Time is everythingTime is the critical success or failure factor in organ transplantationThe time it takes to identify organs in a potential donor, to matching with a potential recipient. The subsequent extraction, transportation and transplantation of the organ or organs into one or more patients.Time is eveything…….so everything that we do in this vital process must be as efficient and time effective as possible.
So from the time that a potential donor has been identified the clock is ticking….What does this mean exactly?
It might be helpful to look at organ survival times Organs survive at different rates and even with proper handling techniques the Ischemic*, or out of body times of key organs are:Heart 4 hoursLung 6 hoursLiver 12 hoursPancreas 12 hoursKidney 36 hoursThe shorter the Ischemic time the greater the chance of a successful outcome for a transplant recipient patientthe time from an organ losing a blood supply to the time the organ regains a blood supplyAs you can see these aren’t very long times, especially for Hearts and lungs.But this is only part of the story….
Did you know?Some hard facts to focus the mind on the challenges faced
Waiting and Hoping…..This is the reality, today in the UK.
In 2008 analysis of all Western Euopean countries resulted in the UK reporting one of the worst record for organ donation.This analysis resulted in a number of recommendations being made to improve this record for the future.One of the key recommendations was that the existing paper and telephone based organ offering process should be replaced with a user intuitive, fully functional web based system. That truly moves organ donation into the 21st century.
EOS – In Greek mythology she was the Goddess of the dawn where this system heralding a new dawn in organ donationEOS is a secure website for specialists to share confidential medical information about deceased donors securely (It doesn’t hold information about living people).
All of the the different types of Usersneeds, wants, (and limitations) of were given extensive attention throughout the entire process (not just the design process).While our industry talks a lot about user centred design and we think about the needs of users, sometimes you need to use deep ethnographic methods to really understand the people, systems and environments.
As part of this approach, user research is especially critical to design when we are designing for domains we don't personally experience every day.User research is especially critical to design when we are designing for domains we don't personally experience every day.So what is special about user centred design for EOS?The goal of EOS is to save more lives but failure could mean organs go to waste. Failure during the research (fainting in theatre, being in the way in an intensive care unit) had the potential to make our research dangerous to vulnerable patients. Our protocols needed to be designed to match the hospital environment.In this project we did user research with our users as they facilitated organ donation. We knew that efficiency was lifesaving and the NHS client shared that vision. Eos is used in a variety of physical environment so by both medical experts and non-experts. We needed to understand those users, their goals and the environments and processes around their work.
What did we learn?We knew and our client understood that their life saving vision could only work if we understood their business deeply and could design with users needs as the prime focusAt the beginning we learned about the places where we'd be going to do the research. We learned there are transplant units but the removal of organs takes place where the donating patient has been treated (any Uk hospital). Like the donation nurses, we needed to be on call and able to travel to wherever the donation would take place. What are the implications of being on call for so many hospitals? The physical environment of the donation is often new to the specialist nurse facilitating the donation. They might be in that hospital for their first time. Getting official access to medical records is ok if the other hospital staff are supportive of organ donation, but IT systems and network access were challenging. There is no national user account system for NHS IT. Specialist Donation Nurses needed their own laptops and independent internet access.
What did we learn from working with Donation nurses and medical teams?
We asked the donor coordinators, specialists and teams to draw us a picture and to tell us what they needed to do they job effectively. This included re-using the good, introducing more functionality and making the whole user experience better, quicker and ultimately delivering better quality organs to recipients
We applied the look and feel of the organ donor card as the logon screen – reinforcing brand consistency
We set the business contextWe mapped out and designed the process to match the new way of working, taking all user input into consideration
We designed the navigationWe designed and built the screensWe tested on users Nurses from the transplant units and the donation specialist nurse teams were regularly involved throughout the process. At the coal face of organ donation, they actually used the systems more actively than surgeons. so when we ran paper prototype user testing, and held regular design reviews via webconference, those nurses participated. During development they included their colleagues in reviews and during user acceptance testing we brought in an even wider set. During the rollout our now expert set of nurses helped their colleagues learn as we conducted simulations two or the times with each user of the system till the people, process, equipment and environment were all smoothly coordinated.
Remember we said time is everything? EOS has significantly contributed to improved safety (transcription errors, etc), improved quality of organs (time spent with donor) and increased number of organs (time spent with donor families pushing up the consent rate). EOS has significantly contributed to saving time, along with all the other things that have been put in place.
And finally Whilst EOS is the system that manages the flow of organs from donor to recipient the ODR is the website that the public can sign up to which means that you have declared that you would like your organs to be made available to the benefit of others in the event of your death.