Healthcare users are a demanding group. Multiple beeping and blinking devices, frequent interruptions, competing demands, and high-risk tasks overload their cognitive capacity, leaving them with little patience for ambiguity or inefficiency and - more importantly - at risk for making serious errors. We will introduce participants to the factors motivating healthcare technology users by offering a peek into the world of a busy nurse and showing examples of the tragic errors that can result when overload occurs. We then propose six design principles based in cognitive theory and illustrated with real world examples as a framework to help UX designers motivate healthcare technology users by minimizing cognitive load. Participants will leave the session with actionable knowledge they can apply to current projects.
4. EHR Example
Lab Result
K+
(3.1 mEQ/L)
Dr. A
IV K+ Order 1
(40 meQ over 4 hr)
Dr. A
IV K+ Order 2
(100 meQ addition to existing fluid)
Dr. A
Attempted to cancel first order
(cancelled a similar order by mistake)
Pharmacy
Filled Order 1
Changed Order 2
(too much K+, used 80 meQ)
Nurse(s)
Carried out Order 1
Carried out Order 2
(40 meQ IV bolis and 80 meQ/L drip started}
Dr. B
Mistakes low K + lab result as
NEW
Treats for low K+
Patient
K+
(7.8 mEQ/L, normal = 3.7-5.2 mEQ/L)
Shift Change
36 hours later
!
!
! !
!
(ONC, Health IT: Patient Safety Action & Surveillance Report, 2013: p.4)
5. Human use errors are NOT a tiny problem
Institute of Medicine, 2000, To Err is Human
44,000 – 98,000 deaths/year
Approximately one full 747 crashing every day
6. Human use errors are NOT a tiny problem
Institute of Medicine, 2012, Best Care at Lowest Cost
North Carolina: 18% of hospital patients are harmed
Medicare: 14% of hospital patients harmed
Classen et al: 33% of hospital patients harmed
Estimated 86% of adverse events are unreported!
James, 2013, Journal of Patient Safety
New estimate of preventable deaths: 210,000 –
400,000/year
Preventable incidents of “serious harm”: 2 – 8 million/year
8. Designing for the Context of Use
“Standards for drugs and medical devices
concentrate on safe design and production,
with less attention to their safe use [in context].”
- Institute of Medicine, To Err is Human,1999
9. We’re not in Kansas Anymore!
Fear of Litigation
Infection Control
Heavy Regulation
High Risk Tasks
Multi-Tasking
Time Critical Tasks
Mistakes = Lives
High Accountability
Sleep Deprivation
Complicated Technology
Multi-Disciplinary Teams
10. An inside look at the
healthcare environment…
Trauma Patient Video
13. What Did You Notice?
The need for speed
Frequent interruptions/multi-tasking
Multiple handoffs
Multiple, diverse players
Lots of equipment, all with unique UIs
The pressure to get it right
14. An inside look at the
healthcare environment…
ICU Nurse Video
17. What Did You Notice?
The pressure for accuracy
Frequent interruptions/multi-tasking
Lots of equipment, all with unique UIs
Multiple, diverse players
Training during task performance
18. User’s Motivations: Comparison Across Industries
Online Retail Social Media Healthcare
Need for speed Med Med to High Extremely High
Need for accuracy Med to High Low Extremely High
Consequence of
slow response
Low Low to Med
Med to Extremely
High
Consequence of
error
Med Low to Med
Med to Extremely
High
User stress level
Low Low to Med
Med to Extremely
High
Environmental
distractions
Low to Med Low to Med
Med to Extremely
High
Variety of
technology
Low Low Extremely High
19. How do we create
technology for this unique
user group & complex
context?
21. Cognitive Load
Whitenton, K. (2013). Minimize Cognitive Load to Maximize Usability. Article published online.
Cognitive Load:
The amount of mental resources required
to operate the system
22. 3 Kinds of Cognitive Load
Intrinsic
Load
1 Extrinsic
Load
2 Germane
Load
3
Problem
complexity
- Starting an IV
- Using a
defibrillator
- Conducting
robotic
surgery
Unrelated
working
memory
load
- Distractions
- Mental notes
- Conversation
Processing
memory going
towards building
LTM schema
- How is this IV
pump different
from the one I just
used next door?
