This study investigates the role of the anesthesiologist as designers to create new avenues of communication, co-operation and education between clinicians and design related expertise. In this study a comparison is made of how nine anesthesiologists envisage the anesthesia machine as a prototype composition relevant to their specialization, experience, and environment. Currently clinicians are trained to modify their behavior to meet equipment requirements (Dalley et al. 2004); this research seeks to balance established approaches to take into account established behavior, previous experiences, habits and the capability of simulation validation. In recognizing the anesthesia machine must cater to all specializations and levels of expertise, the question for this study is: can clinician prototyping and simulated use provide design themes consistent with current equipment and workplace layout, published studies or new innovation? INTRODUCTION An awkward design evolutionAnesthesia’s history of clinician inspired design is similar to the development of many biomedical devices that originated from clinical needs and clinician invention. Today’s anesthesia machine stems from early hand held devices and now largely conforms to a table and chassis format derived in the 1930s. However in the last 40 years the design of anesthesia equipment has become constrained by the complexities of technology, regulation and standardization for safe use. Technological advances have “widened the gap between the load of information and the quality of its delivery” leading to emerging technologies negatively affecting healthcare safety through inadequate design (Kohn et al., 2003; Kiefer & Hoeft, 2010). Contradicting the digital revolution, the ergonomic layout is awkward as a result of its design evolution where technological devices for anesthesia delivery and patient monitoring have been applied with little regard to ergonomics encountered in procedural diversity and vigilance (Westhorpe, 1992; Calkins,1992). The current design approach delivers complex equipment in a legacy format as a standardization in recognizable form, components and perceived safe use that diminishes the importance of ergonomic work methods (Weinger, 1999). In the last decade, evidence of continued investigation is limited, suggesting that ergonomic problems are either risky to resolve, dependant on technology advances, or ignored. This paper first questions design issues surrounding this awkward precedent and second, develops a relationship centered methodology, engaging and connecting the professions of design and anesthesiology with the technologies and practices of simulation and prototyping. We hypothesize that a new partnership methodology with anesthesiologists should improve the clinicians’ ability to efficiently and effectively communicate potential future directions.Relevance and motivationThe physical and procedural needs of the clinicians’ workplace have received variable input in the design of equipment with emphasis being placed on engineering and screen based digital interaction (Kiefer & Hoeft, 2010). This brings about situations where the anesthesiologists must both physically and cognitively adapt to the equipment as the user adapts to a variety of clinical situations (Weinger 1999). The anesthetic machine is a physical composition that presents operational controls and sensory feedback. There has been no fundamental change in its structural form (a 4 wheeled trolley with table, storage draws and mechanisms for the delivery and monitoring of anesthesia) over the last 80 years. However new anesthetic machines have replaced many physical interactions with monitor based activities that increase the training and operational requirement for users as new features are layered upon existing features. Consequently this can mask the anesthesiologists understanding of safe operation in both normal and critical situations (Dalley et al., 2004). This raises the need for
展开▼
