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in-patient in hospital bed

Insights from an impatient in-patient

Published: April 2023

Blair Hutton
Blair Hutton, Design Consultant

The year just gone marked my tenth at Shore, almost entirely spent absorbed in the development of diagnostic devices, drug delivery systems and trainer demo devices. Here, we product design engineers are required to bring to the drawing board any previous applicable skills while ever learning new aspects unique to this specialist sector by osmosis, benefiting from the knowledge of more experienced colleagues as well as project-specific insights from the clients themselves.

While meeting our customers’ most fundamental requirements, there is also an expectation to enhance user experience. This allows us to maintain a lead in an increasingly competitive market while ultimately satisfying the end user, typically a patient, their caregiver and/or their HCP (Health Care Professional).

Here, then it would appear invaluable to try and see the world through our customers’ eyes. A ‘user-centred’ approach can appear a clichéd trope, long since wheeled out by enthusiastic design graduates (as I may have been) or companies trying to ‘nutshell’ their USP, but nonetheless remains essential.

people conducting user study for a Shore designed medical device

Many times previously I had observed Human Factors and User Studies involving observing real users but only ever in a simulated environment, or occasionally participated in internal equivalents, assisting with appraisal of my colleagues’ designs first hand, at different stages of their evolution. All the while though I had been fortunate never to have truly spent any time in the shoes (bed socks, perhaps) of our patients.

In-patient user experience

Until recently that is. A sudden affliction creeping up on me over a 48-hour period culminated in a frantic 999 call and being rushed to hospital in an ambulance for the first time in my life. Also unprecedented was an excruciating level of pain not to be wished on my worst enemy. A fraught first day in hospital brought a bed’s eye view of x-ray, MRI, CT scan and even an ECG and numerous blood tests before a root cause was established.

All the while this heavily analgesic-addled patient curiously asking ‘where am I being taken now?’ or ‘what does that machine do?’, as anyone might.

Feeling the pain for user-centred design

If the above processes sound quite straightforward on paper, they were not without a fair degree of discomfort. When designing products for our end user, especially when the patient is concerned, we must of course also seek to minimise pain, especially where any form of injection or infusion is involved. During my hospital sojourn I was to become very familiar with both, via all manner of needles and cannulæ.

From experience of various projects, the notion of patient discomfort, as observed by clinical ‘pain studies’, is notoriously hard to quantify. Factors influencing the level of pain experienced are commonly cited as gauge and length of needle, whether delivered intradermal, intravenous, subcutaneous or intramuscular, commonly dependant on the purpose and physical properties of the drug product involved.

IV drip with cannula

Other human factors come into play, dependant on the approach of the HCP administering such as location of injection site, force applied and speed of both needle insertion and drug delivery. Of the myriad of HCPs to frequent my ward one would affectionately become known as “Doctor Pain”, if only silently to myself. Their bedside manner would be tested by incessant enquiries of ‘what exactly is that?’ and ‘what are you doing with it now?’ in the interests of my gauging the relative effects of each of these factors. They, a different sort of “patient”.

While I, as the average designer would hope to pay more than lip service to the pursuit of optimising user comfort, the level of pain I was to experience, turned up to the max during my initial affliction and variously from any treatment thereafter, has left me more motivated than ever to this end. By carefully considering the form of a device, we can reduce a patient’s perception of expected discomfort, as well as the ‘true’ level of pain experienced upon its application.

As I only learnt after the event, Dolorimetry (the measurement of pain sensitivity) is typically quantified on a self-assessed scale from 1-10. Mine, at the time might have been measured by some choice words and a volume of screaming; ‘OOYAH’ units if someone has to give them a name! More quantifiable measures are provided in clinical studies by bespoke instruments such as algometers and dolorimeters which may be the subject of a future article.

Involving patients in the design process

My experience as an impatient in-patient was a powerful reminder of the importance of user-centred design. It also highlighted the need for collaboration between designers and HCPs and involving patients in the design process, especially to the end of optimising comfort and minimising pain. Only by truly understanding the needs and experiences of patients can we create products that improve their quality of life and help them to manage their conditions.

This is something we’re extremely passionate about at Shore – our expert Designers and Human Factors team focus on the interaction between an individual and a product, and in particular its usability to enable safe and effective treatment.

If you’re looking to integrate usability insights into a project, then reach out to myself and the team and we’d love to discuss further.

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