- How do I hold this
transducer at
each stage of
insertion
23. Cognitive Load is Cumulative
+
Intrinsic
Load
Extrinsic
Load
Germane
Load+ =
Total
Cognitive
Load
24. Cognitive load affects performance
Performance Drop with Cognitive Overload
Mental Capacity
Cognitive Demand
(Total Cognitive Load)
Performance
Drews, FA et al (2009). Text messaging during simulated driving behavior. Human Factors, 51, 762-770.
Pashler, HE (1984). Processing stages in overlapping tasks: Evidence for a central bottleneck.
J of Experimental Psychology: Human Perception and Performance, 1, 395-403.
Wickens, CD (1991). Processing resources and attention. In D. Damos (ed.), Multiple-task performance,
p3-34. London, UK: Taylor & Francis.
26. Don’t Try This at Home
Procedural Task
Create a new contact for “Jane Doe”
Phone number: 800-555-9634
27. Distraction
Don’t Try This at Home
Procedural Task
Create a new contact for “John Doe”
Phone number: 800-555-5678
Cognitive Task
Count by 2s
28. What if these were health care tasks?
Procedural Task
Setup an IV
Cognitive Task
Calculate fluid rate
Answer patient questions
Distraction
Child crying
Overhead page
29. Humans have limited
cognitive capacity… but
the cognitive demands
on healthcare workers
continue to increase
Capacity
The Conflict
32. Design Rules for Reducing Cognitive Load
Be Simple
1
Be Consistent
5
Be a Team Player
6
Be Helpful
2
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Smart
Be Calm
4
3
33. Design Rules for Reducing Cognitive Load
Be Simple
1
Be Consistent
5
Be a Team Player
6
Be Helpful
2
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Smart
Be Calm
4
3
37. Be Minimal
Less is more
Show only what you really need
Group related information
Use a clean visual design
Be Direct
Careful use of abbreviations
Careful use of icons
Make alert states obvious
Be Simple
1
38. Be Direct – use obvious alert states
Be Simple
1
FusionCharts Patient Monitoring System
40. Provide Guidance
Through the workflow
Next steps
Access to help
Be Helpful
2
41. Be Helpful
2
Before: Where do I start? Where can I get help?
Provide Guidance - Provide a place to start
On Off
Button Button Button
Button Button
Complex
Information
Display
StatusDisplay
ON
ON
ON
ON
StatusDisplay
ON
ON
Link Link Link Link
43. Provide Guidance
Through the workflow
Next steps
Access to help
Prevent Errors
Make it obvious
Make it easy
Make it “dummy-proof”
Prevent omissions
Be Helpful
2
“When you are stressed
out, [making it] dummy
proof is better.”
– OR Nurse
46. Design Rules for Reducing Cognitive Load
Be Simple
1
Be Consistent
5
Be a Team Player
6
Be Helpful
2
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Smart
Be Calm
4
3
47. Technology should serve as a natural extension of our task
performance rather than a barrier to overcome.
Be Smart
3
48. Be a Natural Extension
… of the user
Hold information in memory for the user
Perform calculations for the user
… of the task
Providing the right tools at the right time
Recognize errors or alert conditions
Be easy to ignore when not needed
Be difficult to ignore when there’s danger
Be Smart
3
49. Be Smart
3
Lab
K+
(3.1 mEQ/L)
Dr. A
IV K+ Order 1
(40 meQ over 4 hr)
Dr. A
IV K+ Order 2
(100 meQ addition to existing fluid)
Dr. A
Attempted to cancel first order
(cancelled a similar order by mistake)
Pharmacy
Filled Order 1
Rejected Order 2
(too much K+, suggested 80 meQ)
Nurse(s)
Carried out Order 1
Carried out Order 2
(80 meQ/L drip and 40 meQ IV bolis started}
Dr. B
Mistakes lab result as NEW
Treats for low K+
Patient
K+
(7.8 mEQ/L)
Normal K+ Level: 3.7-5.2 mEQ/L
Shift Change
36 hours later
!
