SEIPS WORK SYSTEM FACTORS PARTICIPANT INOCULATION
People
Barrier: Some newer members of team unfamiliar with certain aspects of task. Facilitator: Supportive working environment, friendly and respectful team
Environment
Physical environment: Barrier: Difficult for staff in participant’s room to negotiate bed and table; find comfortable positions to undertake task; see wall clock and perform the checks. Barrier: Difficult for member of staff in anteroom to see and hear what was happening during inoculation. Barrier: Anteroom too small to support donning and doffing PPE without risk of contamination. Facilitator: Large, well-lit spaces which could be adapted Socio-organisational environment: Barrier: Regular meeting in the laboratory underway at time of inoculation Barrier: Miscommunication between clinical team and laboratory upstairs led to delay in virus arrival. Barrier: Communication unclear with staff not involved in inoculation (e.g. cleaning staff were difficult to find and inform at the time of inoculation which led to delay). Facilitator: Structured team briefings already in use – could be adapted External environment: Barrier: Conflicting and rapidly changing advice during course of pandemic from national bodies on levels of personal protective equipment (PPE).
Task
Barrier: Task required several steps to be taken in order – process not supported by checklist. Barrier: Team members reported being unclear on precise time virus was in OxCRF. Barrier: Use of PPE not standardised across team members with lack of clarity over exactly what to wear in different areas e.g. corridors. Observed different ways of donning and doffing PPE. Facilitator: Adaptability of team members
Tools / Technology
Barrier: Lengthy study protocol used as a form of checking tool in participant’s room. Protocol cumbersome and time-consuming with more than 50 steps. Paper based records used - difficult to sort through and keep clean. Facilitator: Study team already designing simplified checklist Barrier: “Do not enter” sign placed on door to anteroom too early, therefore, ignored before the virus arrived. Barrier: No other visible indication that virus was in OxCRF. Barrier: No technology for 2-way communication between participant’s room and areas outside. Facilitator: Easy, non-intrusive solution found in collaboration with OxCRF and the COV-CHIM study team to provide better in-room audio-visual facilities during study