Archive for the ‘Decisions and Human Factors: Engineering methods and Design Importance’ Category

Human-Computer Interaction (HCI)

April 29, 2013

HCI is the study of interaction between people and computers. Interaction between users and computers occurs at the user interface, which includes both software and hardware. According to the Association for Computer Machinery, HCI is concerned with the design, evaluation, and implementation of interactive computer systems for human use and with the study of major phenomena surrounding them. In the healthcare environment, and specifically implementing and electronic medical record (EMR), it is important to understand HCI to ensure the users and the computers interact successfully. The goals of HCI are to deploy usable, safe, and functional systems. Developers must try to understand how people use technology in order to produce computer systems used by their intended audience, which will improve the collection of accurate data. Consulting with the end users is important in gaining the understanding of their needs. Also, maintaining the involvement of the end user will often result in an increased acceptance of the new process or new system to be used. When evaluating the computer system, identifying the appropriate end user is important. Receiving feedback from someone who will interact with the interface on a daily basis is a good resource. Tasks the users will be performing and how often these tasks will be performed, need to also be defined. Measurements should be established, such as the number of users performing the tasks, the time it takes to complete the tasks, and the number of errors made. Once these evaluation procedures are in place, a system can be designed and tested. After the initial testing, the interface should be analyzed using the same established evaluation criteria. The developers should make changes where necessary as identified from the analysis of the testing, then, repeat the testing and evaluation process until an acceptable user interface is developed. Designing health care information systems utilizing HCI methodologies and usability resources is a critical aspect of increasing patient safety. Well designed computer interfaces and systems allow for correct data entry, understanding the display of information, and assisting with making skillful clinical decisions, which results in reduced errors. Additionally, using HCI concepts ultimately has a positive return on investment to the organization by identifying time needed to complete tasks, time needed to train staff, and the level of support staff involvement. Utilizing these concepts will result in reducing the end users frustration with the system and increases their productivity. Studies prove the benefits and the value of using HCI concepts in developing computer systems. As healthcare organizations implement EMRs, it is imperative to understand the need for human factors in developing computer systems to ensure their systems and their users work together effectively and efficiently.

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Using Human Factors in Designing Forms for Paper or Electronic Documentation

April 5, 2012

Throughout this article, when reference is made to a form this will encompass whether it is a paper form or an electronic form, such as a screen in an electronic medical record system. Human factors focus on designing for human psychological, social, physical, and biological characteristics. Understanding who will be using the documentation tool, whether electronic or paper will enhance its function and understandability by the end-user. The definition of a form is the basic business tool whether printed or electronic for collecting and transmitting information. A form is the catalyst for getting things done, and the record of what was done. Utilizing human factors in forms design is critical to improving the success of the desired outcomes. Spending time and resources on usability testing improves the resulting documentation or use of the system. This will ultimately return improved data capture and reduces errors. At every step of the design process the designer must consider the end-user. For instance, if the end-user is an elderly patient with the possibility of having a disability, consideration must be made in the font size, typography, use of color, and use of plain language. If electronic and information technology is being delivered, following Section 508 standards should be considered. The requirement of this standard, at this time, is for federal agencies; however, it would be wise to consider these standards in all electronic systems for future needs and preparation of any necessary revisions. Plain language, appropriate typography, good layout and screen design may be very necessary for a form to succeed, but these characteristics alone are not sufficient to guarantee that it will work. Human factors and usability testing must be performed to know for sure if the desired results are being achieved. Just as in designing devices, designing forms to be used appropriately and efficiently, the design for the interaction between the user and the form must acknowledge the users’ capabilities, stress levels, work environment, and training needs. Forms must be designed to encourage cooperative responses and lead the form-filler through the form. If designed properly, forms should not cause confusion or inaccurate data gathering. The purpose of a good form is to collect or provide accurate information. If the form doesn’t do that, then it isn’t a good form. It isn’t fulfilling its purpose. Usability testing of forms will enhance the structure and design of the questions and layout of the form. Testing with end-users who are not familiar with the form will help to identify where confusion may be and where changes are needed to reduce errors and increase productivity. Not only is the productivity increased by the end-user, but also increased by the staff who is receiving the data captured on the form, which can be in multiple departments within an organization. Management spends a great deal of time making decisions based on the data it receives and much of this comes from forms. Management time is costly and forms should be designed to reduce labor content as much as possible. Yet forms cost far more than most people realize. Managers frequently see only the printing cost, or in the case of electronic forms, the design cost. Forms design is a critical aspect to optimal data capture. It is particularly interesting to me that when performing an analysis of the task, when designing a medical device, electronic medical record system, tool, or screen display on a medical device, the data from this analysis study is generally captured on a form. The use of a form is so vital to every business aspect and to optimal data capture which enables one to make decisions and to move processes through the workflow. I am surprised at how often people assume because they have a computer and a printer they are now a forms design professional and can design a form. Form analysis and designing requires a forms professional knowledgeable, not only in rules of design analysis for appropriate data capture and transmission, but must be knowledgeable in utilizing human factors and process analysis. This is a crucial area in reducing errors and increasing understandability. Whether the end-user is clinical, non-clinical, staff, the patient or family, this does not change the need for proper forms design. Forms affect everyone and play a very important role in every business process within an organization.