!
!
!
!
EHR:
- Recognize patient already has
fluids and suggest Order 2 to
reduce pain.
EHR:
- Recognize unsafe levels of K+
EHR:
- Recognize unsafe levels of K+
EHR:
- Recognize unsafe levels of K+
EHR:
- Better shift change updates & alerts
- Improved usability around date &
time on lab results
- Recognize unsafe levels of K+
51. Be Attractive
Use soothing colors
Use a neutral color palette
Provide ample white space
Be Calm
4
“We assume if it looks nice,
it’s a good product.”
- OR Nurse
56. Be Attractive
Use soothing colors
Use a neutral color palette
Provide ample white space
Be Mindful
Careful use of animation
Pay attention to use of audio
Avoid causing “alarm fatigue”
Be Calm
4
57. Be Mindful – of audio and animation use
Be Calm
4
58. Design Rules for Reducing Cognitive Load
Be Simple
1
Be Consistent
5
Be a Team Player
6
Be Helpful
2
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Smart
Be Calm
4
3
60. Provide simple, consistent workflows
Within the design
Across your product line
Across similar medical devices
With users’ expectations
Be Consistent
5
61. Within and between your product(s)
Be Consistent
5
Use templates and style guides
62. Within and between your product(s)
Be Consistent
5
Inventory interaction behaviors
(alerts, modes, button states, controls, feedback, etc.)
63. With users’ expectations
Be Consistent
5
Measure users’ mental models
64. With users’ expectations and needs
Be Consistent
5
Interview and observe users in context
65. Be a Team Player
6
Recognize that you are part of a technology team…
whether you want to be or not
66. Be a Team Player
6
The product team’s world view
Our Other
Awesome
Product
ACME
Our Other
Awesome
Product
ACME
Our New Awesome Product
ACME
Competing
Product
Competing
Product
Competing
Product
Competing
Product
Competing
Product
Related
Product
Related
Product
Related
Product
Related
Product
67. Our New
Awesome
Product
ACME
Our New
Awesome
Product
ACME
Be a Team Player
6
The user’s world view
Competing
Product
Our Other
Awesome
Product
ACME
Related
Product
Related
Product
Related
Product
Competing
Product
Competing
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product Unrelated
Product
Unrelated
Product
Our Other
Awesome
Product
ACME
Related
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product
Unrelated
Product Unrelated
Product
Unrelated
Product
Policy
Safety
Patient
Management
Stress
Management
Accuracy
Efficiency
Protocols
Regulation
Interpersonal
Relationships
Risk
Record Keeping
Fatigue
Human
Emotions
Distractions
Quality
68. Take a systems engineering perspective
Avoid local success, global failure
Consider the other technology being used in conjunction with yours
Competitors’ products
Other products from your company
Non-related technology (smart phones, tablets, medical devices, EHRs,
patient monitors, etc.)
Each technology might have their own unique
Workflows
Audio sounds
Visual alerts
Icon sets & color palette
How will your product fit in with the existing technology?
Be a Team Player
6
69. Be a Team Player
6
then find a way to complement rather than compete
Study competitors, related products, industry standards,
and the use environment…
70. Be a Team Player
6
Be different ONLY if you improve the global user experience.
Don’t be different, just to be different.
71. Design Rules for Reducing Cognitive Load
Be Simple
1
Be Consistent
5
Be a Team Player
6
Be Helpful
2
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Smart
Be Calm
4
3
72. How do I know if my
design’s cognitive load is
manageable?
