We investigated the effects of a shift schedule evaluation tool with ergonomics recommendations on employee wellbeing. The study sample was from the Finnish Public Sector study (n=7002 employees). The shift planners' use of the shift schedule evaluation tool was linked to employees' self-reported wellbeing outcomes. Inverse probability weights, reflecting the likelihood of the evaluation tool's use by the shift planner, were calculated using multilevel mixed-effects logistic regression for each participant and logistic regression for each ward. Wards using the tool (intervention group) were compared to those not using it (control group) with a generalized linear model. No association was found between the tool's use and wellbeing at the ward level. In the individual level, lower psychological distress was found in the intervention group (Risk ratio 0.92, 95% Confidence interval 0.85-0.99). More rigorous use of the tool may be necessary to achieve significant benefits for wellbeing.

Implementing change in complex healthcare systems is inherently difficult, with most change initiatives failing. Human Factors/Ergonomics can support change processes through better understanding of the current system and designing and implementing new improved ways of working. One in four patients have a documented antibiotic allergy. Inaccurate and unverified antibiotic allergy labels have a negative impact on patient outcomes. The authors have been involved in the successful introduction of a new approach to allergy de-labelling in the intensive care unit. The primary objective of this study was to outline how this change was supported by applying Human Factors/Ergonomics to the change process. The Cube socio-technical systems analysis was used to understand and support this complex change across four domains of culture, system functioning, action and sensemaking and across a change cycle of understanding the current 'as is' problem; co-designing the 'to be' solution; planning and preparing to change; implementing and embedding the change. Over the course of the study 85 patients with either a reported non-immune or low risk antibiotic allergy were successfully de-labelled. This study exemplifies Human Factors/Ergonomics in action and has shown that taking a structured approach to change, that aims to understand and alter different system components, can achieve results.