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Medication Errors

February 28, 2012

The nurse ”is the last line of defense” in preventing medication errors. One must read and reread and recheck all labels. In light of many errors in dosing recently in relation to the medication Heparin, one must read and reread and recheck all labels. The vials of Heparin state 1 unit dose. As a nurse you must check and recheck the orders, the dose, the patient, on all medications, If medication is prepared by the pharmacy, we must not take it for granted the mixture of medications is correct. We must be careful in rushing to give medication, must check and recheck everything, before administering any medication, Errors, do happen as nurses we are the last line of defense to catch these errors.

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When Will Technology Catch Up

December 9, 2010

The age of technology has made great strides in the medical profession, improving the care of patients and in many ways making bedside nursing more efficient.  I began my nursing career in the mid 1970’s, everything was done on paper, the lab would come and draw blood at 6 o’clock in the morning to tell us what a person’s blood glucose was for insulin coverage prior to the bedside glucose monitors we now have.  The younger nurses that I work with love to hear about the “old days when” from myself and other nurses who have been around for more than a decade.

As we go through our daily work week we have cat scan, x-ray, lab draw results continuously flowing through our computers, usually available within an hour of a patient being tested, allowing for further testing and treatment decisions that use to take up to 24 hours or longer for doctors to accomplish, are now accomplished during a single shift.

From Monday to Friday information flows smoothly most of the time, but then it is the weekend and it seems that time reverses and we are in another era.  This past weekend was my weekend rotation, I recall one patient in particular that was hoping to go home, his discharge was going to be determined by the results of  an echocardiogram that was done early Saturday morning.  His cardiologist came in at 1 o’clock, no report was available within the computer or when cardiac testing was called.  Sunday came and went, Monday morning the man was discharged.

This scenario was seen more frequently prior to the technology now available to us,  however it needs to be available seven days a week to give the best care possible and save money, the weekends need to catch up technologically with the Monday through Friday work week.

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Decisions in Healthcare: Man vs Machine

November 10, 2009

After reading the current blogs on medication administration I now have to question my desire to implement a dispensing system in our hospital and nursing home. Our administrative team has been looking over different EMR systems, including medication administration, to improve the patient care and efficiency in our facility. All of the vendors mention the time saving that happens with the electric medical records, and they all state that their systems will all but eliminate errors. It is interesting to hear from others with experience using these types of systems that the errors still occur. I concur that a computer is only as good and error free as the person entering the data, or the one using the machine. If each person included in the administration and delivery of the medication does not follow correct protocol, there will always be medication errors. The advent of machines does not take away the importance of learning and using correct procedure for delivery of medical care.

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