73. Evaluating Your Design for Cognitive Load
Common methods used in uncommon ways
Design Review
Cognitive Walkthrough
Simulated Use Usability Testing
Field Research
Competitive Product Review
Direct Observation
74. Evaluating Your Design for Cognitive Load
Minimalism
Abbreviation & icon use
Consistency across screens & workflows
Intrinsic
Load
Extrinsic
Load
Germane
Load
Design Reviews
Cognitive Walkthrough
Guided workflows
Paths for novice v. expert users
Contextually-specific use cases (e.g., surgery,
ER, home care)
Intrinsic
Load
75. Evaluating Your Design for Cognitive Load
Simple to use
Easy interpretation of status
Obvious next steps
To ensure workflows and content are accurate
and useful
To test audio and animation use
To ensure product is usable when used in
conjunction with other technology
To ensure product is easy to learn when
experienced with other brands or past versions
Extrinsic
Load
Germane
Load
Simulated Usability Testing
Intrinsic
Load
76. Evaluating Your Design for Cognitive Load
Task performance in a realistic setting
Simulation lab in a medical facility
Research lab modified to mimic use setting
Real world environment
With a realistic level of cognitive load
Distractions
Ambient Noise
Interruptions (major and minor)
Multi-tasking
Finger or foot tapping while performing task
Reading the time from a wall clock when each step of task is
performed
With appropriate pre-use training
Intrinsic
Load
Extrinsic
Load
Germane
Load
Simulated Usability Testing
77. Evaluating Your Design for Cognitive Load
Task analysis
Workflows
Context analysis
Extrinsic
Load
Germane
Load
Field Research: Pre-design
Competitive Product & Regulation Review
Industry standards
Regulatory guidelines
78. Considering Cognitive Load During Design Validation
Intrinsic
Load
Extrinsic
Load
Germane
Load
Be Simple & Helpful
Design Walkthrough / Heuristic Evaluation
Cognitive Walkthrough
Iterative Usability Testing
Be Smart & Calm
Field Research
Task Analysis
Iterative Usability Testing
Be Consistent & a Team Player
Competitive Product Review
Regulation and Guidance Review
Design Review
Simulated Use Usability Testing
Direct Observation
80. Checklist for Reducing Cognitive Load
Through Design
For a copy, email one of us or
see me after the session.
shannon@sage-research.com
julie@themangementdoc.com
84. THANK YOU!
Julie Rennecker, PhD RN
Principal Consultant
The Management Doc, LLC
Julie@TheManagementDoc.com
Shannon Halgren, PhD
Chief HF/UX Consultant
Sage Research & Design, LLC
Shannon@sage-research.com
85. References
Drews, FA et al (2009). Text messaging during simulated driving behavior. Human Factors, 51: 762-770.
Eriksen, CW & Eriksen, BA (1974). Effects of noise letters upon the identification of a target letter in a non-search task.
Perception and Psychophysics, 16: 143-149.
Gasper, JG et al (2014). Are Gamers Better Crossers? An Examination of Ation Video Game Experience and Dual-task Effects
in a Simulated Street Crossing Task. Human Factors, 56(3): 443-452.
Horsky, J et al (2003). A framework for analyzing the cognitive complexity of computer-assisted clinical ordering. J of Biomedical
Informatics, 36: 4-22.
Institute of Medicine (2000). To Err is Human: Building a Safer Health System. Committee on Quality of Health Care in
America, LT Kohn, JM Corrigan, & MS Donaldson (eds). Washington, DC: National Academies Press.
Institute of Medicine (2012). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. M Smith et
al (eds.), Committee on the Learning Health Care System in America. Washington, DC: National Academies Press.
James, JT (2013). A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. J of Patient Safety, 9: 122-
128.
Katidioti, I and Taatgen, NA (2014). Choice in Multitasking: How Delays in the Primary Task Turn a Rational into an Irrational
Multitasker. Human Factors, 56(4): 728-736.
Kalyuga, S (2011). Informing: A Cognitive Load Perspective. Informing Science: the Int’l J of an Emerging Transdiscipline, 14:
33-45.
Pashler, HE (1984). Processing stages in overlapping tasks: Evidence for a central bottleneck. J of Experimental Psychology:
Human Perception and Performance, 10: 395-403.
Pashler, HE et al (2001). Attention and Performance. Ann Rev Psychology, 52: 629-651.
