Designing the design phase of critical care devices: a cognitive approach.
Designing the design phase of critical care devices: a cognitive approach.
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设计重症监护设备的设计阶段：认知方法。
DOI：
10.1016/j.jbi.2004.11.001
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Patel,VimlaL
中科院分区：
文献类型：
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作者：
Malhotra,Sameer;Laxmisan,Archana;Keselman,Alla;Zhang,Jiajie;Patel,VimlaL
在这项研究中，我们展示了如果在设计阶段考虑到患者管理中涉及的各种认知因素，如何使用于患者护理的医疗器械更安全。本文的目的是描述一种方法，用于获得患者的安全功能的见解，来自机构决策的调查，可以纳入医疗器械的设计者。产品的设计周期，无论是医疗器械、软件还是任何类型的设备，在概念和过程上都是相似的。通过一系列步骤，我们获得了与医疗差错和患者安全相关的信息。然后利用这些来定制通用设备设计周期，以改善重症监护设备的生产。首先，我们为在大型医院的临床、行政和工程领域具有不同专业水平的个人提供了假设的临床场景，每个场景描述了涉及医疗专业人员和医疗器械的医疗错误事件。然后，我们要求受试者在阅读每个场景时“大声思考”。使用一组问题作为探针，然后我们要求我们的受试者识别关键错误并将其归因于不同的玩家。我们记录并转录了这些反应，并对每个场景进行了认知任务分析，以确定不同的实体是“恒定的”、“部分可修改的”还是“可修改的”。我们比较了受试者对任务分析结果的反应，然后将它们映射到可修改的实体。最后，我们对这些实体与医疗器械错误的关系进行了编码。我们建议将这些可修改的实体纳入器械设计周期可以改善器械最终产品，以更好地进行患者安全管理。
In this study, we show how medical devices used for patient care can be made safer if various cognitive factors involved in patient management are taken into consideration during the design phase. The objective of this paper is to describe a methodology for obtaining insights into patient safety features—derived from investigations of institutional decision making—that could be incorporated into medical devices by their designers. The design cycle of a product, be it a medical device, software, or any kind of equipment, is similar in concept, and course. Through a series of steps we obtained information related to medical errors and patient safety. These were then utilized to customize the generic device design cycle in ways that would improve the production of critical care devices. First, we provided individuals with different levels of expertise in the clinical, administrative, and engineering domains of a large hospital setting with hypothetical clinical scenarios, each of which described a medical error event involving health professionals and medical devices. Then, we asked our subjects to “think-aloud” as they read through each scenario. Using a set of questions as probes, we then asked our subjects to identify key errors and attribute them to various players. We recorded and transcribed the responses and conducted a cognitive task analysis of each scenario to identify different entities as “constant,” “partially modifiable,” or “modifiable.” We compared our subjects’ responses to the results of the task analysis and then mapped them to the modifiable entities. Lastly, we coded the relationships of these entities to the errors in medical devices. We propose that the incorporation of these modifiable entities into the device design cycle could improve the device end product for better patient safety management.