independence Dr Louise Moody Reader in User-Centred Health Design - - PowerPoint PPT Presentation

User-centred design supports independence

Dr Louise Moody

Reader in User-Centred Health Design & Director, Centre of Excellence in Product & Automotive Design, Coventry University UK. User-Centred Design Expert, D4D & HDTI

CEPAD

centre of excellence in product and automotive design

Monday 4th March

Department of Industrial Design

MDes/ BA (Hons) Automotive and Transport Design Product Design Interior Design

Michael Goatman

Postgraduate courses MA Automotive Design MA Vehicle Interiors MSc Design Transport MSc Industrial Product Design In 2005 Coventry University was recognised as an international Centre of Excellence in Product and Automotive Design (CEPAD)

wwwm.coventry.ac.uk/csad/industrialdesign

Health Design & Technology Institute

www.hdti.org.uk

• Cross-faculty institute promoting the self management of health, well

being and independent living in a community setting

• Improving products and services in the

community healthcare and wellbeing sector

• Focusing on people with long term conditions,

disabled people and the ageing population

• Helping people maintain an active economic

and social life

HDTI Activity

• Design expertise and engagement with end

users, evaluating the effectiveness of interventions Commercial consultancy

• Conferences, meetings, seminars, workshops

for practitioners, academics, small businesses and service users Professional development and training

• In collaboration with Faculties and external

regional, national and international partners Applied research projects

• Health and social care, design, management,

engineering Undergraduate and postgraduate courses

Devices 4 Dignity

• D4D is a national resource working with patients, industry,

academia and clinicians to find out what people really need, then bringing together national teams of experts to design and develop solutions and deliver

• Based in the NHS to identify areas of high need and prioritise

– Care professionals/ Academia/ Patients/Carers/Charities/Industry

• Encourage innovation by funding proof of principle projects,

thus de-risking the concept for follow-on R&D funding

• Deliver technology back into the NHS service
• Provide an opportunity for active stakeholder engagement and

collaboration

“To deliver innovative technology solutions to support patients with long term conditions, which preserve their dignity and independence” www.devicesfordignity.org.uk NHS Academia Industry Users

National Network

• It has established a national network– to create the

right project team for co- development

• A core team in Sheffield Teaching Hospitals

coordinating input from partners: – 7 NHS Trusts – 3 Universities – 2 formal charity partners – National Innovation Bodies

D4D Focus

Urinary Continence Management

• 2nd most common reason for need for institutional care

Renal Technologies

• 0.05% of population but 2% of NHS budget

Assistive and Rehabilitative Technologies

• 11 million people in the UK with disabilities

Some Definitions…

Ergonomics / Human Factors – “is concerned with the application of what we know about people, their abilities, characteristics, and limitations to the design of equipment they use, environments in which they function, and jobs they perform” (www.hfes.org) User-Centred Design - A design philosophy and approach that places users at the centre of the design process from the stages of planning and designing the system requirements to implementing and testing the product. Co-design - Designers and people not trained in design, working together during the design / development process

The User-Centred Design Process

Identify the user Research / involve the user Create goals Design Prototype Test Produce

Primary user Secondary user Tertiary user Collect data: interviews, questionnaires focus groups,

• bservations,

video Evaluate users, environment, behaviour & experience Understand what qualities are important to the user Identify usability and how it can be measured Effectiveness, efficiency, safety, utility, learnability, memorability

When the user becomes the co-designer

Users should test throughout the design process Be sure that instructions can be intuitively understood Evaluate designs Have the user test the object in the environment that the product will be used and document Give the user minimum instructions on how to use the product Evaluate user satisfaction Continue to evaluate the product with user feedback

Wilcox, Hur & Miller

Ideas, Concepts, mocks ups Design criteria

UCD Projects

• Surgical training systems (virtual reality)
• Processes for increased safe behaviours and crisis management
• Design of patient information for a UK screening programme
• Online support for carers
• Online support for young adults surviving cancer
• Decision support tools for healthcare professionals
• Incident reporting tool for adverse incidents within the NHS
• Incontinence

Levels of Co-Design

User Tester Informant Design partner Design decision- making is largely made by designers Users’ full participation is utilised throughout the design process Late involvement Early involvement

Level of co- design Methods Benefits Risks User: tests a final concept to see how it works

• Observation of

testing

• Video
• Preference surveys
• Builds empathy
• Easy to implement
• Quick
• No issues of retention
• Passive & limited input
• Cost of late changes
• Frustrated users

Tester: testing

• f prototypes
• nce initial

design work complete

• Workshops
• Lab testing
• Observation
• Few skills required from

the user

• Rapid results
• Can improve usability
• Cost of late changes
• If time is short, changes may

not be made

• Designers may not like the

feedback Informant: plays a part in the design process at various stages determined by the designer

• Observation with

existing technology

• Feedback on

sketches, concepts, paper prototypes

• Interviews, focus

groups, surveys

• User impact from the

start

• Schedules and location

can be flexible

• Greater impact on

usability and acceptability

• Requires more time and

money

• Designers determine

involvement

• Flexible & frequent

involvement can be hard to arrange Design partner: throughout the whole design process

• All of the above and

tools specific to the group

• Richness of skills,

experience etc

• Empowers the user
• Most significant impact
• n acceptability and

usability

• Slower and more costly in

development time

• Challenges of power, decision

making, communication & collaboration

• Logistics

Involving Users from the Outset

Impact

• n

design Time

Early development Prototype Production

The biggest impact of involving users is early in the development process, due to the ability to make changes at minimal cost

Usability Testing

“I’ve stopped wearing trousers, it does bulge under trousers.”