Posner, MI & Petersen, SE (1990). The Attention System of the Human Brain. Ann Rev Neurosci, 13:25-42.
Wickens, CD (1991). Processing resources and attention. In D. Damos (ed.), Multiple-task performance, p3-34. London, UK:
Taylor & Francis.
Wicklund, M., Kendler, J. and Strochlic, A. (2011). Usability Testing of Medical Devices. CRC Press, Taylor & Francis Group,
Boca Raton, FL.
Notas del editor
Good morning. Thank you for joining us. When we started designing products for healthcare, several years ago, we quickly realized that what we thought we know about design, didn’t always apply to healthcare. That realization interested us enough to explore this product use environment at a deeper level and to shift our design processes to meet the unique needs of these users. In this talk we’ll share what we’ve learned.
We’re happy to be here this morning to talk with you about cognitive load—which we refer to as “cognitive overhead”--as it applies to healthcare technology design. We’ll talk about what cognitive overload is, how it affects healthcare workers, and ways that we designers can minimize it through our product designs.
I’m going to begin by taking about error.
We ALL make mistakes. And we know mistakes, or what we in Human Factors call Human Use Errors, are made in the healthcare environment.
But, what factors affect when and how often human use errors are made?
How can the design of medical devices and applications minimize human use error?
These are some questions we’ll be exploring during this presentation.
Let’s begin by taking a quick look at a few documented human use errors in the use of medical technologies…
In healthcare, a common source of human use error are what call fatal tubing mash-ups. This is where a healthcare working connect two tubes together that should not be connected.
In this case, a feeding tube was accidentally inserted into a trach tube port and milk was delivered to an infants lungs.
The result was fatal.
And, in this example, an unfortunate string of errors related to the use of an Electronic Health Record (EHR) put a patient in serious danger, though he lived.
It began when
A gentleman had a low K level, 3.1 mili equivalients. It’s just a little bit low, but does require treatment.
Dr. A orders a K bolus to be delivered over a short period of time…
Then he noticed the pt. already has an IV so decides it would be better to add the K to the existing IV fluid for a longer delivery time which results in greater pt. comfort (K sometimes burns).
He attempted to cancel the first order, but instead cancelled a similar order by mistake.
Pharm. filled the first order and changed the second order to comply with hospital policy around K treatments, but did fill it.
Both orders, the bolus and the slower K administration, were carried out by the nurses.
Shift change: Dr. B sees the 3.1 K level and interprets is as a new, post treatment lab value and treats for low K.
K now has more than doubled. I very high or low level can stop the heart. They caught this mistake
The problem wasn’t that these healthcare workers didn’t care or were being careless, it was that the EHR allowed these mistakes to happen. There were several places along the way where the HER could have been more helpful in preventing this series of mistakes.
“While health IT presents many new opportunities to improve patient care and safety, it can also create new potential hazards.5 …poor user interface design or unclear information displays can contribute to clinician errors.” (ONC, Health IT: Patient Safety Action & Surveillance Report, 2013: p.4)
We wish that these errors were isolated incidents, but they’re not--the statistics on healthcare errors are staggering..
In 2000, the IOM published a study that got a great deal of public attention. In that report, they stated that almost 100,000 people per year died due to preventable medical errors. This is the equivalent of one full 747 crashing every day, which of course, we would hear about.
This report caused a number of new initiatives, guidelines and regulations designed to prevent human use error.
However, fast forward a little more than a decade…
Subsequent studies published in 2012 and 2013 suggest that the situation has not improved
Even worse, approximately 86% of adverse events are unreported
A second study found that the original study may have underestimated the problem by as much as a factor of 4, putting the number of preventable deaths as high as 400,000 per year
and the incidents of preventable “serious harm” are as high as 2-8 million/year.
It’s difficult to determine the proportion of these errors due to medical device design, but as designers, we certainly don’t want to worsen the problem.
ACT II
One recommendation from the original IOM study was that device design needed to pay more attention to the use of devices IN CONTEXT, not just whether they delivered the appropriate fluid or electric current, for example, at the correct rates.
