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Marcilly R, Schiro J, Genin M, Somers S, Migaud MC, Mabile F, Pelayo S, Del Zotto M, Rochat J. Detectability of use errors in summative usability tests of medical devices: Impact of the test environment. APPLIED ERGONOMICS 2024; 118:104266. [PMID: 38479216 DOI: 10.1016/j.apergo.2024.104266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 02/20/2024] [Accepted: 03/05/2024] [Indexed: 05/03/2024]
Abstract
The regulations on summative usability evaluations of medical devices (MDs) emphasize that the test environment must have sufficient ecological validity for generalization to real-life use. Here, we examined the influence of environmental fidelity (a component of ecological validity) on the detectability of MD use errors. A total of 140 participants participated in a summative usability evaluation of an anaphylactic shock auto-injector device under either a high-fidelity condition or a condition acceptable from the manufacturer's perspective, lower-fidelity condition. The numbers of errors detected in each condition were compared by applying descriptive statistics and logistic and Poisson multivariate regressions. We found that the level of fidelity did not influence the overall number of use errors detected but did influence the detection of certain use errors. To optimize the test environment and increase the detection of use errors, each environmental feature's role in the test task should first be examined.
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Affiliation(s)
- Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; Inserm, CIC-IT 1403, F-59000, Lille, France.
| | - Jessica Schiro
- Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; Inserm, CIC-IT 1403, F-59000, Lille, France
| | - Michael Genin
- Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - Stéphanie Somers
- Inserm, CIC 1403 - Centre d'investigation Clinique, Université de Lille, CHU de Lille, 59000, Lille, France
| | - Maria-Claire Migaud
- Inserm, CIC 1403 - Centre d'investigation Clinique, Université de Lille, CHU de Lille, 59000, Lille, France
| | | | - Sylvia Pelayo
- Univ. Lille, CHU Lille, ULR 2694, METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; Inserm, CIC-IT 1403, F-59000, Lille, France
| | - Marzia Del Zotto
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jessica Rochat
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Baumann S, Stone RT, Abdelall E. Introducing a Remote Patient Monitoring Usability Impact Model to Overcome Challenges. SENSORS (BASEL, SWITZERLAND) 2024; 24:3977. [PMID: 38931760 PMCID: PMC11207983 DOI: 10.3390/s24123977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Telehealth and remote patient monitoring (RPM), in particular, have been through a massive surge of adoption since 2020. This initiative has proven potential for the patient and the healthcare provider in areas such as reductions in the cost of care. While home-use medical devices or wearables have been shown to be beneficial, a literature review illustrates challenges with the data generated, driven by limited device usability. This could lead to inaccurate data when an exam is completed without clinical supervision, with the consequence that incorrect data lead to improper treatment. Upon further analysis of the existing literature, the RPM Usability Impact model is introduced. The goal is to guide researchers and device manufacturers to increase the usability of wearable and home-use medical devices in the future. The importance of this model is highlighted when the user-centered design process is integrated, which is needed to develop these types of devices to provide the proper user experience.
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Affiliation(s)
- Steffen Baumann
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA 50011, USA;
| | - Richard T. Stone
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA 50011, USA;
| | - Esraa Abdelall
- Department of Industrial Engineering, Jordan University of Science and Technology, Ar-Ramtha 3030, Jordan;
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3
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Pelayo S, Marcilly R, Bellandi T. Human factors engineering for medical devices: European regulation and current issues. Int J Qual Health Care 2021; 33:31-36. [PMID: 32991690 DOI: 10.1093/intqhc/mzaa103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/15/2020] [Accepted: 08/26/2020] [Indexed: 11/14/2022] Open
Abstract
A large proportion of the patient injuries or deaths attributable to medical device (MD) misuse can be eliminated and/or mitigated by adopting an effective human factors and ergonomics (HFE) approach. The implementation of a usability engineering process is now mandatory for MD manufacturers seeking to obtain the European Union's CE Mark. Here, we describe the European Union's HFE regulation and highlight the challenges faced by (i) manufacturers implementing this regulation and (ii) regulatory bodies charged with assessing the compliance of usability files. In Europe, 95% of MD manufacturers are small- and medium-sized enterprises; compliance with the CE Mark regulations is a real challenge to their competitiveness. Levels of knowledge about HFE vary greatly from one regulatory organization to another, which can sometimes lead to very different expectations. We also present the specific use-related risk management approach required by the HFE regulation. Lastly, we focus on the limitations of the HFE regulation for MDs and on future HFE challenges in further reducing and/or eliminating MD use errors. The main challenge is the need to go beyond technology design and the premarket assessment and to look at the postproduction stage; the coupling between an MD and a sociotechnical system can lead to consequences that were not predicted during the design process. This implies the need to consider the emerging properties of technologies in use by involving all the stakeholders.
