Tuesday, 1 April 2014

Looking for the keys under the lamp post? Are we addressing the right problems?

Recently, I received an impassioned email from a colleague: "you want to improve the usability of the bloody bloody infusion pump I am connected to? give it castors and a centre of gravity so I can take it to the toilet and to get a cup of coffee with ease". Along with photos to illustrate the point.

He's completely right: these are (or should be) important design considerations. People still want to live their lives and have independence as far as possible, and that's surely in the interests of staff as well as patients and their visitors.

In this particular case, better design solutions have been proposed and developed. But I've never seen one of these in use. I've seen plenty of other improvised solutions such as the bed-bound patient being wheeled from one ward to another with a nurse walking alongside holding up the bag of fluid while the pump is balanced on the bed with the patient.

Why don't hospitals invest in better solutions? I don't know. Presumably because the problem is invisible to the people who make purchasing decisions, because staff and patients are accustomed to making do with the available equipment, and because better equipment costs more but has minimal direct effect on patient outcomes.

An implication of the original message is that in CHI+MED we're addressing the wrong problem: that in doing research on interaction design we're missing the in-your-face problem that the IV pole is so poorly designed. That we're like the drunk looking for the keys under the lamp post because that's where the light is, when in fact the keys got dropped somewhere else. Others who claim that the main problem in patient safety is infection control are making the same point: we're focusing our attention in the wrong place.

I wish there were only one problem to solve – one key to be found, under the lamp post or elsewhere. But that's not the case. In fact, in healthcare there are so many lost keys that they can be sought and found all over the place. Excuse me while I go and look for some more...

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