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Showing results for tags 'User centred design'.
Found 72 results
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Content ArticleMartin Bromiley talks about the importance of design whether systems or processes to enable staff in healthcare to do the right thing.
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Content ArticleGlobal healthcare providers are exploring the use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. The authors of this study, published in Nature, tested whether LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM or a source of their choice (control). T Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in fewer than 34.5% of cases and disposition in fewer than 44.2%, both no better than the control group. The authors identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, they recommend systematic human user testing to evaluate interactive capabilities before public deployments in healthcare.
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Community Post
Can the NHS learn from healthcare systems overseas?
Steve Turner posted a topic in Organisational
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Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views? -
Content ArticleClive Flashman, Patient Safety Learning's Chief Digital Officer, shares his presentation slides from the Health Plus Care 2022 conference. The presentation slides include basic principles, how to involve the patient and public in design, key issues and Clive's ten top tips for digital health innovators.
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Content ArticlePoorly designed electronic health records (EHRs) are common, and research shows poor design consequences include clinician burnout, diagnostic error, and even patient harm. One of the major difficulties of EHR design is the visual display of information, which aims to present information in an easily digestible form for the user. High-risk industries like aviation, automotive, and nuclear have guidelines for visual displays based on human factors principles for optimised design. In this study, Pruitt et al. reviewed the visual display guidelines from three high-risk industries—automotive, aviation, nuclear—for their applicability to EHR design and safety.
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Content ArticleNew developments in artificial intelligence (AI) are extensively discussed in public media and scholarly publications. While in many academic disciplines debates on the challenges and opportunities of AI and how to best address them have been launched, the human factors and ergonomics (HFE) community has been strangely quiet. In this paper, Gudela Grote discusses three main areas in which HFE could and should significantly contribute to the socially and economically viable development and use of AI: decisions on automation versus augmentation of human work; alignment of control and accountability for AI outcomes; counteracting power imbalances among AI stakeholders. She then outlines actions that the HFE community could undertake to improve their involvement in AI development and use, foremost translating ethical into design principles, strengthening the macro-turn in HFE, broadening the HFE design mindset, and taking advantage of new interdisciplinary research opportunities.
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Content ArticleIn her latest blog, Patient Safety Commissioner Henrietta Hughes discusses MHRA's Yellow Card reporting system and why, until we have mandatory reporting, including for devices that are working as designed, we will continue to see avoidable harm occurring to patients. She stresses that it is vital that the voices and views of patients, clinicians, manufacturer, and health providers participate in the design and delivery of devices.
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EventuntilIn this Patient Partnership Week webinar, the Patients Association will be talking about their work with patients, the Royal College of Physicians and NHS England to explore what the future of outpatient care should look like. The webinar will be chaired by Sarah Tilsed, Head of Patient Partnership. Joining her are: Dr Fiona McKevitt, Clinical Director for Outpatient Recovery and Transformation, NHS England Dr Theresa Barnes, Clinical Lead for Outpatients, Royal College of Physicians Irene Poku, Representative Patient and Public Involvement and Engagement with experience of using outpatient services. Sarah champions the voice of patients in our work and the work of other organisations. As outpatients is such a pivotal part of the NHS and is visited by millions of patients, it really is important that patients feed into the design and delivery of this service, as they know what is and isn’t working for them in terms of their care. The webinar will explore how patients have been involved. Register
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EventuntilDigital technologies are transforming the way in which health and care is delivered. They have played a crucial role in enabling the delivery of services during the pandemic and are set to continue to play a pivotal role in the design, delivery and innovation of health and care going forward. This event will take a deep dive into the practical implementation of digital solutions in health and care. We will explore how data insights and technology are being used to improve care, access and user experience against the backdrop of the impact of Covid-19. Sessions will also provide an opportunity to assess how a range of digital tools from simple to complex can be used to innovate service design, support integration, improve population health management, and reduce health inequalities, touching on implications for staff and patients. Book a ticket
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Content ArticleMeasuring a patient’s height is a routine part of a healthcare encounter. But once completed, how often is this information used? For most of us who fall within 95% of the mean population height, this metric is rarely discussed, but what happens when it is overlooked? And what about those on the outer tails of the bell curve of population distribution? Almost 1 million (909,222) adults in the United States are at least 6'4", more than the entire population of South Dakota (884,659). Conversely, an estimated 30,000 Americans have a form of dwarfism, typically defined as an adult height no taller than 4'10". However, despite this prevalence, the healthcare system struggles to provide consistent, adequate care for patients with extreme heights.