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Affiliation(s)
- Sylvia Pelayo
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Institut Coeur Poumon, Bld Professeur J. Leclercg, F-59000, Lille, France.,INSERM CIC-IT 1403, Centre d'Investigation Clinique pour les Innovations Technologiques, Institut Coeur Poumon, Bld Professeur J. Leclercg, F-59000, Lille, France
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, Institut Coeur Poumon, Bld Professeur J. Leclercg, F-59000, Lille, France.,INSERM CIC-IT 1403, Centre d'Investigation Clinique pour les Innovations Technologiques, Institut Coeur Poumon, Bld Professeur J. Leclercg, F-59000, Lille, France
| | - Tommaso Bellandi
- Regional Centre for Clinical Risk Management and Patient Safety, Via Taddeo Alderotti 26/N, 50100, Florence, Italy
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Surma-Aho A, Hölttä-Otto K, Nelskylä K, Lindfors NC. Usability issues in the operating room - Towards contextual design guidelines for medical device design. APPLIED ERGONOMICS 2021; 90:103221. [PMID: 32823145 DOI: 10.1016/j.apergo.2020.103221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 12/16/2019] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Most usability assessments of medical devices describe the problems of individual devices in detail, but few account for the real context of use or provide designers with actionable guidelines for improvement. To fill this gap, this paper reports the results of a case study on the usability of operating room technologies and documents the creation of contextual design guidelines for operating room device design. We spent 64 h in a gynecological operating unit conducting interviews with staff and observing device use during surgery. With qualitative analysis methods and based on existing usability principles, we created 21 design guidelines for the operating room context. The new guidelines highlight interactions between multiple devices, staff members, as well as other contextual factors. While the guidelines require further validation, they can potentially support the creation of more safe, ergonomic, and intuitive medical devices.
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Affiliation(s)
- Antti Surma-Aho
- Aalto University Design Factory, Betonimiehenkuja 5 C, Espoo, Finland.
| | - Katja Hölttä-Otto
- Aalto University Design Factory, Betonimiehenkuja 5 C, Espoo, Finland
| | - Kaisa Nelskylä
- Helsinki University Hospital, Helsinki University, Haartmaninkatu 2, Helsinki, Finland
| | - Nina C Lindfors
- Helsinki University Hospital, Helsinki University, Topeliuksenkatu 5, Helsinki, Finland
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Parreira P, Sousa LB, Marques IA, Santos-Costa P, Cortez S, Carneiro F, Cruz A, Salgueiro-Oliveira A. Study Protocol for Two-Steps Parallel Randomized Controlled Trial: Pre-Clinical Usability Tests for a New Double-Chamber Syringe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:8376. [PMID: 33561056 PMCID: PMC7696070 DOI: 10.3390/ijerph17228376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022]
Abstract
A new double-chamber syringe (DUO Syringe) was developed for intravenous drug administration and catheter flushing. This study presents a protocol for pre-clinical usability tests to validate the golden prototype of this new device, performed in a high-fidelity simulation lab by nurses. A two-steps parallel randomized controlled trial with two arms was designed (with standard syringes currently used in clinical practice and with the DUO Syringe). After randomization, eligible and consented participants will be requested to perform, individually, intravenous drug administration and flushing, following the arm that has been allocated. The procedure will be video-recorded for posterior analyses. After the completion of the tasks, nurses will be asked to answer a demographic survey, as well as an interview about their qualitative assessment of the device. A final focus group with all participants will also be conducted. Primary outcomes will concern the DUO Syringe's effectiveness, efficiency, and safety, while secondary outcomes will focus on nurses' satisfaction and intention of use. The pre-clinical protocol was defined according to the legal requirements and ISO norms and was reviewed and approved by the Ethics Committee of the Health Sciences Research Unit: Nursing of the Nursing School of Coimbra.