Legbag Design

“I couldn’t imagine being in a relationship with a leg bag and showing it to someone”. “I’m sure its my

• wn bloody

fault.” “I have to shake off like a bloke.” “Without it, life would be impossible”

• Reduce the likelihood of accidental opening
• Reduce the likelihood of leaving the tap open
• Eliminate dripping of urine once the tap is closed
• Ensure ease of opening and closing (low force, one

handed)

• Provide clear indication that the tap is fully closed
• Maximise comfort against the skill

Legbag Design

Legbag Design

• Early testing has enabled users to

assess the tap function and appearance and make comparison with existing products

• A Urology expert group meeting - 30

healthcare professionals and expert users

• A community focus group with

continence nurse

• Interviews with patients and a carer /

spouse

• Tap 3 has most potential
• Dissemination

Catheter Design

• Mediplus presented a new catheter

design (indwelling urethral) that they believed would be more resistance to encrustation and blockage

• Aim: to identify usability issues

associated with insertion and removal to inform the final prototype taken forward to manufacture and future clinical evaluation

• Iterative design: 3 phases of usability

evaluation and development

Testing

• 16 urology staff handled the prototypes in a

simulated environment (a male Limbs & Things Catheterisation Trainer) during walkthroughs and interviews

• Focus on

– The compromise in material stiffness for patient comfort and retention in the bladder – A large lumen to prevent blockage (20% larger) – Transparency of deployment mechanism – Design of the locking mechanism to reduce infection likelihood and improve comfort – Ease of adjusting position once inserted – Reliance on training / instruction

Results

• The catheter was regarded as easy to insert
• The tubing was significantly improved – it is suitable for short term use,

but too stiff for long term use

• The retention strength was also regarded to be good.
• Benefits compared to the Foley Catheter:

– Less actions and equipment involved in catheter insertion – There is no balloon to over inflate or burst – It potentially enables one handed activation of the catheter – If the catheter is pulled by the patient the whole product will be removed (rather than tearing and leaving some of the catheter inside the body)

• The company involved is responding to feedback to produce a final

prototype design to take forward to manufacture and future clinical evaluation.

WheelSAS: Wheelchair Stability Assessment System

• This project aims to bring to the point of

commercialisation a system that: – Facilitates the stability testing of wheelchairs – Predicts dynamic stability as well as static stability in different situations – Offers expert knowledge to support the wheelchair prescriber in tuning the wheelchair to an individual patient’s needs – The wheelchair performance is optimised for the user, their lifestyle, capabilities and environment

C of G moved towards front

• Benefits

– Rearwards stability

• Problems

– Harder to propel – Harder to brake – Hard to tip e.g. Get up curbs

• Benefits

– Easier to propel & manoeuvre – Easier to brake – Easier to tip

• Problems

– Increased risk of accidental rearwards tipping (and risk of head striking the ground)

C of G moved towards rear

Inclined Ramp Tests

• Most wheelchair services in the UK assess wheelchair stability (for

specific cases) by using a static inclined ramp test

• Involves positioning a wheelchair and occupant on a ramp forwards,

backwards and sideways to see if the chair tips.

• The test is done at 12° for attendant push wheelchairs, and 16° for

self propelled and electric wheelchairs.

• Ramp weighs 7.8kg, and folds up to be carried around

Development Priorities

Mark 1:

• For 4 wheeled chairs
• Hardware + software
• Focused on static stability
• Supports clinical judgement
• Portable
• Easily stored and moved
• Less distressing for client
• Aesthetics
• Usable software
• Communication to patients
• PDF output

Mark 2:

• Include 6 wheeled chairs
• Dynamic stability integrated
• Automatic data capture e.g.

wheelchair geometry, photographs for patient notes

• Education of the wheelchair

users of chair capability

The stakeholder analysis (survey and interviews) have led to the following specification:

WheelSAS

User Involvement

• From the initial project idea and writing the funding application,

through the evaluation phases that we are now approaching

• The engineers and OTs have greatest input because our concern is

how well the system assists their clinical judgement – they are part

• f the design team
• Wheelchair users have been involved in the stakeholder group

throughout and are contributing to the design of the interface in terms of how we present information to the patient

• The evaluation will focus on the impact on the clinician, the user and

carer

Current Position

System Mk1 nearly complete

• Integrating system components into a prototype rig including

packaging & styling

• Graphical User Interface development underway
• Mathematical models for predicting dynamic stability
• Iterative usability and performance testing with prescribers and

patients through our stakeholder group Evaluation begins June 2013

• Case studies of system use with different patient groups
• Prescriber and patient feedback

Prototype development for Mk2 will continue in parallel

Problems with UCD!

• 1. Ethics
• 2. User engagement & retention
• 3. Time & money
• 4. Logistics
• 5. Emotion
• 6. Designing for all
• 7. Team buy in
• 8. Language and communication
• 9. Decision making and power

So why do it?

• To improve the experience of the user
• Build empathy and team synergy
• More accurate requirements and a better match between the decisions of the

design team and the needs and task of the user

• To produce a product that only has relevant functionality, avoiding features that

are not wanted / cannot be used

• Detecting problems early in the design process and eliminate future redesign to

improve usability

• Minimizing or eliminating the need for documentation and training as the product

is well designed

• It doesn’t just save money, it can make money - increase the number of satisfied

customers who will make repeat purchases and recommendations

Thank you.