Through our own research, we’ve seen that a critical component of this “context” is the mental workload of the healthcare user.
All of us involved in healthcare know that it’s a complex, high-risk world full of logistical and regulatory challenges just to name a few…
So it should be no surprise that healthcare workers have a lot on their mind when they’re interacting with the devices you’ve designed.
The first follows a trauma patient who arrives in the ER with a head trauma.
The second will provide a look at one hospital unit through the eyes of an ICU nurse.
As you watch this first video, notice the wide number of complex micro-environments found within this healthcare facility …
2 minutes
“In this video, we saw a fairly typical trauma patient sequence beginning with the LifeFlight helicopter (or other ambulance) transferring to the ER, on to surgery, and finally to an ICU bed. What did you notice that might be important for you to keep in mind for designing healthcare devices?
Here are some things we noticed …
The first follows a trauma patient who arrives in the ER with a head trauma.
The second will provide a look at one hospital unit through the eyes of an ICU nurse.
As you watch this first video, notice the wide number of complex micro-environments found within this healthcare facility …
2 minutes
As you watch this video, try to keep track of all the different tasks and technologies this nurse works with across a few hours…
2 minutes
“Rook” ICU/Post-Op Nurse
Rook cares for a recovering post-op patient while awaiting another from surgery…
After working with her own patient, Rook assists in room set-up for a new admit…
After room setup, Rook gets a call – another patient is arriving from surgery…
Throughout the day, Rook mentors a novice CTICU nurse…
After assisting a nurse colleague, Rook’s primary patient is about to arrive…
“In just 2 minutes, we saw an ICU nurse perform several tasks:
Care for/monitor a post-op patient
Setup for a new admit
Receive a second post-op patient
Mentor a novice ICU nurse
Assist colleague
Get supplies
Etc.”
What did you notice that might be important for you to keep in mind when designing healthcare devices?
[TAKE THEIR COMMENTS] --- if giving talk to smaller group
While the task details might vary from one hospital unit to the next or between hospital units and outpatient clinics, there are several recurring themes that span unit types and facilities…[READ SLIDE]
Longer version/smaller group
IF MANY COMMENTS: “Those are great observations—here are a few that we came up with: …”
IF NONE or FEW COMMENTS: “Here are some things we noticed: …”
To appreciate why designing for healthcare is so different, let’s step back and take a look at
User motivations when performing technology tasks in healthcare compared to performing technology tasks
in other industries that we as a UX community more frequently support.
READ SLIDE
To answer this question, we’d like to review some basic concepts from cognitive psychology [Click!]
Julie: and to do that I’ll turn it over to Shannon, the cognitive psychologist member of our team.
Shannon:
Let’s spend a few minutes going back to Cognitive Psych 101
You can think of this as how much “brain power” is required to perform a task
Intrinsic Load - how complex the problem is All these examples have an intrinsic degree of cognitive demand even when performed on a simulator. Intrinsic load includes things like the number of steps to be remembered to complete the task, information that must be held in memory between steps in a task sequence, or activites/tasks that must be performed simultaneously [e.g., needing to hold down a button while inputting a new setting, needing to press two keys simultaneously, …]
Extraneous Load - load on working memory unrelated to problem at hand distractions--Audio or visual; information being remembered; participating in conversation with the patient, doctor, or family member
Germane Load - processing effort going towards the development of schema in LTM (creating connections, sequencing, rehearsing, building scaffolding)
As long as the cognitive demand is less than capacity/threshold, then performance is adequate.
But, the moment the demand exceeds threshold, performance suffers
I’m going to ask you to do a little experiment with me so I can demonstrate what it feels like to experience cognitive load.
For this exercise you’ll need to open the contact list on your mobile phone or tablet .
Go ahead and pull out your devices now and display your contact list.
Now, I’m going to give you a simple procedural task to perform with this device:
Please create a new contact for Jane Doe and enter her phone number.
All done? How did that go?
Most of you probably found it pretty simple to do - it’s something you’ve done a least a few times before.
