John Clarkson

Health care process modelling: which method when?

OBJECTIVE The role of process modelling has been widely recognized for effective quality improvement. However, application in health care is somewhat limited since the health care community lacks knowledge about a broad range of methods and their applicability to health care. Therefore, the objectives of this paper are to present a summary description of a limited number of distinct modelling methods and evaluate how health care workers perceive them. METHODS Various process modelling methods from several different disciplines were reviewed and characterized. Case studies in three different health care scenarios were carried out to model those processes and evaluate how health care workers perceive the usability and utility of the process models. RESULTS Eight distinct modelling methods were identified and characterized by what the modelling elements in each explicitly represents. Flowcharts, which had been most extensively used by the participants, were most favoured in terms of their usability and utility. However, some alternative methods, although having been used by a much smaller number of participants, were considered to be helpful, specifically in understanding certain aspects of complex processes, e.g. communication diagrams for understanding interactions, swim lane activity diagrams for roles and responsibilities and state transition diagrams for a patient-centred perspective. DISCUSSION We believe that it is important to make the various process modelling methods more easily accessible to health care by providing clear guidelines or computer-based tool support for health care-specific process modelling. These supports can assist health care workers to apply initially unfamiliar, but eventually more effective modelling methods.

Key influences on the user-centred design process

To develop inclusive design materials that are well suited to design practice and thus more likely to be adopted, a better understanding of this practice is needed. A triangulated study was thus conducted, including observations of case studies, interviews with designers and a literature review. The study examined many aspects of design practice, focusing on the consideration of users and influences on method uptake. Four overarching themes were identified: clients’ influence, informality, variation, and time and cost constraints. Implications include the need to educate clients in the value of inclusive design; the need for informal, cheap, yet insightful inclusive design methods; and the value of providing a range of flexible materials for different design situations.

Physical gestures for abstract concepts: Inclusive design with primary metaphors

Designers in inclusive design are challenged to create interactive products that cater for a wide range of prior experiences and cognitive abilities of their users. But suitable design guidance for this task is rare. This paper proposes the theory of primary metaphor and explores its validity as a source of design guidance. Primary metaphor theory describes how basic mental representations of physical sensorimotor experiences are extended to understand abstract domains. As primary metaphors are subconscious mental representations that are highly automated, they should be robustly available to people with differing levels of cognitive ability. Their proposed universality should make them accessible to people with differing levels of prior experience with technology. These predictions were tested for 12 primary metaphors that predict relations between spatial gestures and abstract interactive content. In an empirical study, 65 participants from two age groups (young and old) were asked to produce two-dimensional touch and three-dimensional free-form gestures in response to given abstract keywords and spatial dimensions of movements. The results show that across age groups in 92% of all cases users choose gestures that confirmed the predictions of the theory. Although the two age groups differed in their cognitive abilities and prior experience with technology, overall they did not differ in the amount of metaphor-congruent gestures they made. As predicted, only small or zero correlations of metaphor-congruent gestures with prior experience or cognitive ability could be found. The results provide a promising step toward inclusive design guidelines for gesture interaction with abstract content on mobile multitouch devices.

Design Process Improvement

About this book: There is always room for improvement in design. Maybe there is need for a better product, or for a better, more effective and economic, design process-the late delivery of new products has been shown to be the single largest contributor to the loss of company profits in the UK. Our own experience of working with automotive, aerospace and healthcare companies has shown that effective communication, management of change and process planning are essential ingredients for an effective product development process. This book aims to develop an understanding of these issues as a means to facilitate design process improvement. Part I contains a series of review articles written by a team of international experts on models of design, perspectives on design, design practice and design management. Part II provides an introduction to the wealth of academic research on these topics by presenting the activities of research centres from around the world. It is for: business leaders who want to understand the role of design management as a driver for commercial success; design managers who want to improve their company design procedures; designers who want to know how to design more efficiently; researchers who want to explore the field of design process improvement. An up-to-date source of information on design process improvement may be found at: http://www-edc.eng.cam.ac.uk/designprocessbook. Written for: Academic and practising engineering designers, managers responsible for design matters, libraries, senior undergraduate and early postgraduate students.

Capability measurement for Inclusive Design

Understanding users’ capabilities, needs and expectations is key to the domain of Inclusive Design. Much of the work in the field could be informed and further strengthened by clear, valid and representative data covering the full range of peoples capabilities. This article reviews existing data sets and identifies the challenges inherent in measuring capability in a manner that is informative for work in Inclusive Design. The need for a design-relevant capability data set is identified and consideration is given to a variety of capability construct operationalisation issues including questions associated with self-report and performance measures, sampling and the appropriate granularity of measures. The need for further experimental work is identified and a programme of research designed to culminate in the design of a valid and reliable capability survey is described.

