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Research indicates that sources of work-related stress (WRS) impact on the physical, social, and psychological health of pilots. Furthermore, specific features of the job can increase a pilot?s risk in relation to developing a mental health (MH) issue. It is impossible to remove all stress from the work life of pilots. A high stress situation may not necessarily be det-rimental to the person, once they have learned to cope with it in a healthy manner. Nonetheless, risk pertaining to WRS need to be effectively managed by a pilot?s employer. Therefore, it is important to identify solutions at an airline and pilot self-management level. This paper reports on the findings of human factors research undertaken with commercial pilots pertaining to work-related stress (WRS) and its impact on wellbeing, performance, and safety. The findings of a series of co-design workshops and a follow-up anonymous survey were analysed to identify potential solutions at (1) an airline and (2) pilot self-management level. Potential solutions are framed in relation to six impact scenarios. Furthermore, they are located within the existing regulatory framework, including the latest implementation rules (IR), acceptable means of compliance (ACM), and guidance material (GM) as outlined by the European Union Aviation Safety Agency (EASA 2019). Proposed interventions should promote wellbeing and positive mental health while also addressing suffering and mental ill health. Airline interventions might focus on enhancing existing Safety Management System (SMS) approaches to better manage risks pertaining to WRS, advancing new tools to enable wellbeing briefing, risk assessment, and reporting, and training pilots in relation to MH awareness, risk identifying behaviour, and coping strategies. Furthermore, new role/functions might be introduced to support the implementation and management of WRS/wellbeing/MH safety/risk processes at an airline level. Requirements for new digital tools to support pilot awareness of WRS/wellbeing/MH, self-management of WRS/wellbeing/MH and risk identification both inside and outside the cockpit are also proposed. Some of recommendations arising in this research require changes to the existing rule-making and/or modification to existing AMC and GM.

Work has an important role in terms of promoting wellbeing. However, it can also have negative effects on our physical and mental wellbeing leading to stress, fatigue, poor teamwork and engagement, and burnout. Many companies treat workers in terms of enterprise resources. Operations management often overlooks the 'human factor' and specifically, the relationship between worker wellbeing and performance, and the design of work management processes and associated technologies to support this. The impact of new work and workforce practices/trends such as the blended and flexible workforce along with new automation and artificial intelligence (AI) technologies enabling business process, performance/work, and workforce management, presents both risks and opportunities. This paper introduces a new work management concept – namely, 'intelligent work'. Intelligent work is defined in relation to work that is smart, health, ethical and safe. Critically, it is underpinned by concepts of workplace health protection and promotion, along with progress in automation and AI technologies. This concept has been advanced a part of a human factors action research program addressing responsible business, sponsored by the Irish government.

Objective: The objective of this research was to advance an improved model of Flight Crew task performance. Background: Existing task models present a "local" description of Flight Crew task performance. Method: Process mapping workshops, interviews, and observations were conducted with both pilots and flight operations personnel from five airlines, as part of the Human Integration into the Lifecycle of Aviation Systems (HILAS) project. Results: The functional logic of the process dictates Flight Crew task requirements and specific task workflows. The Flight Crew task involves managing different levels of operational and environmental complexity, associated with the particular flight context. In so doing, the Flight Crew act as a coordinating interface between different human agents involved in the Active Flight Operations process and other processes that interface with this process. Conclusion: This article presents a new sociotechnical model of the Flight Crew task. The proposed model reflects a shift from a local explanation of Flight Crew task activity to a broader process-centric explanation. In so doing, it illuminates the complex role of procedures in commercial operations. Application: The task model suggests specific requirements for pilot task support tools, procedures design, performance evaluation and crew resource management (CRM) training. Also, this model might be used to assess future operational concepts and associated technology requirements. Lastly, this model provides the basis for the operational validation of both existing and future cockpit technologies.

Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the 'real world'. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.

BACKGROUND: Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the 'real world'. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. METHODOLOGY: We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. RESULTS: Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). CONCLUSIONS: This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need ...