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Affiliation(s)
- Pedro Parreira
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
| | - Liliana B. Sousa
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
| | - Inês A. Marques
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
- Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of CIMAGO, Faculty of Medicine, CIBB, University of Coimbra, 3000-354 Coimbra, Portugal
| | - Paulo Santos-Costa
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
| | - Sara Cortez
- Muroplás—Plastic Engineering Industry, 4745-334 Muro, Portugal;
| | - Filipa Carneiro
- PIEP—Innovation in Polymer Engineering, Guimarães, 4800-058 Braga, Portugal;
| | - Arménio Cruz
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
| | - Anabela Salgueiro-Oliveira
- The Health Sciences Research Unit, Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal; (P.P.); (I.A.M.); (P.S.-C.); (A.C.); (A.S.-O.)
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Miclăuş T, Valla V, Koukoura A, Nielsen AA, Dahlerup B, Tsianos GI, Vassiliadis E. Impact of Design on Medical Device Safety. Ther Innov Regul Sci 2020; 54:839-849. [PMID: 32557299 PMCID: PMC7362883 DOI: 10.1007/s43441-019-00022-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022]
Abstract
The growing number of emerging medical technologies and sophistication of modern medical devices (MDs) that improve both survival and quality of life indexes are often challenged by alarming cases of vigilance data cover-up and lack of sufficient pre- and post-authorization controls. Combining Quality with Risk Management processes and implementing them as early as possible in the design of MDs has proven to be an effective strategy to minimize residual risk. This article aims to discuss how the design of MDs interacts with their safety profile and how this dipole of intended performance and safety may be supported by Human Factors Engineering (HFE) throughout the Total Product Life-Cycle (TPLC) of an MD in order to capitalize on medical technologies without exposing users and patients to unnecessary risks.
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Affiliation(s)
- Teodora Miclăuş
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
| | - Vasiliki Valla
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
| | - Angeliki Koukoura
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
| | - Anne Ahlmann Nielsen
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
| | - Benedicte Dahlerup
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
| | | | - Efstathios Vassiliadis
- Evnia Group, Copenhagen Business Center, Hellerup Strandvejen 60, 2900, Copenhagen, Denmark
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Jiang KC, Mohedas I, Biks GA, Adefris M, Tadesse Adafrie T, Bekele D, Abebe Z, Kolli A, Weiner A, Davila J, Mengstu B, Bell C, Sienko KH. Assessing the Usability of a Task-Shifting Device for Inserting Subcutaneous Contraceptive Implants for Use in Low-Income Countries. J Med Device 2020. [DOI: 10.1115/1.4046092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Women in low- and middle-income countries (LMICs) have limited access to long-acting contraceptives. Access to long-acting contraceptives, such as subcutaneous contraceptive implants, could be increased by task-shifting implant administration from advanced to minimally trained healthcare providers. The objective of this study was to investigate the usability of a task-shifting device for administering subcutaneous contraceptive implants. Healthcare providers (n = 128) from multiple health centers in Ethiopia were trained to administer implants on an arm simulator with the traditional method and a method using the device. Participants were observed while inserting implants into the arm simulator, and procedural error rates were calculated. Observations were analyzed using an iterative inductive coding methodology. For the device-assisted method, minimally trained healthcare providers had larger procedural error rates than other professions (p = 0.002). For the traditional method, physicians had larger procedural error rates than nurses and midwives (p = 0.03). Several procedural errors were identified such as participants inserting and removing the trocar and plunger completely or inserting and/or removing the trocar too far or not enough. These findings reinforce the importance of performing formative usability testing during the early phases of a medical device design process, considering users' mental models, and avoiding assumptions about healthcare providers' abilities.