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Content ArticlePatients with respiratory disease deserve a correct diagnosis and guideline driven care that is standardised, patient focussed and delivered by a healthcare professional with suitable training and experience in a site and timeframe to meet their needs. Sadly, patient groups such as the BLF and Asthma UK have recognised that this is often not the case. The Respiratory Service Framework (RSF) attempts to demonstrate what that excellence is – and how it may be delivered at a population level. Developed by the Primary Care Respiratory Society (PCRS) Service Development Committee, the Respiratory Service Framework helps those looking to design a patient focussed respiratory service working across all sectors of out of hospital care to see the ideal components for a given population of patients. It has been designed to be applicable and helpful to those delivery care at a PCN or ICS level.
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Content ArticleThe shift towards a digital-first healthcare system has accelerated during the COVID-19 pandemic, demonstrating that, given the opportunity for better access, people will engage in new ways with their health and wellbeing services. However, while many individuals have developed a greater awareness of their health and taken meaningful steps to improve it, the pandemic has exposed, and potentially increased inequalities in health outcomes due, in part, to inequalities in access to the technologies, connectivity, and digital and/or health literacy needed to improve outcomes equitably. The move to Integrated Care Systems (ICS) provides an opportunity to give greater priority to patient engagement and to integrate services around a 360 degree view of patient’s needs, focusing on how people experience their lives and health conditions, rather than on specific treatment/disease areas or pathways. This blog from Catherine Skilton, Deloitte, discusses what ICSs can do to realise the long-held vision of a person-centric health and care system.
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Content Article
Absence of user-centric design: a threat to patient safety
Aditi Desai posted an article in Design for safety
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. -
Content ArticleIn this Episode of the 'This Is Nursing' podcast series, Gavin Portier speaks to Amanda McKie, Matron -for Learning Disabilities & Complex Needs Coordinator at Calderdale & Huddersfield NHS Foundation Trust. In this episode Amanda talks about health inequalities, mental capacity, advocacy and high profile key documents such as Death by Indifference, the LeDer Mortality programme and the current case of Oliver McGowan. Learning disabilities is a life long condition and they can present in any areas of health care. In this podcast we discover how important it is to have an understanding an appreciation and insight into the care experience of a person with a learning disability and their parents or carers.
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Content ArticleWhat does person centred care mean for the role of patients? Fundamentally, it is an ethos that is intended to put users at the heart of services; encouraging a view of them as participants, not patients; active, not passive. This thinking should apply both to people accessing services as individuals and to citizens collectively – and that means the role of patients, and of their voice, is multiple. Chris Graham explores this further in his blog.
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Content ArticleModels and methods of work system design need to be developed and implemented to advance research in and design for patient safety. In this paper, Carayon et al. describe how the Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety, which provides a framework for understanding the structures, processes and outcomes in health care and their relationships, can be used toward these ends. An application of the SEIPS model in one particular care setting (outpatient surgery) is presented and other practical and research applications of the model are described.
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Content ArticleOver the last 20 years, the Royal College of Art has been a fierce proponent of the role of design to improve and save lives, leading the debate on the efficacy of design thinking when applied to real societal needs. Nowhere is this better exemplified than by its impact on healthcare and patient safety. With increasing pressure on the national healthcare system, public services and provisions have to meet ever more stringent financial, resource and efficiency objectives. The Royal College of Art has demonstrated how systems-led thinking and a design approach to understanding the user’s needs can effectively reduce infection and medical error, and improve treatment spaces and patient communication.
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Content ArticleIn this talk, Steven Shorrock outlines seven fallacies of work-as-imagined, concerning outcomes happen, how people work, how we design and implement, and how we think. A number of examples provided by healthcare workers are given. The talk was given at the HSJ Patient Safety Congress 2019. Presentation slides Video of presentation (29:21)
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Content ArticleThe COVID-19 crisis has created a watershed moment for the NHS, demanding a reappraisal of how essential services are delivered to the public. Even prior to COVID-19, the NHS recognised a pressing need to rethink healthcare using user-centred design principles, based on populations, not organisations. With the advent of the pandemic that pressing need has become an operational imperative. Digital capability has been and will continue to be a key part of transformation, but will only work when aligned with reforms in other key enablers such as financial flow, workforce planning and regulation. Many industries have already made the shift to enabling collaboration and innovation through more agile models of delivery by embracing technologies like artificial intelligence (AI), internet of things (IoT) and/or flexible and secure forms of (multi) cloud storage. Health, on the other hand, until now has introduced new technologies with the objective of improving existing pathways and service delivery models. There is now an opportunity to reimagine healthcare, driving true transformation enabled by digital capabilities.
