Human Factors in Healthcare Blog

In no particular order, here is what I learned this summer:

1. All cars sold to haul kids on vacation trips should have “glass wall” options like taxis to close off the back seat noise and shrapnel
2. If someone says they are car sick, it is better to stop and spend 5 minutes for a short walk than to clean vomit for 15 minutes
3. GPS systems can be wrong…really, really wrong:  “turn left onto the (non-existent) ferry”
4. Seemingly small wayfinding and other design flaws in hospitals can grow large when your friend or brother are sick
5. Medical residents are getting more and more savvy about patient safety (this is a good thing)
6. Medical residents are impatient with progress in patient safety (this is a great thing)
7. You can say you are going to write blog posts every week, then life happens

For those (still) reading my posts, I am going to upgrade the system to make sure you get announcements of my new posts.  For those about to read my posts, I am going to improve my marketing and networking to inspire me to continue my posts more regularly.

My son decided to stress test his parents with 60% body rash last Saturday.  We keep a pretty “clean” and food consistent house due to our daughters allergies to 9 food ingredients (from peanuts to poppy seeds!).  So, we could not figure out the rash and were worried it could “spread” to his respiratory system (this has happened with our daughter).  On Sunday, 5AM, his rash worsened and moved into his eyelid area and mouth.

Every time I visit the emergency room with a family member, I cannot dismiss the fact I know that colleagues of mine study the relative design chaos that “lives here”.  Plus, sifting out the bad illnesses from horrible illnesses from run-of-the-mill illnesses is not that easy.  Missing diagnosis is a common reliability issue with super experts, much less someone half asleep and over-worked.

In short, after six physicians in three settings across 2 days saw my son with 40-60% body and facial rash, we took prednisilone and Benadryl until he was bouncing off the walls!  Even though the medications did not seem to work at first, in a few days he was back to his normal bouncing-off-the-walls self, with no rash.

The hardest thing for my wife and I was keeping track of the medication and dosing.  6.25 ml of Prednisilone…really?   10 mL Benadryl as every 6 hours, 5mL Ranitidine as every 8 hours, and 6.25 (then 5mL) Prednisilone as every 12 hours (or twice a day).  Oh, and sometimes we forgot one and then gave it, but 2 hours off cycle.  Needless to say, we used paper medication records to keep track and still messed up (double doses and missed doses).  Anyone who can figure out how to design a way out of this design mess, in a robust, usable, and well-accepted by physicians, will be a billionaire!

Oh, yeah, the markings on the picture of that medication measuring cup are kind of hard to see.  REALLY exciting at 2AM!

Any of you helping your child with grade school homework have experienced feelings of surprise, pride, irritation, and nausea.  Surprise and pride over the depth of questions.  Irritation and nausea over our limitations in answering the so-called simple questions.

Last night my daughter needed my review of her 5th grade essay on convincing others to visit a place that she loved.  She loves writing stories and has a very interesting style that is born out of watching Pokeman and reading Hardy Boy books.  I quickly noticed that her essay was actually a first person account of our trip to Universal Studios – not in the systematic, 5-paragraph, and outline-driven style of pursuasive essays.  As I pushed her to write an outline, she kept pushing me with questions that challenged the useful nature of this style.  Her toughest question: “will they read it if it’s organized, but boring”.  She wasn’t arguing to turn it into a cartoon or music video…she just wanted “data” that standard essay was more effective than story narrative (with surprising twists and lots of action words).  We finally agreed that she could have elements of both styles.

This interaction got me thinking about how I have watched people actually read “stuff”.  From journal articles to small booklets to huge handbooks, how do people actually interact with various formats.  I’ve seen many usability studies of devices and software where the users manual or quick reference guide were used in very interesting ways (i.e., non-linear).  A few trends I’ve seen:

1. People thumb through and skim — not study
2. Pictures and big headlines are eye “stops”
3. One page guides are almost NEVER flipped over

 So, the cleverness and time needed to create useful written guidance should equal the resources to create the words themselves.  Asking 10 year old kids will reveal this…and, doing usability tests in a way that allows people to read and be guided as they would in real life.