The document discusses a project to improve the patient information reporting experience for Community First Responders in Scotland. It aims to develop improved forms and data capture methods through observing first responders, identifying problems, and testing prototype designs. The project will produce new Patient Care Record forms and product designs for better information capture, recording, and transfer. Outcomes will be presented at a March 2012 conference for first responders.

1. Scottish Ambulance Service - Community First Responder:
Improving the Community First Responder patient info reporting experience.
Outline:
This project will investigate the situation surrounding
the Scottish Ambulance Service Community First Responders
experience of administering first aid while recording vital
patient information relevant to the transfer of the patient to the
ambulance and onto the hospital. Currently, the First Responders
complete a Community First Responder, Patient Care Record
that must capture specific key clinical information, but has been
suggested to be difficult to use and may not necessarily capture
the most relevant data required for ongoing patient care. You
will experience, observe and record the interactions and the
user-experience involved within this context and develop design
proposals and prototypes for improved information capture and
transfer. The project output will include designs for improved
Patient Care Record forms as well as product design proposals for
improving data capture, recording, and transfer.
It is proposed that the outcomes from the project be made
available for presentation at the Community First Responders
conference in March 2012.
Approach:
This project is being run with students from year 3 product
design and product design engineering departments working
collaboratively to develop a range of design proposals. Working
in small teams, each team will be responsible for developing a
distinct project outcome presented to a high level of detail and
resolution. By experiencing some of the training Community
First Responders undertake, you will get first-hand experience
of the First Responder-patient interaction. Insights and design
opportunities will be identified through research and by observing
the delivery of first aid, information gathering and transfer of
patient to the ambulance - this can be achieved through role-
play as well as during Community First Responder focus group
workshops. Having identified the key problems and the relevant
design opportunities, you will develop design concept proposals
and refine through user feedback and testing with Community
First Responder and ambulance crew focus groups. The designs
will then be further developed to an experience prototype level
that communicates how the user will interact with and use the
product. To further explain how the product will be used, the
projects will be presented with visualisations of the appropriate
user scenario using storyboards and/or video prototypes.
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert

2. Cultural Probes
Our first look.
Before we started this project, user probes were sent out
to all first responders in Scotland. This not only informed the First
responders of the project we were running but gave us a first look
into the journey a first responder goes through on an average
call out. These probes were very simple but contained a huge
variety of responses, we gathered vast amounts of information
from the thirty or so probes we got back. With in these forms
were the outlines of many problems with the system, there were
a few matters that came up numerous times in many probes.
The form that first responders have to fill out on hand over to
the ambulance seems to be one major concern, not only this
but the information that is recorded is rarely used, this leads first
responders to believe that recording information on the form to
be an inefficient way to record.
Key Insights
> Finding location
> Connection with the ambulance
> Access to Hospital database
> Detailed and updated information
> Information transfer
> Difficulty in filling a paper form
> Absence of an information hierarchy
> Low information overlap
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert

3. A Day with the First Responders: <
Initial problems with the form. < Call comes into control
< < First Responder receives call
The next step was to actually meet the first responders
<<
in a workshop where we could gather more information, insights
and opportunities. To get started in the workshop we drew a
time line and mapped an average call out, from this we then Find location
looked through the time line step by step to highlight areas
with problems or unenjoyable interactions. We then took this a
step further and looked for areas where opportunities lay, and
what ideas the first responders had themselves. We gained huge
amounts of information from this workshop, again with certain
<< Set off to call
problems cropping up again and again.
<< Travelling to location
< < Arrive at scene and treat patient
Main points we came away with:
-The form needs to be simple with big fonts, many first responders
are elderly so shouldn’t need reading glasses to fill out the form < < Ambulance arrives
-Lots of responders don’t fill out forms regularly so they are very
<<
daunting - too many fields, no hierarchy
-Most important date on the form, Date, Team, who was there
Transfert patient and info
-Many didn’t think the paper form was the way forward
-Would be handy for the ambulance crew arriving to receive
date in real time as it would hurry the ambulance if it was life
<< Patient leaves with paramedics
threatening, or slow down if it wasn’t urgent
-Could ward the ambulance of danger
-Would be good to know where the ambulance was to reassure
< < First Responder packs up
the first responder that its on its way
-Skill decay is a bit problem, too long a time between training
and not getting enough practice.
<< Follow up
O
P
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert