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Affiliation(s)
- Kevin C. Jiang
- Department of Biomedical Engineering, University of Michigan, 1101 Beal Avenue, Ann Arbor, MI 48109
| | - Ibrahim Mohedas
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109
| | - Gashaw Andargie Biks
- Department of Health Systems and Policy, Institute of Public Health, University of Gondar, P.O. Box 196, Gondar 6200, Ethiopia
| | - Mulat Adefris
- Department of Obstetrics and Gynecology, University of Gondar, P.O. Box 196, Gondar 6200, Ethiopia
| | - Takele Tadesse Adafrie
- Department of Epidemiology and Biostatistics, University of Gondar, P.O. Box 196, Gondar 6200, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, P.O. Box 1271, Gulele Addis Ababa 1000, Ethiopia
| | - Zerihun Abebe
- Office of the Provost, St. Paul's Hospital Millennium Medical College, P.O. Box 1271, Gulele Addis Ababa 1000, Ethiopia
| | - Ajay Kolli
- Medical School, University of Michigan, 1301 Catherine Street, Ann Arbor, MI 48109
| | - Annabel Weiner
- School of Information, University of Michigan, 105 South State Street, Ann Arbor, MI 48109
| | - José Davila
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109
| | - Biruk Mengstu
- College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Carrie Bell
- Department of Obstetrics and Gynecology, University of Michigan, 4260 Plymouth Road, Ann Arbor, MI 48109
| | - Kathleen H. Sienko
- Department of Mechanical Engineering, University of Michigan, 2350 Hayward Street, Ann Arbor, MI 48109
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Sampaio ÁM, Simões P, Arezes P, Pontes AJ. Hand-Product Contact Point Detection on Surgical Instruments – A User Evaluation. ERGONOMICS IN DESIGN 2019. [DOI: 10.1177/1064804619862677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The interaction of hand tools with the user is crucial and a key factor for his or her performance. In specific medical devices like surgical instruments, it is also important to ensure patient safety, namely, to avoid the risk of a surgical instrument’s being left inside a body. This article investigates the patterns of hand-to-product contact areas by identifying the potential locations to couple an external add-on tracing device on surgical instruments. A user evaluation study was conducted to determine the contact areas between the surgeons’ hands and different surgical instruments. The methodology, the results, and a discussion are described below.
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Estock JL, Pham IT, Curinga HK, Sprague BJ, Boudreaux-Kelly MY, Acevedo J, Jacobs K. Reducing Treatment Errors Through Point-of-Care Glucometer Configuration. Jt Comm J Qual Patient Saf 2018; 44:683-694. [PMID: 30064953 DOI: 10.1016/j.jcjq.2018.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Blood glucose (BG) testing is the most widely performed point-of-care (POC) test in a hospital setting. Multiple adverse events reported to the Food and Drug Administration (FDA) revealed that treatment decisions may be affected by information displayed on the POC glucometer's results screen. A randomized, crossover simulation study was conducted to compare two results screen configurations for ACCU-CHEK Inform II, a POC glucometer. METHODS Prior to the study, a heuristic evaluation of the results screen configurations and a pilot study were conducted to select the two results screen configurations for comparison. At two multicampus medical centers, 66 nurse participants experienced two computer-based simulation scenarios that asked them to interpret glucometer readings and make treatment decisions for simulated patients with 32 mg/dL BG levels and subtle symptoms of hypoglycemia. One scenario displayed a numeric value ("32 mg/dL"), and the other displayed a range abbreviation, such as "RR LO" (out of reportable range; low). Treatment errors were recorded when the participant did not treat the hypoglycemic patient with glucose or when they administered insulin. RESULTS When ACCU-CHEK Inform II displayed an "RR LO" reading, 10.6% of participants made a treatment error, including 6.7% of participants with prior training on the meaning of an "RR LO" reading. None of the participants made a treatment error when ACCU-CHEK Inform II displayed a "32 mg/dL" reading. CONCLUSION Displaying a numeric BG reading eliminated potentially life-threating treatment errors caused by confusing range abbreviations. Manufacturers should consider these findings during future research and development of POC glucometers.
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Affiliation(s)
- Jamie L Estock
- Center for Medical Product End-user Testing, VA [US Department of Veterans Affairs] Pittsburgh Healthcare System (VAPHS), Pittsburgh.
| | - Ivan-Thibault Pham
- Center for Medical Product End-user Testing, VAPHS, is User Researcher, Bose Corporation, Framingham, Massachusetts
| | | | - Benjamin J Sprague
- Quality and Patient Safety, Medicine Service Line, VAPHS, is Clinical Instructor of Medicine, Division of General Internal Medicine, University of Pittsburgh Medical Center
| | | | | | - Katrina Jacobs
- VA National Center for Patient Safety, Ann Arbor, Michigan. Please address correspondence to Jamie Estock
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Valdez RS, McGuire KM, Rivera AJ. Qualitative ergonomics/human factors research in health care: Current state and future directions. APPLIED ERGONOMICS 2017; 62:43-71. [PMID: 28411739 DOI: 10.1016/j.apergo.2017.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 06/07/2023]
Abstract
The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care.