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Content ArticleA communication passport is a way of supporting a vulnerable person with communication difficulties when they have to transition through different events, such as changing schools, or their first job. Ryan’s family made a specific communication passport for his medical file so that all the medical professionals could learn a little about Ryan before they met him and therefore be better prepared and able to interact with him. Here, his mum shares their example to illustrate how it can be used to improve quality of care.
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Content ArticleThe report, Improving care by using patient feedback, published by the National Institute for Health Research, features nine new research studies about using patient experience data in the NHS. These show what organisations are doing now and what could be done better. Here, we highlight one of the examples from the report, showing some correspondence between a patient and a nursing team. Vanessa Sweeney, Deputy Chief Nurse and Head of Nursing – Surgery and Cancer Board at University College London Hospitals NHS FT decided to share a example of positive feedback from a patient with staff. The impact on the staff was immediate and Vanessa decided to share their reaction with the patient who provided the feedback. The letter she sent, and the patient’s response are reproduced here: Dear XXXXX, Thank you for your kind and thoughtful letter, it has been shared widely with the teams and the named individuals and has had such a positive impact. I’m the head of nursing for the Surgery and Cancer Board and the wards and departments where you received care. I’m also one of the four deputy chief nurses for UCLH and one of my responsibilities is to lead the trust-wide Sisters Forum. It is attended by more than 40 senior nurses and midwives every month who lead wards and departments across our various sites. Last week I took your letter to this forum and shared it with the sisters and charge nurses. I removed your name but kept the details about the staff. I read your letter verbatim and then gave the sisters and charge nurses the opportunity in groups to discuss in more detail. I asked them to think about the words you used, the impact of care, their reflections and how it will influence their practice. Your letter had a very powerful impact on us as a group and really made us think about how we pay attention to compliments but especially the detail of your experience and what really matters. I should also share that this large room of ward sisters were so moved by your kindness, compassion and thoughtfulness for others. We are now making this a regular feature of our Trust Sisters Forum and will be introducing this to the Matrons Forum – sharing a compliment letter and paying attention to the narrative, what matters most to a person. Thank you again for taking the time to write this letter and by doing so, having such a wide lasting impact on the teams, individuals and now senior nurses from across UCLH. We have taken a lot from it and will have a lasting impact on the care we give. The patient replied: Thank you so much for your email and feedback. As a family we were truly moved on hearing what impact the compliment has had. My son said – “really uplifting”. I would just like to add that if you ever need any input from a user of your services please do not hesitate to contact me again
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Content ArticleThis report, published in BMJ Open Quality, sets out the findings of a National Health Service Improvement (NHSI) working group on care communication which included clinicians, patients, patient representatives, NHSI staff and academics from different disciplines. The group’s activities included running four national focus groups and discussion days, in addition to conducting national and international literature searches on healthcare communication and communication improvement. The group’s conclusions are that six domains of care communication warrant attention and improvement: the care environment information exchange attitude and listening aligning and responding team communication communicating with unique groups. Together, these domains expand the definition of healthcare communication from communication as information transaction to communication as complex social and local dynamic. The report outlines the consequences of this expanded definition for healthcare communication improvement and improvement research.
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Content Article
WHO: Perth declaration for patient safety (July 2009)
PatientSafetyLearning Team posted an article in WHO
The Inaugural Australian Patients for Patient Safety Workshop, held over 3 days in Perth from July 7 ‐9, 2009, brought together a group of 40 health consumers, many of whom had experienced medical error or health system failure, health providers and health policy makers from around Australia. Participants were selected for their efforts as change agents who have worked proactively to improve the safety of health care in Australia and their desire to further improve safety in health care, in partnership. Participants came together to build trust, functional working relationships grounded in mutual respect and appreciation of what each brought to the field of patient safety and to form strategies and action plans for improving patient safety in Australia. The core of those strategies and action plans is the Perth Declaration for Patient Safety. -
Content ArticleThe author of this article, published in Health Issues, argues that the experience and wisdom of consumers positively impacts on improvement in every dimension of health care quality. From a consumer perspective, those dimensions of quality can be described as care that is: accessible equitable safe effective efficient timely appropriate consumer-centred.
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Content ArticleThis editorial piece, published in the Medical Journal of Australia (MJA), argues that new strategies need to be considered in order to make significant progress in the area of patient harm. One such approach is to enable patients, carers and families who have experienced poor-quality care and preventable health care harm to develop solutions in partnership with clinicians, health providers and policymakers.
