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Medical Equipment Library Design: Revealing Issues and Best Practice Using DiCoT

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This paper was presented at IHI2012:
Werth, J. & Furniss, D. (2012). Medical Equipment Library Design: Revealing Issues and Best Practice Using DiCoT. International Health Informatics Symposium (IHI 2012), Miami, Florida, Jan 28-30.
http://dl.dropbox.com/u/2191887/My%20Publications/2012_JWDF_MEL_IHI.pdf

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Medical Equipment Library Design: Revealing Issues and Best Practice Using DiCoT

  1. 1. Medical Equipment Library Design:Revealing Issues and Best Practice Using DiCoT Julia Werth & Dominic Furniss
  2. 2. Clinical practice often evolves in response to local issues and opportunities, hence it is diverse. Can we recognise, describe and compare thisdiversity to reveal issues and best practice across similar clinical settings?
  3. 3. Content• What is DiCoT?• What is a Medical Equipment Library?• What design opportunities did we recognise?
  4. 4. DiCoT: Distributed Cognition for Teamwork • Where did DiCoT come from? Open Clip Art from papapishu 2007
  5. 5. • Distributed Cognition• Focuses on socio-technical systems• Focuses on the propagation and transformation of information• Uses information processing concepts• E.g. How a cockpit remembers is speed
  6. 6. • Contextual Design• Advice on doing observational studies• Focuses on developing models and representations of work practice• Models used for reflection, assessment and design
  7. 7. DiCoT’s Five Models• Information Flow Model• Physical Model• Artefact Model• Social Model• Evolutionary Model Open Clip Art from Geralg_G 2010
  8. 8. DiCoT Principles (an example)Information Flow Model’s Principles• Information movement• Information transformation• Information hubs• Information buffers• Communication bandwidth• Informal and formal communication• Behavioural trigger factors
  9. 9. Medical Equipment Libraries
  10. 10. MEL Information Flow
  11. 11. MEL1 Physical
  12. 12. MEL2 Artefact
  13. 13. MEL Social
  14. 14. MEL Evolutionary
  15. 15. Design Opportunities and Requirements
  16. 16. Process• Focus (on Medical Equipment Libraries)• Data gathering *• Develop 5 models• Comparisons between contexts• Issues & Best practice• Design opportunities & Requirements *
  17. 17. Data Gathering• 6 visits in total (4xMEL1, 1xMEL2 & 1xMEL3) Visits lasted between 1-4hrs• 3 interviews with management at MELs• 5 interviews with experts across UK• Feedback and validation on results
  18. 18. Design Opportunity 1Identification and Tracking of Equipment• Medical devices go missing – £££• T-card system was good [Situation Awareness]• Out-of-hours is a particular problem• RFID?
  19. 19. Design Opportunity 2Better Administrative Systems• MEL2 uses codes for devices e.g. D01, D04• MEL2 and MEL3 use T-card system• MEL1 non-streamlined (notes-forms-database)• Usage reports were recognised as good practice but MEL1, 2 and 3 did not do them• Barcodes? QRcodes?
  20. 20. Design Opportunity 3Solutions for Out-of-hours Working• MEL1 has a skeleton service at weekends• MEL1 has a smaller room for devices that are frequently used• ID card entry to gather ‘who’ and ‘when’• CCTV for tracking people• Regular libraries have self checkout?
  21. 21. Design Opportunity 4Better Knowledge Sharing and Support BetweenPractitioners• Currently some meetings and word-of-mouth• EBME discussion forum• NAMDET• Developed online community support tools?• Our small scale study reveals best practice
  22. 22. Design Opportunity 5Usage of Physical Space and Dedicated Areas• Space is often limited (MEL1 is bigger)• Need separation between dirty and clean areas• Clear barriers? Disinfectant sprayed?• Equipment that knows it is dirty? Violation alerts?
  23. 23. Content• What is DiCoT?• What is a Medical Equipment Library?• What design opportunities did we recognise?
  24. 24. Full Thesis Available from:http://www.sighit.org/thesis.php
  25. 25. Thank you! Questions Julia Werth & Dominic Furnissjuliacwerth@gmail.com d.furniss@ucl.ac.uk

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