4. Taking a Step Back, The Bigger Picture:
Information Overlay.
IDEAL SITUATION
H.D. F.R. A.C.
H.C.
A.C.
H.C. H.D.
F.R.
HOW PATIENT’S DATA ARE SHARED AND RECORDED WITH THE NEW PROCEDURE. HOW PATIENT’S DATA ARE SHARED AND RECORDED WITH THE CURRENT PROCEDURE.
Before we started to generate concepts and first ideas
it was important that we took a step back to look at the bigger
picture, and the problems that surround the whole service. Up
until now the first responders had told us about very specific Patient Condition General
problems that they expereince during call outs, we wanted to Treatment Details Information
find a fundamental problem behind these specific problems.
Medical Information To Be Checked
We found the information overlay throughout the whole service Hospital
very poor. Information collected and information used were
two very different things. As you can see from the two diagrams
at the top of the page, as it stands very little information first
responders collect is used, and then again what the ambulance
crew collect is not necessarily needed in the hospital. The second
diagram shows what we want to work towards achieving.
Ambulance Caller Bystander <
100% information overlay so that every piece of data collected
is relevant and needed, this will reduce time wasted collecting
information that will not be used in the future.
The diagram at the bottom of the page shows all the Patient Condition General
different stake holders that either collect information or relay Treatment Details
information. This shows very simply, a complex process that Information
1st Resp EMDC
can loose, misplace or mistake information. From the caller to To Be Checked
the Hospital the variety of stake holders and the information
they require is vast. Between each stake holder are many ways
in which information can be miss heard, miss recorded or even
confused with other information. This diagram now shows the
different levels of information an dhow complex they can be, so Updated Location Location
achieving 100% information layover is very unlikely. During this
project we should look to improve and increase the amount of Patient Condition Patient Condition
information layover, if we can improve this in anyway all stake Dispatcher
holders will benefit.
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert

5. Ranking Information Key Opportunities
What is important.
A key insight we gained from both talking to the first > Smarter navigation to location
responders and from looking at the form first hand was the
lack of hierarchy of information. It was important to look at the > Overall communication system
information recorded in two was; how relevant the information
was to all stake holders and how important information was > Hospital and EMDC database
compared to other details on the form in terms of saving
lives. After further research we came up with the hierarchy
> Information push to the responder
you can see below in the graph. As we are also looking at the
information layover, we only ranked information recorded by the
> Rapid and efficient information share
first responder that the ambulance crew need. We ranked the > Tick-in check up boxes
information this way to combat both problems at the same time.
> New kinds of device and supports
> More useful and effective questions
2
1 1
Incident/ Patient details
Response Time
3
Initial assessment
Importance
Treatment
5
Medical History
6
Medication
Handover
4 7
Section on Form
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert

6. Three concepts, Low, Mid and High tech
Concepts for today, tomorow and years from now.
As the brief states we need to generate concepts that
System and Application
can be; put in place tomorrow and a future implementation. We
looked at this in a slightly different way, we looked at producing,
a low, mid and high tech solution. This then not only addressed
the implantation tomorrow and the future aspect but shows a
variety of solutions that can need different price bands. But
the lower tech doesn’t necessarily mean that it will be cheaper,
investing in technology that is either timeless of has a long life
time could save money in the long run. It is important that we
take this into account as users may be deterred by high initial
costs, but if explained shortsightedness can be removed.
Medium Tech Device
New Paper Form
2012 2013 2014
>
HIGH TECHNOLOGY > A new application
MEDIUM TECHNOLOGY > A new writing device
LOW TECHNOLOGY > A new paper form
Group 7: Ben Rodgers Massimo Papini Martin Keane Ruari Lambert