Week 5: Creating a Stage
Industrial Designers understand that abstract ideas become clear for users when they are made physically tangible. One of the final outcomes of this project will be a full-on walkthrough of the Resuscitation Bay of the Future, and this week, the team started to assemble one. Apparently there was a line-item in the project budget for this, and so over the course of the week a few pieces of large medical equipment started showing up: the same model hospital gurney used in the resuscitation bay, the same model trash-can, the same model shelving unit, the same model wheeled storage cart.
Of course, some of the devices in an RB cost tens of thousands of dollars. There is no line-item for that, so the team did the next best thing: they printed out huge, blown up pictures of the equipment in question and mounted them on foam core. The overall impression is actually quite immersive. And useful, for getting the proportions and logistics of the current RB environment down.
The whole room mock-up also serves as a framework around which the team can start to assemble prototypes of solutions they’ve come up with for the “family car” expression. The room they built this week is the family car. Soon they’ll get to work on “pimping it out.”
A Bit of a Conversation
“Aidan suggested an ‘orchestrator’ character, to oversee things, information flow, etc,” said Matt.
“Yea, that’s sort of a waste of money. And time. And training. No hospital will ever go for that. The current cast of characters we’ve got here,” Dr. Siegel said, pointing to the diagram on the wall, “should work better through this project. There’s no reason to add anyone. For the stuff we’re talking about, a ‘chart nurse’ might be more appropriate.”
“What happens with this documentation stuff? Why, or where, really, does it break down?” Alex said.
“Well, I should say first that during an intervention, we’re generally so concerned with the patient that we ignore things that are not essential. But if I were to pick a moment, I’d probably say that logging into the Pixis system sort of takes a while, you have to take off your glove and all that, and that’s generally where the charting process goes to hell.”
Matt: “Why do you have to log in?”
Nate: “Well, there’s a lot of drugs in there. And there are a lot of drug abusers in the world who can get high off of anything.”
Alex: “What about a kind of ‘breaking glass’ sort of thing, like on emergency alarms or axes. Like you break the glass and get to the drugs you need quickly. And maybe it takes your picture at the same time, or something, so everyone knows who did what and when.”
Nate: “Yea, that could work. There just has to be some accountability there. The other really important rate-limiting factor there is IV access. Depending on the patient, it can take a while to get that going.”
Matt: “How important is time in this overall equation?”
Nate: "Sort of less important.”
Alex: “More important to be able to do things easier?”
Nate: “Yes.”
Kate: “What do you think about the family car slash concept car dynamic?”
Nate: “For non-design people like me, I think it’s a great metaphor. It really gets to the heart of it, it’s easily understood.”
Kat: “Switching gears a bit, are RBs supposed to be universal?”
Nate: “Not really. There’s not much standardization, but generally different facilities construct their RBs for their different needs.”
Kat: “We need to do more research on how it operates in a pediatric environment, I think.”
And with that, the week really started. The team has had these Q&A sessions with Dr. Siegel periodically throughout the project. I like to think of these sessions as an effort to both define and explore the borders of the current reality. After them, the team goes off and does more research, perhaps drafts new concepts and starts to play around with them. In essence, they work on constructing a future, alternate reality. Some aspects of this new reality will work, others will not, demanding another Q&A session. It’s a fascinating, back-and-forth, creative development model.
Information Flow
Following the partner's comments from the previous week, Nicole immediately set out to organize and diagram the information flow from the start to the finish of a patient’s “journey” through the emergency system. This whole area quickly became a cornerstone of analysis, thought and design for the rest of the project. The whole section came to dominate the “Critical Connections” segment of the project.
Nicole first took the same axis of care that the team had used to explain the “journey” of the patient. At each stage, some information is gathered, updated, transferred or copied. She, with help from Dr. Siegel and some of the nurses at Rhode Island Hospital, tracked this information at each stage, starting with the original 911 call. For each stage, she tracked what was being transferred, and color-coded it by form (lavender for verbal communication, yellow for written documentation, and blue for electronic documentation transfer). The result is an elegant, visually arresting diagram of every parcel of information throughout the whole process. This is particularly useful in diagnosing bottlenecks (like forms having to be copied, manually, several times before a patient can be sent to the Operating Room, or another wing of the hospital) and designing efficient data and tracking systems for the future.
The Culling of the Herd
As noted before, by this point the team had assembled well over 500 sketches/ideas. Even if every single one was brilliant and original, there was little hope of making sense of that many of them. Clearly, some needed to go, especially as they were scheduled to present to Aidan Petrie, Item co-founder, at in internal design review session on Friday. Only the best concepts would make it to presentation.
As usual, for this crew, there was a logical, systematic way to go about deciding which ones needed to go. They drew up little voting sheets, with three and a half questions: Is there a clear benefit? Is it technically feasible? Is it short-term or long-term feasible? And the chuckle factor.
“The chuckle factor is our term for the reaction you get to something that, on the face of it, is a little ridiculous, but might end up being sort of cool. So it could be representative of really innovative thinking, or it could just be crazy,” said Matt.
The votes were tallied, discussed, and then the concepts rearranged by how well they had polled. “Yes” concepts at the top of the ubiquitous, large gray boards, “Maybe” concepts somewhere down the middle, “No” concepts at the very bottom, and all of them in the correct thematic corral (Patient Centric, Staff-Centric, Critical Connections). Only the “Yes” concepts would be presented at the design review (which had just been moved to Monday, to everyone’s collective relief).
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