE in relation to Sustainability goals. Results achieved in this study set a body of knowledge through which systematically explore the possible contributions that Sustainable HCD may produce at all design scales, and for which a choral research effort is needed of all HFE community.

Domotics improves quality of life of people with disabilities. Maintaining independence and participation in daily life is the main goal in inclusive projects, starting with rehabilitative interventions. Complex technological systems tailored to conditions and life style of individuals with disabilities can be implemented through open source technology. This case report discusses the design features and results of domotic projects aimed at promoting independence and participation in daily life of people with severe disabilities. Crucial factors for the success of the projects were: customization of the system according to the needs of end users and its adaptation during the progression of the disease; relevance of social connections with respect to the use of technology by the individual; potential interference of unpredictable events that could compromise the user’s technological experience. This field of technological application is full of opportunities but still needs proofs of effectiveness. Individualized projects require a lot of technical attention and human care, even in the subsequent stages of implementation. The numerous criticalities that could undermine the success of systems of this type must be addressed by appropriately considering individual cases, the use of resources and the technological intensity of the projects.

Nowadays society, increasingly oriented towards actions to enhance its urban contexts, tries to promote better lifestyles and increasingly inclusive social practices. The work proposed in this article presents the results of the research project: “Guidelines for the review of the park project aimed at social inclusion, sustainability and usability of the cultural and sporting activities of the Carpugnane area”, funded by the Municipality of Calenzano and conducted by the Ergonomics & Design Laboratory of the University of Florence. The research used the methodological tools of Ergonomics for Design, Human-Centred Design and Inclusive Design and the collected data allowed the design of a people-centred park, suitable for citizens of all ages, which is sustainable and inclusive. The approach, adopted in this work, has provided an effective strategy in allowing the assessment and design of urban environments, ensuring safety, psycho-physical well-being and healthy lifestyles for all, taking into account human diversity and social inclusion factors.

With the ageing of population, healthy, safe and pleasant workspaces can be useful to nudge joyful and active ageing, instead of coercive actions to force people not to retire. Embracing this vision, the Indoor Quality & Ergonomics Lab (Dip. ABC - Politecnico di Milano) is engaged in research and dissemination on friendly workplace design, for all ages, with contributions from Ergonomics and Design for All. Design, knowingly or not, has always influenced user behaviour, playing a key role in improving decisions about Health, Safety, and Happiness. Ergonomics makes this process aware and offers method and tools to optimize interactions between people, organizations and environments. With the aim of spreading culture and tools for all ages friendly workplaces to design and management professionals, as well as to the academic world, a framework is constructed as basis for planning of training interventions, and a pilot course is designed, both reported in this paper.