Seated behind one-way glass, human factors specialists are able to observe and record the complex interactions of clinicians with their work environment.
University Health Network
Think of it as a case of lab life trying to imitate real life.
From behind a two-way mirror, researchers observe and record medical staff trying to use intravenous drug pumps and other devices while being continuously interrupted by a Code Blue or other emergencies that could cause them to make mistakes. To increase the sense of true hospital reality, actors are sometimes brought in to play confused — and confusing — patients.
Welcome to the Centre for Global eHealth Innovation associated with Toronto’s three-hospital University Health Network (UHN) and the University of Toronto (U of T).
Human Factors Specialist Tara McCurdie observes clinicians interacting with healthcare technology in the simulation labs of the Centre for Global eHealth Innovation.
University Health Network
The facility, which opened in 2004, boasts a $6 million test-bed laboratory and has become what its founders believe is the largest hospital-based human factors “usability” institution in the world. The staff of 18 full-timers and graduate students looks at how the purpose for which a machine is designed often collides with the seemingly endless ways people can become confused about how to use technology properly.
While making usable technology is the meat and potatoes of the consumer-products world, “much medical equipment is poorly designed and not subject to the usability testing that takes place in other industries,” says Joseph Cafazzo, an assistant professor in the Institute of Biomaterials and Biomedical Engineering in the faculty of medicine and co-head of the facility.
Furthermore, while a confusing device can be a great annoyance as a consumer item, there is more at stake when it comes to medical equipment.
The Centre is capable of recreating complex clinical environments to study clinician interactions with medical devices in development.
University Health Network
“When you step up to an ATM machine and are frustrated by it or when there is a sign pointing you down a wrong corridor, those are all just inconveniences,” says Cafazzo. “The poor design in health-care systems can result directly in patient death and injury.”
So the UHN and U of T collaborated to create a facility where some of its 4,000 doctors and nurses can test how usable a technology is in scenarios meant to simulate the hectic hurly-burly of real-life hospital practice. The idea is both to help industry make better devices and to pinpoint the best equipment for hospitals that are in the market for new machines.
What has emerged from this are usability successes. A new pain-medication pump, developed in conjunction with the British company Smiths Medical, went through 10 design iterations before it was judged as truly usable. A portable battlefield ICU unit, which had to be able to operate in a darkened airplane, was also improved after being tested in a simulated plane hold. And the Ontario Ministry of Health and Long-Term Care now understands it has to deal with the fact that nurses in some hospitals ignore the smart features of their new and expensive medication pumps — warnings of wrong dosages, in particular — and use them just like the old ones.
But beyond all, the laboratory has educated hospital users on their role in making medical technology better. “Devices shouldn’t be evaluated by engineers, by the people designing them,” says Richard Cooper, professor of anaesthesia at the U of T and a test participant. “They should be evaluated by people using them.”
