Glimpsing the Future of the Trauma Bay
Whew ! Ten weeks goes quickly, even in the dog days of summer. Here's a quick progress report on the first phase of the Trauma Bay of the Future project. Keep visiting for more detail as the project is debuted to medical industry players and the innovation community over the next two months.
Week One and Two: Finding our bearings
In the first two weeks, the design team gets up to speed on all things Resuscitation Bay. This is a place that takes ten years for the pros to master, so ten days gives our outsiders just enough understanding to start to make sense of the emergency department, trauma treatment, and resuscitation bay. In preparation for the upcoming intensive observation, much time is spent absorbing the context in which ER doctors and nurses do their most critical work. The design team alternates between primary first-hand accounts and casting a wide net of secondary research across the Web, ensuring that the understanding of context is not limited to our primary venue of Rhode Island Hospital, and is balanced against national and global needs and trends. By the end of the two weeks, the team knows their way around a emergency department, a large design area has been plastered with work diagrams and photos, and the stage is set for some intense work.
Week Three and Four: Swimming in it
The core technique of industrial design teams is to watch what people do (and don't do) while working, rather than taking at face value what they say. Our design team takes a deep dive into the resuscitation bay environment across several hospitals, eventually spending over 200 hours observing emergency care in trauma bays. Copious notes are taken, adhering to a strict privacy protocol, and case examples begin to cover the largest bulletin board you've ever set eyes on. But instead of documenting the clinical details of a patient, as a medical researcher might, the designers look for how the staff works together and communicates, how they adapt the equipment to meet their needs, and where they run into problems. In focus groups with doctors and nurses, a facilitator probes the staff's perception of their current reality and their unmet needs, and gives an opportunity for the pro's to expand on particular points the design team has noticed in observations, to truly understand what works and doesn't in today's world.
Week Five and Six: Wash, Rinse, Repeat!
Although trauma bay observations continue, the design team has now shifts to an analysis of unmet needs, thorny problems and their underlying causes. Ordering and prioritizing these shines light on some emergent unifying themes. This is an organic, iterative process - the team describes needs and problems, pointing to themes, which then lead to possible solution areas. Expert at exploring these solution directions, team members quickly sketch them, intellectually stretch them to the nth degree, and then fiercely question them. The questions lead to another layer of understanding around the needs and problems, and the process starts over. In one run, the group generates over 400 potential design solutions in an hour. Emergency Medicine doctors, designers external to the project, and technology experts all critique the progress and help the design team dig deeper. It's exhausting work, but the team knows that each turn of the wheel brings the new vision more sharply into focus.
Week Seven and Eight: Something to get your arms around
There is no doubt that a trauma bay is a system - a complex swirl of medical professionals, supplies and equipment, technology, communication, protocols, knowledge and expertise. Luckily all of these interlocking pieces come together in a defined space, a room not much bigger than a garage stall. This makes it possible for the design team to make some of the solution directions and examples tangible, touch-and-seeable. Call it prototyping, mock-ups, or stagecraft, the full scale examples that the team put together brought out and focused discussion and feedback in a way a powerpoint slide never could. Using a combination of resuscitation bay furnishings borrowed from Rhode Island Hospital, shaped foam-core, poster-sized photos and hand sketches, the team first put together rough two-dimensional prototypes of a near-future and far-future RB that integrated their best solution directions. Many of the high-runner opportunities deal with enabling technology or work standards, but the physical space still provides an ideal stage set on which to flesh these out and discuss tradeoffs with external experts.
Week Nine and Ten: Painting the picture of the future
Time to pull all the threads together. At this point the design team has focused in on their best and highest impact ideas, and they focus these into a more elaborate foam core stage set and supporting visuals and videos to tell the story of the Resuscitation Bay of the Future. Some themes that emerged early, for example the "patient as the hub", have made it all the way through to a set of design sketches and guiding principles for product solutions. Others have dropped by the wayside on the way to the final presentation. As the first phase wraps up, the team's business analyst starts to overlay the economic business drivers for moving from today's piecemeal reality to a future design that is holistic, integrated, and standardized. A wider group of stakeholders - equipment manufacturers, hospital groups, associations of medical practitioners, and researchers - must buy into this vision as both compelling and financially advantaged. The "final" presentation is an arbitrary milestone, but marks a transition to sharing the project with this wider community, and to building momentum for the next phase of the project - where we develop some of the broad strokes of the design vision into detailed designs for equipment, technology, or work standards.
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