Human-Centred Design in Healthcare

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As a resident physician, I know the challenges that hospitals face in providing good quality clinical care. Many of these challenges require more than just a better understanding of clinical knowledge; they require a deep analysis of the complex problems hospitals face, including a better understanding of the physical, cognitive and emotional needs of the different kinds of people who interact with each other in a highly stressful environment.

After seeing how others used Human-Centred Design (HCD) to create products and services that improved the quality of care, I joined PDD for a six week internship to learn how HCD could be applied to the challenges I’ve seen. A few examples of the products that inspired me to learn more about HCD…

Examples Scenarios:

1) Improving the Emergency Department Experience

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Human-Centred-Design-in-Healthcare_hospitalImage credit: www.abetteraande.com

Emergency departments (ED) can create a lot of anxiety for patients and families. Patients often ask me how long the wait will be to get into a bed or how long it will take before to get a test result. They may be in pain or looking after someone who is. They may not know what’s wrong with them and fear that it’s something serious. EDs are often chaotic, unpredictable, and stressful environments that pose serious communication challenges between patients and healthcare workers.

The Design Council set out to improve this communication gap by identifying trigger emotions such as anxiety, frustration, violence, and aggression in the ED setting. By mapping the patient journey through the ED systematically from multiple perspectives, they were able to identify opportunities for improvement in environmental, service, informational, digital, lighting, and sound design.

They designed a patient guidance system to better explain the ED environment using a multi-touchpoint solution that combined signage, patient leaflets, and digital messages to orient the patient through their journey. The system anticipated common questions patients had and addressed the patient’s sense of uncertainty with clear and respectful explanations. Evaluations from the project found that 75% of patients perceived less frustration during their visit!

 

2) Improving the Quality of CPR

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Human-Centred-Design-in-Healthcare_CPRmeterhospitalImage credit: www.laerdal.com

When someone is in cardiac arrest, early recognition and good quality uninterrupted chest compressions is a key part of good cardiopulmonary resuscitation (CPR).  Starting chest compressions immediately after a cardiac arrest can double or triple the chance of survival. Effective CPR consists of fast and deep compressions. However, training the public and healthcare professionals in the proper techniques for CPR is tricky as it’s difficult for instructors to assess the speed and depth of the compressions. 

Providing real-time feedback on the quality of CPR could greatly enhance learning and application in the field. The CPRmeter by Laerdal provides audio-visual cues on the quality of CPR, and allows learners to identify parts of CPR training where they need to improve. The meter is placed on the chest and is able to detect how deep and fast chest compressions are, giving useful feedback to the resuscitation team. Studies show that the quality and effectiveness of CPR increases with the use of such meters. Moreover, this technology is now being applied and tested in real clinical settings.

http://www.annemergmed.com/article/S0196-0644(12)01853-7/abstract
http://www.ncbi.nlm.nih.gov/pubmed/21296838

 

3) Breathing New Life into Autoinjectors

Human-Centred-Design-in-Healthcare_SanofiAuviQImage credit: www.auvi-q.com

Anaphylaxis can be life threatening for people with allergies. The body’s immune system goes into overdrive creating a rash, swollen eyes, mouth, and difficulty breathing. Being able to recognize and self-inject adrenaline through an auto-injector can be lifesaving. Patients with allergies carry auto-injectors with them in case they develop anaphylaxis after being exposed to allergen. Patients used an auto-injector will usually avoid the need for an ambulance and will avoid breathing problems and more serious complications of anaphylaxis. 

Current autoinjectors offer a convenient compact design with an easy to use format. However, the start of a severe allergic reaction can disorient most people! Sometimes, patients may not be able to self-administer their auto-injector and have to rely on bystanders to help. There are numerous reports of patients and bystanders misinterpreting the instructions for auto-injectors. Sometimes they are confused about which direction to point the auto-injector, leading to misfiring, injecting in the wrong location, and sometimes injecting the wrong body part. A product by Sanofi Auvi-Q has a built in voice instructional tool that guides patients through administering epinephrine in the case of anaphylaxis. The product’s long term success in the market is yet to be determined but numerous user groups have applauded the new design as being more user friendly!

 

Dr Sahil Gupta

About Dr Sahil Gupta

Title: Emergency Medicine Resident Physician
Dr Sahil Gupta is an Emergency Medicine resident physician at the University of Alberta in Edmonton, Canada. He is doing an internship with PDD to learn about applying human centered design in healthcare settings.

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