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  • Absence of user-centric design: a threat to patient safety

    Aditi Desai
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    Aditi Desai is a Consultant Obstetrician and Gynaecologist and has worked as a doctor in maternity and women's healthcare for the last 25 years. 

    Having recently read the blog ‘Dangerous exclusions: The risk to patient safety of sex and gender bias, Aditi highlights how many aspects presented in the blog resonate with staff working in healthcare and other industries.


    I have recently been introduced to your organisation. It came as a pleasant surprise to know that there is an organisation that is so passionate about patient safety. I have perused your platform, the resources and the contents showcasing your enthusiasm and efforts in detail.

    The content is easy to understand, succinct and relevant. You have been bringing important issues to the attention of the policymakers and regulators in a coherent and meaningful manner, which is a monumental task.

    I have recently read the blog ‘Dangerous exclusions: The risk to patient safety of sex and gender bias‘. Many aspects presented in this article resonate with staff working in healthcare and other industries. This especially affects women adversely and can cause fatigue and chronic musculoskeletal stress.

    Medical instruments and devices, as well as equipment such as operating theatre tables, have not been designed in a user-centric manner, taking into consideration the variation in anthropometrics.

    Operating theatre tables and laparoscopy equipment stacks are designed for users with a height of 5’10” and above. Many hand instruments are designed for large hands.

    I wish to share my personal experience. I have been working in healthcare, maternity and women’s surgery for the last 25 years. I’d like to share a couple of photos.


    The first photo shows me holding forceps which are used to hold tissue and stop bleeding. It is quite apparent that it has been designed for a large male hand. Smaller forceps are not available in the tray or have to be specially ordered through a process that is not easily accessible. The organisation that I work for is quite supportive but the entire system is not set up to enable healthcare providers with the tools and technology designed in a user-centric fashion to make it easier to do the right thing.


    The second photo shows me standing on a platform that is frequently used by short surgeons, usually female, to elevate themselves. This helps them operate effectively when patients are on theatre tables that are designed for tall surgeons. This results in a shuffling act, as you have to press the diathermy pedals during surgery time and again in gowns and clogs that may be ill-fitting, never mind the risk of tripping and falling.

    After years of effort of juggling and acrobatics, you get used to working around these annoyances. We are fiercely envious of tall colleagues (male and female) now and again.

    About the Author

    As a Consultant Obstetrician and Gynaecologist working at Wolverhempton NHS trust, I feel privileged to have worked as a doctor in maternity and women's healthcare for the last 25 years and to be a part of a brilliant team and organisation.

    I have recently been involved in projects involving prevention of accidentally retained items during childbirth which has evolved form Keele University. I have collaboratively obtained research grants in 2022 to develop this innovation.

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