----
Now, I’m going to ask you to do that same task again, but this time, we’re going to add some cognitive load.
DON’T start the next task until I tell you to begin.
This leads us to a dilemma in healthcare.
Product design simply can not be part of the problem. We need to contribute to the solution.
We’ve developed a set of SIX design principles addressing the three aspects of cognitive load:
[Read through list]
Now, we’ll look more closely at each one.
First, we need to address the intrinsic load imposed by whatever device we’re designing.
The two key principles here are “Be Simple” and “Be Helpful.”
[READ SLIDE].
One key to simplicity is…
Read slide
Here’s an example: You’re 10 minutes late out the door. Which would you rather use to decide if you need to grab a coat?
The example on the right is a great example of less is more -
It provides only what you need
Even a visual design can be distracting
A second key to Being Simple is “Be Direct…”
Patient Monitoring System by Fusion Charts
Status is clear at a glance
Graphics support rather than distract
Appropriate visual heirarchy
[Read slide]
One of the best ways to be helpful is to provide guidance to assist the user during task performance
[read slide]
Here’s a conceptual example from one of our projects:
If you were a new user, where would you start? How would you get help?
Our redesign took a guided workflow approach and provide a clear place to start and immediate access to additional help.
Hungarian designer Kevin Harald Campean
http://designtaxi.com/news/360796/A-Bold-Sleek-Redesign-Of-The-First-Aid-Kit/?goback=%2Egde_63344_member_275785103#%21
Hungarian designer Kevin Harald Campean
http://designtaxi.com/news/360796/A-Bold-Sleek-Redesign-Of-The-First-Aid-Kit/?goback=%2Egde_63344_member_275785103#%21
It isn’t enough to only focus on the intrinsic load of our product.
As we saw in the video, our products will be used in complex environments, so we also need to think about helping users dealing with a heavy extrinsic load.
The key principles here are “Be Smart” and “Be Calm.”
Let’s take a look at how the EHR could have been more helpful during this series of unfortunate events.
Healthcare workplaces are over stimulating and stressful environments
The technology, in contrast, needs to be “calm”
We’ll use the color palette we selected for this presentation as an example. If we did our job right, you didn’t even notice the colors until we pointed them out. Or, if you did notice them, it was because you liked them.
Some might feel this color palette is more exciting, but it’s also is more tiring to view over long time periods
A subtle color palette allows more attention to be given to alerts. This allows alerts to be less demanding themselves.
This color palette demands more vigilance to detect alerts.
Finally, we need to recognize the contribution to Germane Load made by each additional device added to the users’ world.
Formative research techniques can be used to gather data on user expectations.
Card sorts can be used to understand users’ mental models …
And field research can be used to gain an intimate understanding of users’ environment, tasks, motivations and needs.
Beyond consistency within your own product, it is important to recognize that your product is part of a technology team…whether you want to be a team player or not!
Free clip art
Free clip art
Free clip art
[Ascom could be a good example here: In some facilities, the client uses their entire suite of products; in others, only the handset or only the console, etc.]
Evaluating the cognitive load of your design doesn’t require new research methods so much
as attending to additional aspects of the design while using familiar methods, such as
Design Reviews, Cognitive Walkthroughs, Usability testing & field research, etc.
I’ll walk through a few examples to show you what I mean…
Real world environment:
coffee shop; subway; living room
Modified Research Lab:
Room setup to mimic patient care setting
Equipment placement similar to actual use
Interruptions:
Answering unrelated questions
Doctor asking for a new task stat
Phone call/Text message
Provide Appropriate Level of Training prior to testing
Team trainings
Sales Rep training
Instructions for Use available
Consider lag time between training and task performance
What you [designers] do matters.
Medical device design can mean the difference between injury & safety, life & death.
Your designs can be the difference between a manageable level of cognitive load…
… where your users feel like super heroes …
… or an unmanageable level of cognitive load which leads to human use error.
“We hope this has been helpful. Be well & do good work.”
…. And now we’ll take any questions.