Using a human factors-centric approach to development and testing of a face shield designed for healthcare workers: A COVID-19 case study for process and outcomes

ABSTRACT Background: Face shields are a critical piece of personal protective equipment (PPE) and their comfort impacts compliant use and thus protectiveness. Optimal design criteria for face shield use in healthcare environments are limited. We attempt to identify factors affecting face shield usability and to test and optimize a face shield for comfort and function in healthcare settings. Methods: A broad range of workers in a large healthcare system were surveyed regarding face shield features and usability. Quantitative and qualitative analysis informed the development of iterative prototypes which were tested against existing shields. Iterative testing and redesign utilized expert insight and feedback from participant focus groups to inform subsequent prototype designs. Results: From 1648 responses, six key elements were identified: ability to adjust tension, shifting load bearing from the temples, anti-fogging, ventilation, freedom of movement, and durability. Iterative prototypes received consistently excellent feedback based on use in the clinical environment, demonstrating incremental improvement. Conclusion: We defined elements of face shield design necessary for usability in healthcare and produced a highly functional face shield that satisfies frontline provider criteria and Emergency Use Authorization standards set by the Food and Drug Administration. Integrating human factors principles into rapid-cycle prototyping for PPE is feasible and valuable.