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Feature Christmas 2020: Dr Strange

Delivering human factors at Christmas: how does Father Christmas do it?

BMJ 2020; 371 doi: (Published 16 December 2020) Cite this as: BMJ 2020;371:m4708
  1. Peter A Brennan, consultant maxillofacial surgeon, honorary professor of surgery1,
  2. Rachel S Oeppen, consultant radiologist2
  1. 1Queen Alexandra Hospital, Portsmouth, UK
  2. 2University Hospital Southampton, Southampton, UK
  1. Correspondence to PA Brennan, Peter.brennan{at}

During the festive period, Father Christmas (also known as Santa Claus, Saint Nicholas, and Kris Kringle) has the busiest 24 hours of his year delivering Christmas presents across the world. While this seems an insurmountable task, for him it’s all in a night’s work, facilitated by applying human factors (HF) in many areas.

However, as with healthcare, there is always room for reflection, learning, and improvement for the benefit of consumers.

Father Christmas is unique in having 364 days to prepare for an important job, and could be accused of taking work-life balance to the extreme. Even so, the Christmas task presents a considerable challenge, since staying awake for more than 18 hours leads to deterioration in cognitive function similar to being twice over the UK legal alcohol limit for driving.1

Quite how he manages to function safely at all remains a mystery given the customary glass of wine, sherry, or spirits left out for him by many households. It would be much better to leave a glass of water, as even small deficits in fluid …

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