HealthcareNursingPatient Safety

The RESPOND Study: Using Human Factors and Ergonomics to Reduce Failure to Rescue Rates

Dr Saydia Wesley

Unified Nursing Research, Midwifery & Women’s Health Journal
Author Name :
Dr Saydia Wesley
Category: Abstract
Keywords: Human Factors and Ergonomics (HFE), Systems Redesign, Failure to Rescue (FTR), Quality Improvement, Patient Safety

Unified Citation Journals, 3(2)15-18;
ISSN 2754-0944


Research on serious complications after major surgery shows that the chances of survival depend on how quickly and how well clinical teams react [1]. The RESPOND Study (Rescue for Emergency Surgery Patients Observed to uNdergo acute Deterioration) combines a Human Factors and Ergonomics (HFE) approach with Quality Improvement to enhance response, escalation, and reduction of Failure to Rescue (FTR) rates post-operatively. Failure to rescue (FTR) has been defined as the occurrence of death after a severe, potentially preventable complication[2] and is recognised as an important hospital quality care metric and an indicator of how effective the resources and processes of a hospital are coordinated to overcome postoperative adverse events[3]. FTR has been associated with hospital factors rather than patient characteristics [4]. The RESPOND team used Functional Resonance Analysis Method (FRAM), which focuses on the conflicts and tradeoffs inherent in the process of response, and how staff adapt to them [5]. As a result, 4 workstreams were created and codesigned: (1) Team Strengthening, (2) Patient Involvement, (3) Human Factors Systems Redesign of Escalation, and (4) Shared Ownership. There was an evident reduction in response to deterioration times once the interventions were implemented (Figure 1) in 3 NHS pilot sites in England. There was an increase in response times resulting from NHS strikes and winter pressures after October 2022. It is envisaged that similar results will be associated with the 24 NHS sites across England from 2023 onwards.


Dr. Wesley completed her PhD in Healthcare Human Factors from Loughborough University in 2020. She has over 13 years frontline Critical Care Environment experience. She was on the Chartered Institute of Ergonomics and Human Factors Covid-19 response. Saydia is a member of the Technical Committee for the International Ergonomics Association, and lectures in a number of Universities in England on Patient Safety and HFE. Saydia currently leads the HFE workstream in RESPOND.


  1. Burke, J. R., Downey, C., & Almoudaris, A. M. (2022). 1. Journal of Patient Safety, 140-155.
  2. Silber, J. H., Williams S. V., Krakauer, H., Schwartz, J. S. (1992). 7. Med Care. 615-629.
  3. Hornor M.A., Bilimoria K.Y., (2017), 3. Surgery. 791- 792.
  4. Ghaferi A, A., Birkmeyer J. D., Dimick J.B., (2019).6. Ann Surg. 1029-1034.
  5. Sujan, M., Bilbro, N., Ross, A., Earl, L., Ibrahim, M., Bond-Smith, G., … & McCulloch, P. (2022). 98. Applied Ergonomics, 1-9.

This study is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research (PGfAR); NIHR200868. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Car.

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