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This paper was presented at IHI2012: Werth, J. & Furniss, D. (2012). Medical Equipment Library Design: Revealing Issues and Best Practice Using DiCoT. International Health Informatics Symposium (IHI 2012), Miami, Florida, Jan 28-30. http://dl.dropbox.com/u/2191887/My%20Publications/2012_JWDF_MEL_IHI.pdf
Citation preview
Medical Equipment Library Design: Revealing Issues and Best Practice
Using DiCoT
Julia Werth & Dominic Furniss
Clinical practice often evolves in response to local issues and opportunities, hence it is diverse.
Can we recognise, describe and compare this diversity to reveal issues and best practice across
similar clinical settings?
• What is DiCoT?
• What is a Medical Equipment Library?
• What design opportunities did we recognise?
Content
DiCoT: Distributed Cognition for Teamwork
• Where did DiCoT come from?
Open Clip Art from papapishu 2007
• Distributed Cognition • Focuses on socio-technical systems• Focuses on the propagation and
transformation of information• Uses information processing concepts
• E.g. How a cockpit remembers is speed
• Contextual Design • Advice on doing observational
studies• Focuses on developing models and
representations of work practice• Models used for reflection,
assessment and design
DiCoT’s Five Models
• Information Flow Model• Physical Model• Artefact Model• Social Model• Evolutionary Model
Open Clip Art from Geralg_G 2010
DiCoT Principles (an example)Information Flow Model’s Principles• Information movement• Information transformation• Information hubs• Information buffers• Communication bandwidth• Informal and formal communication• Behavioural trigger factors
Medical Equipment Libraries
MEL Information Flow
MEL1 Physical
MEL2 Artefact
MEL Social
MEL Evolutionary
Design Opportunities and Requirements
Process• Focus (on Medical Equipment Libraries)• Data gathering *• Develop 5 models• Comparisons between contexts• Issues & Best practice• Design opportunities & Requirements *
Data Gathering
• 6 visits in total (4xMEL1, 1xMEL2 & 1xMEL3)Visits lasted between 1-4hrs
• 3 interviews with management at MELs• 5 interviews with experts across UK
• Feedback and validation on results
Design Opportunity 1Identification and Tracking of Equipment• Medical devices go missing – £££• T-card system was good [Situation Awareness]• Out-of-hours is a particular problem• RFID?
Design Opportunity 2Better Administrative Systems• MEL2 uses codes for devices e.g. D01, D04• MEL2 and MEL3 use T-card system• MEL1 non-streamlined (notes-forms-database)• Usage reports were recognised as good
practice but MEL1, 2 and 3 did not do them• Barcodes? QRcodes?
Design Opportunity 3Solutions for Out-of-hours Working• MEL1 has a skeleton service at weekends• MEL1 has a smaller room for devices that are
frequently used• ID card entry to gather ‘who’ and ‘when’• CCTV for tracking people• Regular libraries have self checkout?
Design Opportunity 4Better Knowledge Sharing and Support Between Practitioners• Currently some meetings and word-of-mouth• EBME discussion forum• NAMDET• Developed online community support tools?• Our small scale study reveals best practice
Design Opportunity 5Usage of Physical Space and Dedicated Areas• Space is often limited (MEL1 is bigger)• Need separation between dirty and clean areas• Clear barriers? Disinfectant sprayed?• Equipment that knows it is dirty? Violation
alerts?
• What is DiCoT?
• What is a Medical Equipment Library?
• What design opportunities did we recognise?
Content
Full Thesis Available from: http://www.sighit.org/thesis.php
Thank you!
Questions
Julia Werth & Dominic Furnissjuliacwerth@gmail.com d.furniss@ucl.ac.uk
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