16 Implementation × Human Factors

Question 1

What is the core overlap between implementation science and human factors?

Answer 1

Both explain behaviour as a product of system design. Context shapes action and constraints matter. If behaviour looks irrational, the system is not yet understood.

Question 2

How does human factors redefine non-compliance?

Answer 2

As rational adaptation to constraints. Deviation reflects local rationality and trade-offs under pressure, not defiance.

Question 3

Why do good ideas fail in real work settings?

Answer 3

Because work-as-imagined differs from work-as-done. Simplified assumptions and hidden variability undermine implementation.

Question 4

What does work-as-done mean?

Answer 4

How tasks are actually performed under real conditions, including interruptions and resource constraints. Work-as-done is the design target.

Question 5

Why is work-as-imagined dangerous in implementation?

Answer 5

Because it hides complexity and cognitive load by assuming linear processes and ideal conditions. Many plans describe work-as-imagined only.

Question 6

What is local rationality?

Answer 6

The principle that people act reasonably given their goals, knowledge, and constraints. Understanding decisions requires understanding context.

Question 7

How does cognitive load affect implementation?

Answer 7

High cognitive load reduces reliability and adherence due to memory limits and attention competition. Design should reduce thinking at the point of action.

Question 8

Why are checklists not a universal solution?

Answer 8

Because they can add cognitive load and disrupt workflow. Overuse creates fatigue and poor timing reduces value.

Question 9

What is a sharp end perspective?

Answer 9

The viewpoint of people doing the work in real time, under time pressure and risk exposure. Implementation must be designed from the sharp end.

Question 10

Why does the blunt end matter for implementation?

Answer 10

Because upstream policies and decisions shape sharp-end constraints, including staffing, scheduling, and incentives.

Question 11

How does human factors change the meaning of training?

Answer 11

Training should support systems, not compensate for them. If training is essential, the design is fragile.

Question 12

What is a forcing function?

Answer 12

A design feature that prevents incorrect action. Forcing functions are hard to bypass and deliver high reliability.

Question 13

Why are reminders weak human factors strategies?

Answer 13

Because they rely on memory and attention, leading to alert fatigue and easy dismissal. Reminders signal missed design opportunities.

Question 14

What does human factors mean by error?

Answer 14

Error is a symptom of system conditions, not personal failure. Errors are predictable and contextual.

Question 15

Why do workarounds matter in implementation?

Answer 15

Because they reveal how systems really function. Workarounds indicate hidden labour and design mismatch.

Question 16

What is functional resonance?

Answer 16

The concept that small variations can combine to produce large effects through non-linear interactions. Failures rarely have single causes.

Question 17

Why is standardisation risky without human factors insight?

Answer 17

Because it may eliminate necessary flexibility. Rigid standards push variability underground.

Question 18

How does human factors inform adaptation decisions?

Answer 18

By identifying cognitive, physical, and organisational constraints that drive behaviour. Adapt where pressure is highest.

Question 19

Why do human factors and CFIR complement each other?

Answer 19

CFIR maps where determinants sit, while human factors explains how they operate. Together they deepen diagnosis.

Question 20

What human factors lens improves sustainment?

Answer 20

Designing habits rather than heroics. Defaults and routines enable low-effort reliability.

Question 21

Why is fatigue a critical implementation determinant?

Answer 21

Because fatigued systems degrade silently, with slower detection and more shortcuts. Fatigue undermines good design.

Question 22

What does human factors say about safety culture in implementation?

Answer 22

Culture emerges from systems, signals, and consequences, not slogans. Design choices shape culture.

Question 23

Why is blame incompatible with human factors-informed implementation?

Answer 23

Because blame suppresses reporting and learning. Fear distorts behaviour and silence increases risk.

Question 24

How does human factors change evaluation questions?

Answer 24

From Did they comply to What made this hard? The focus shifts to mechanisms and design.

Question 25

Why does human factors emphasise observation?

Answer 25

Because real work differs from reported work. Observation reveals tacit knowledge and invisible adaptations.

Question 26

What human factors mistake do implementation teams make?

Answer 26

Using human factors language without changing design. Insight without action becomes symbolic.

Question 27

How does human factors improve engagement?

Answer 27

By validating frontline experience, building shared understanding and psychological safety.

Question 28

Why is human factors essential in digital implementation?

Answer 28

Because digital systems tightly couple cognition and action. HF prevents technology-induced harm.

Question 29

What is the biggest human factors contribution to implementation?

Answer 29

Shifting the question from Who failed to What made failure likely, enabling system redesign.

Question 30

In one line, how do human factors and implementation science work together?

Answer 30

They explain behaviour as system-shaped and show how to redesign systems to make good practice easy.