Jonathan West

Taking ergonomics to the bedside--a multi-disciplinary approach to designing safer healthcare.

A multi-disciplinary approach to designing safer healthcare was utilised to investigate risks in the bed-space in elective surgical wards. The Designing Out Medical Error (DOME) project brought together clinicians, designers, psychologists, human factors and business expertise to develop solutions for the highest risk healthcare processes. System mapping and risk assessment techniques identified nearly 200 potential failure modes in hand hygiene, isolation of infection, vital signs monitoring, medication delivery and handover of information. Solutions addressed issues such as the design of equipment, reminders, monitoring, feedback and standardisation. Some of the solutions, such as the CareCentre™, which brings many of the processes and equipment together into one easy to access workstation at the foot of the bed, have been taken forward to clinical trials and manufacture. The project showed the value of the multi-disciplinary and formal human factors approaches to healthcare design for patient safety. In particular, it demonstrates the application of human factors to a complete design cycle and provides a case study for the activities required to reach a safe, marketable product.

Designing out Medical Error: An Interdisciplinary Approach to the Design of Healthcare Equipment

ABSTRACT Medical error is an internationally recognized problem, with major financial and human costs. The design of hospital equipment, devices and environments can contribute to the problem. Clinical staff often have to cope with confusing interfaces and equipment, making their tasks difficult and potentially dangerous. There are calls to rethink the approach to design in healthcare. Design should acknowledge the real-world issues users face in the hospital environment. A collaborative approach is required to understand these issues. This paper outlines the methodologies used in two interdisciplinary case study projects, revealing the importance of a clear set of working methods and detailing the approach taken at each point. The resulting designs aim to better support healthcare processes, reducing the instance of medical error and ultimately saving lives.

The development of SlowMo: How inclusive, user-centred design research can improve psychological therapies for psychosis (Preprint)

Background Real-world implementation of psychological interventions for psychosis is poor. Barriers include therapy being insufficiently usable and useful for a diverse range of people. User-centered, inclusive design approaches could improve the usability of therapy, which may increase uptake, adherence, and effectiveness. Objective This study aimed to optimize the usability of an existing psychological intervention, Thinking Well, which targets reasoning processes in paranoia using a basic digital interface. Methods We conducted inclusive, user-centered design research characterized by purposive sampling of extreme users from the margins of groups, ethnographic investigation of the problem context, and iterative prototyping of solutions. The UK Design Council’s double diamond method was used. This consisted of 4 phases: discover, including a case series of Thinking Well, stakeholder interviews, desk research, user profiling, system mapping, and a mood board; define, consisting of workshops to synthesize findings and generate the design brief; develop, involving concept workshops and prototype testing; and deliver, in which the final minimal viable product was storyboarded and iteratively coded. Results Consistent with our previous work, the Thinking Well case series showed medium to large effects on paranoia and well-being and small effects on reasoning. These were maintained at follow-up despite some participants reporting difficulties with the therapy interface. Insights from the discover phase confirmed that usability was challenged by information complexity and poor accessibility. Participants were generally positive about the potential of technology to be enjoyable, help manage paranoia, and provide tailored interpersonal support from therapists and peers, although they reported privacy and security concerns. The define phase highlighted that the therapy redesign should support monitoring, simplify information processing, enhance enjoyment and trust, promote personalization and normalization, and offer flexible interpersonal support. During the develop phase over 60 concepts were created, with 2 key concepts of thoughts visualized as bubbles and therapy as a journey selected for storyboarding. The output of the deliver phase was a minimal viable product of an innovative digital therapy, SlowMo. SlowMo works by helping people to notice their worries and fast thinking habits, and encourages them to slow down for a moment to find ways of feeling safer. A Web app supports the delivery of 8 face-to-face sessions, which are synchronized to a native mobile app. Conclusions SlowMo makes use of personalization, ambient information, and visual metaphors to tailor the appeal, engagement, and memorability of therapy to a diversity of needs. Feasibility testing has been promising, and the efficacy of SlowMo therapy is now being tested in a multicentered randomized controlled trial. The study demonstrates that developments in psychological theory and techniques can be enhanced by improving the usability of the therapy interface to optimize its impact in daily life.

Creating an Inclusive Architectural Intervention as a Research Space to Explore Community Well-being

This paper outlines a 2-year active design research project coordinated in collaboration with Public Health Northern Ireland and set in the city of Derry/Londonderry to explore how inclusive design methodologies can produce interventions to improve community well-being. The research focuses on the waterfront of the River Foyle and how an inclusive architectural intervention challenged the areas’ negative associations. In the last decade, the waterfront has become synonymous with mental health crisis and suicide. This has led to the phrase ‘I’m ready for the Foyle’ becoming embedded within the communities’ language as a colloquial term for stress. This project seeks to extend inclusive design within the community, creating well-being spaces around the bridges and banks of the river, with outcomes focused on drawing people to the area as a place of celebration and life-affirming activities. The project has helped to develop Inclusive Design as a means of engaging a whole city in the redesign of public spaces for improved well-being.