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Affiliation(s)
- Rupa Sheth Valdez
- Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Hospital West Complex, Charlottesville, VA 22908, USA.
| | - Kerry Margaret McGuire
- Habitability and Human Factors Branch, NASA's Johnson Space Center, 2101 NASA Parkway, Houston, TX 77058, USA.
| | - A Joy Rivera
- Knowledge and Systems Architect Team, Information Management Services, Children's Hospital of Wisconsin, 9000 W. Wisconsin Ave., Milwaukee, WI 53226, USA.
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Howard S, Lang A, Sharples S, Shaw D. See I told you I was taking it! - Attitudes of adolescents with asthma towards a device monitoring their inhaler use: Implications for future design. APPLIED ERGONOMICS 2017; 58:224-237. [PMID: 27633217 DOI: 10.1016/j.apergo.2016.06.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 06/06/2023]
Abstract
Adherence to treatment in asthma is often poor, particularly in adolescents and children where the condition is most prevalent. Electronic monitoring devices have shown potential for improving inhaler use, yet little research has considered the attitudes of patients towards these devices. We gave seven adolescents with asthma an electronic monitoring device to use for one month and collected their views on important issues including monitoring and data sharing. Our results showed that participants felt positively about using the data to demonstrate responsibility for their condition to both their parents and medical professionals, but expressed concern for the attention the device's appearance could draw to them and their asthma. This paper considers the positive and negative perceptions of this novel device and provides new insight into the attitudes of adolescents towards inhaler monitoring, as well as future directions for design and development of monitoring devices for asthma and other chronic medical conditions.
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Affiliation(s)
- Sam Howard
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - Alexandra Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Sarah Sharples
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Dominick Shaw
- Division of Respiratory Medicine, School of Medicine, Nottingham City Hospital, University of Nottingham, Nottingham, NG5 1PB, UK
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12
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Harvey C, Koubek R, Bégat V, Jacob S. Usability Evaluation of a Blood Glucose Monitoring System With a Spill-Resistant Vial, Easier Strip Handling, and Connectivity to a Mobile App: Improvement of Patient Convenience and Satisfaction. J Diabetes Sci Technol 2016; 10:1136-41. [PMID: 27390222 PMCID: PMC5032967 DOI: 10.1177/1932296816658058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Proper management of diabetes mellitus requires regular self-monitoring of blood glucose (SMBG). This research evaluated the usability of the Accu-Chek® Guide Meter that includes a spill-resistant vial, easier strip handling, and wireless connectivity to a mobile app. METHODS A total of 197 participants were allowed to experience typical blood glucose testing tasks on the Accu-Chek Guide Meter, review data such as last result, patterns, and target percentage on the meter and on the mobile app, and then evaluate their experience through a human factors usability survey. Participants used a 6-point agree/disagree scale to rate 34 market statement questions. RESULTS The results of a Pearson chi-square proportions test for each of the 34 market statement questions showed a significant difference (P < .0001) between the disagree responses (1-3) and agree responses (4-6). An overwhelming majority of participants found all aspects of the system, including the test strips, strip vial, and data analysis on the meter and the mobile app, to be a good fit for their lifestyle and to provide a better testing experience. CONCLUSIONS This study found superior usability of the new meter system over the participants' current meters in both the United States and France.