Development of modelling method selection tool for health services management: From problem structuring methods to modelling and simulation methods

BackgroundThere is an increasing recognition that modelling and simulation can assist in the process of designing health care policies, strategies and operations. However, the current use is limited and answers to questions such as what methods to use and when remain somewhat underdeveloped.AimThe aim of this study is to provide a mechanism for decision makers in health services planning and management to compare a broad range of modelling and simulation methods so that they can better select and use them or better commission relevant modelling and simulation work.MethodsThis paper proposes a modelling and simulation method comparison and selection tool developed from a comprehensive literature review, the research teams extensive expertise and inputs from potential users. Twenty-eight different methods were identified, characterised by their relevance to different application areas, project life cycle stages, types of output and levels of insight, and four input resources required (time, money, knowledge and data).ResultsThe characterisation is presented in matrix forms to allow quick comparison and selection. This paper also highlights significant knowledge gaps in the existing literature when assessing the applicability of particular approaches to health services management, where modelling and simulation skills are scarce let alone money and time.ConclusionsA modelling and simulation method comparison and selection tool is developed to assist with the selection of methods appropriate to supporting specific decision making processes. In particular it addresses the issue of which method is most appropriate to which specific health services management problem, what the user might expect to be obtained from the method, and what is required to use the method. In summary, we believe the tool adds value to the scarce existing literature on methods comparison and selection.

From margins to mainstream

Although the academic and broadsheet worlds still tend to refer to ‘the elderly’ and ‘the disabled’, as if they form distinct groups outside the mainstream of society, there is a growing trend to recognise age and disability as something we will all experience, and therefore part of a normal life course. Disabled people have become increasingly assertive about their rights to access buildings and services, while for older people the emphasis is now on independence. Both groups aspire to active participation within the mainstream of society, reject the dependency and institutionalisation that were the norm for much of the last century, and are beginning to assert themselves as consumers who control significant amounts of disposable income. Such new expectations offer a rationale for design that is ‘inclusive’ rather that exclusive, and more closely aligned to contemporary social expectations.

Quantifying design exclusion

Products make demands of their users which effect their utility and usability. As a result, those users who do not have the capability to use the product are denied access to it. For example, a kettle that is so heavy that a weaker user cannot lift it denies access to that user regardless of the cause of their weakness. There are many such products causing access problems with a wide range of users, particularly those who are order or disabled, and it is generally recognised that more inclusive approaches to design must be adopted to resolve this problem.

Human capability and product design

Publisher Summary Designing a product to minimize exclusion requires knowledge of the demands made by a product on its users’ sensory, cognitive, and motor capabilities and knowledge of the range of these capabilities within the user population. Any user whose capability does not meet that demanded by the product is likely to be excluded from using that product, or at the very least experience difficulty. Hence good design requires an understanding of the characteristics and capabilities of the target users of a new product or service, so that it can be designed to operate within their capabilities and meet their needs and desires. This chapter describes various forms of information that help to create a better understanding of these characteristics, along with the users’ sensory, cognitive, and motor capabilities. Users may be described in many ways. Businesses talk about market segments and preferences, medical professionals talk about symptoms and conditions, government talks about socioeconomic factors, and designers talk about anthropometry and capability. All represent different ways in which to describe the diversity of human form, performance, and behavior. All have some relevance to the design of products and services. However, the focus of this chapter is on anthropometry and, in particular, capability.

An Investigation and Review of the Knowledge Needs of Designers in SMEs

Small-to-medium sized enterprises (SMEs) involved in new product development (NPD) face many challenges including minimizing NPD costs, meeting high quality demands, and reducing NPD timescales. It is generally acknowledged, however, that any organization can only realistically hope to meet two or three of these goals. For instance, companies might be able to deliver high quality products in a short time - but this will generally require substantial investment to achieve. In an attempt to meet these demands designers may have to use vast amounts of knowledge during the design of complex multidisciplinary products. This often involves the utilization of large amounts of specialist knowledge and information which is usually poorly documented and difficult to access, but is crucial to successful NPD. There is an obvious need, therefore, for some sort of computer support that will assist the designer through the complex and multidisciplinary design process. This paper presents the initial findings from a revi...