MediCall

Future anaesthesia

The result of my first term project in my master studies. We developed a communication system for hospitals that target the anaesthesia teams. The project is made in collaboration with Getinge that are specialists in ventilation and anaesthesia machines. The over all aim with this project was to design for professional use and to create a better work environment for the anaesthesia nurses in particular.
Approach

The project is set up as a classical interaction design project where we conducted interviews, observations, field and desktop research and co-creations.  Followed by analysing our insights to find out the challenges the nurses face. We’ve been working in a human centered way and in close contact with the nurses throughout the project.

Personal Learnings

During this project, I learned the importance of early prototyping and tangible material to open up for discussion. Both together with users and also in the design team.

Project Info

Fall 2017, 10 weeks

Partners: Umeå Institute of Design, Getinge

Team: Geert Roumen, Yijia Tao

#Professional use, #Interaction Design, #User Experience, #User centred design


Future Anaesthesia Care – MediCall

Re-imagining the communication between nurses and doctors to enhance collaboration

We developed a communication system consists of three parts: one screen in the operation room, one personal device for the doctors and an earpiece. Enabling the team to use the interface in an hands free manner. Through the operation room system the user can share visual data about the patients status whilst simultaneously attend the patient. The external doctor receiving the call can then quickly judge if her presence is required or not.

Earbud for doctor

Screen in operation room

Phone


Research of anaesthesia

Anaesthesia is the state of temporary loss of awareness. It includes paralysis, unconsciousness, and pain relief. During a surgery there is an anaesthesia nurse/doctor that is putting the patient to sleep and provides the patient with drugs for pain and paralysis. Putting a patient to sleep and waking them up are two very critical moments during an operation and can create a lot of stress for the nurses. If it is done wrong or something unexpected happens it can result in brain damages or suffocation.

Understanding our persona

The most important person for our persona is the patient. Everything they do is to give the patient the best experience that they could possibly have. The majority of the work for a anaesthesia nurse happens in the beginning and the end of the surgery. During a operation it can be very calm, just observing and then suddenly a stressful moment and then it is important for the nurses to be able to go from a passive, observing mode to action instantly.

“If the anaesthesiologist is in an other operation, I need to wait for him to call back. During that time I try to phrase what to say, background and question, so that I can communicate as efficiently as possible.”

-Nils, anaesthesia nurse

“In the United States and Sweden anaesthesiologists take care of several patients at the same time. It’s because there is a lack of experienced anaesthesiologists.”

-Dilip, anaesthesiologist

“I write the doctors number on my scrub, to have it easily accessible .”

-Nils, anaesthesia nurse

Today’s work flow in establish contact

In a operation room today there is a lot of important communication in-between colleagues inside the operation room and outside. This is necessary for good teamwork and patient safety. But the system for contacting someone outside of the operation room is not designed for the medical context. Today phones and pagers are used which can easily be misplaced. Often in Sweden the anaesthesia nurse needs to call the anaesthesiologist for advise or to receive authorisation for certain procedures. The anaesthesiologist takes care of multiple patients simultaneously and doesn’t always have time to call back right away. In critical moments this can be crucial.

Insights and design opportunities

Information delay

As the flow chart above visualises there are many moments that can create bottlenecks in the information being communicated. The system used today is outdated and unreliable. We wanted to change this and create a more efficient system so that the nurses can have more time for the patients.

Information loss

During operations the patients is connected to a anaesthesia machine and monitors that measure vitals such as blood pressure and blood oxygen level. This information is important to be able to judge the situation correctly. Today this is only communicated by voice and because of that information can easily get lost.

Urgency level

There is no way to communicate the urgency level in a situation when calling for help or advice. There is only the normal phone call/page to a specific person or the emergency call for everyone to go to the operation room. To be able to communicate the urgency level is something that is important for the doctor to be able to prioritise the different situations.

How might we communicate more efficiently and with additional layer of information?


A new way of communication between nurses and doctors

In operation room communication

The communication device inside the operation room is specific for the room and contains information about who to call in case of need or emergency. The speed dial calls are adapting to the patient and the type of operation.

Overview key-screens

Share urgency level already at the start

When making a call the caller sets the urgency level before so that the receiver already from the start knows if she needs to answer or if another situation is more important. Because of the importance of efficiency we chose to have three actions on the physical button, urgency level, contacts and call. In one simple movement you can do all of these three actions.

Voice recognition to highlight keywords

The system is using voice recognition during the call to pick up keywords and suggest actions on what’s being said. The users on both ends can then chose to act on it or not.

Instant Information sharing

During the call the team can chose to share the information that is picked up by the system. It can be different vitals, medicines or amount of blood. It will then be visible for both the sender and receiver in both devices to keep track on the call.

Keep track on what’s next

If the caller wants to save their own information that’s also possible. By moving the bubble to the right it is saved to act on later. Actions can for example be order more medicine or change the amount.

Benefits with our design

Visual communication

Always at the same location

Focus at the patient at the same time as getting advice


Process: Concept development

During this project, we got the opportunity to attend several surgeries. We spend many hours in the operation room, sometimes up to 5h straight. This allowed us to get a good understanding of the flow and critical moments using classic methods such as observation, interviewing, and probing. We later shared the observations and conversations we had among the team using role play and mapped everything out.

At the end of the research phase, we held a research workshop with representatives from Getinge, where we summarised all the insights we got so far and gathered deeper information and experiences of each area we found. We asked questions like: what is this for you and what if it was different and asked the participants to brainstorm new scenarios based on the information we presented.

Smart hacks and critical work flow

The anaesthesia nurse is the last person the patient sees before the surgery and the first they see when they wake up, therefore the nurse has a big and important role in calming the patients down as much as they can before the surgery.
We also found interesting behaviours during our observations. Such as where the phone got lost and that the wrong number was called some times. Which causes a lot of unnecessary stress in the operation room.

Ideation through prototyping: Call for efficiency

During the process, we produced many prototypes to explore how they fit into the users daily life. We had conversations and tested the different concepts we had with the nurses. We wanted to make the flow as efficient and usable as possible to handle in critical moments. The most important features like “speed call” and “urgency level” should be the fastest ones to get to.

Developing the user interface and user testing workshop together with nurses

We tested the final concept in a workshop setting together with the nurses we’ve been working with throughout the project. We divided the concept into three parts that we tested: the urgency level with sound and amount of levels, the voice recognition system and where to place the device.

Conclusion

This was a very interesting project to go deep into with multiple possible directions, but no matter how much time you have there is not enough to learn every detail. The challenge then is to decide where it in this particular case makes most sense to focus.

My contribution

I contributed throughout the entire process from user research, ideation, prototyping, and user testing. My main focus was the user research, facilitating workshops and creating interaction flows and storytelling.

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