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Affiliation(s)
- Craig Harvey
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge, LA, USA
| | | | - Vanessa Bégat
- Department of Mechanical and Industrial Engineering, Louisiana State University, Baton Rouge, LA, USA
| | - Stephan Jacob
- Cardio Metabolic Institute, Villingen-Schwenningen, Germany
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14
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Schnittker R, Schmettow M, Verhoeven F, Schraagen JMC. Combining situated Cognitive Engineering with a novel testing method in a case study comparing two infusion pump interfaces. APPLIED ERGONOMICS 2016; 55:16-26. [PMID: 26995032 DOI: 10.1016/j.apergo.2016.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/08/2015] [Accepted: 01/11/2016] [Indexed: 06/05/2023]
Abstract
We validated the usability of a new infusion pump interface designed with a situated Cognitive Engineering approach by comparing it to a reference interface using a novel testing method employing repeated measurements and process measures, in addition to traditional outcome measures. The sample consisted of 25 nurses who performed eight critical tasks three times. Performance measures consisted of number and type of errors, deviations from a pre-established normative path solution, task completion times, number of keystrokes, mental effort and preferences in use. Results showed that interaction with the new interface resulted in 18% fewer errors, 90% fewer normative path deviations, 42% lower task completion times, 40% fewer keystrokes, 39% lower mental effort and 76% more subjective preferences in use. These outcomes suggest that within the scope of this case study, combining the situated Cognitive Engineering approach with a novel testing method addresses various shortcomings of earlier testing methods.
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Affiliation(s)
- R Schnittker
- Department of Cognitive Psychology and Ergonomics, Faculty of Behavioural, Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | - M Schmettow
- Department of Cognitive Psychology and Ergonomics, Faculty of Behavioural, Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | - F Verhoeven
- Institute for Engineering and Design, Utrecht University of Applied Sciences, P.O. Box 182, 3500 AD Utrecht, The Netherlands.
| | - J M C Schraagen
- Department of Cognitive Psychology and Ergonomics, Faculty of Behavioural, Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Department of Human Behaviour and Organisational Innovation, TNO Earth, Life and Social Sciences, P.O. Box 23, 3969 ZG Soesterberg, The Netherlands.
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Furniss D, Masci P, Curzon P, Mayer A, Blandford A. Exploring medical device design and use through layers of Distributed Cognition: How a glucometer is coupled with its context. J Biomed Inform 2015; 53:330-41. [DOI: 10.1016/j.jbi.2014.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 12/01/2014] [Accepted: 12/15/2014] [Indexed: 12/19/2022]
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16
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Flores-Vaquero P, Tiwari A, Alcock J, Hutabarat W, Turner C. A product-service system approach to telehealth application design. Health Informatics J 2014; 22:321-32. [PMID: 25466775 DOI: 10.1177/1460458214558313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A considerable proportion of current point-of-care devices do not offer a wide enough set of capabilities if they are to function in any telehealth system. There is a need for intermediate devices that lie between healthcare devices and service networks. The development of an application is suggested that allows for a smartphone to take the role of an intermediate device. This research seeks to identify the telehealth service requirements for long-term condition management using a product-service system approach. The use of product-service system has proven to be a suitable methodology for the design and development of telehealth smartphone applications.
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17
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Blandford A, Furniss D, Vincent C. Patient safety and interactive medical devices: Realigning work as imagined and work as done. ACTA ACUST UNITED AC 2014; 20:107-110. [PMID: 25866466 PMCID: PMC4361486 DOI: 10.1177/1356262214556550] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Medical devices are essential tools for modern healthcare delivery. However, significant issues can arise if medical devices are designed for ‘work as imagined’ when this is misaligned with ‘work as done’. This problem can be compounded as the details of device design, in terms of usability and the way a device supports or changes working practices, often receives limited attention. The ways devices are designed and used affect patient safety and quality of care: inappropriate design can provoke user error, create system vulnerabilities and divert attention from other aspects of patient care. Current regulation involves a series of pre-market checks relating to device usability, but this assumes that devices are always used under the conditions and for the purposes intended (i.e. work as imagined); there are many reasons for devices being used in ways other than those assumed at development time. Greater attention needs to be paid to learning points in actual use and user experience (i.e. work as done). This needs to inform manufacturers’ designs, management procurement decisions and local decisions about how devices are used in practice to achieve co-adaptation; without these, we foster risks and inefficiencies in healthcare.
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Affiliation(s)
- Ann Blandford
- UCL Interaction Centre, University College London, London, UK
| | - Dominic Furniss
- UCL Interaction Centre, University College London, London, UK
| | - Chris Vincent
- UCL Interaction Centre, University College London, London, UK
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