Lessons learned from an impatient in-patient
Published: April 2023

In a previous article, I recounted how a sudden unforeseen affliction had landed me in hospital for a stay which brought with it some first-hand subjective insights that no amount of third-party research could have afforded.
My ability to be mentally stimulated may have been somewhat enhanced by some extremely strong painkillers, my enforced ‘breakfast’ of choice at that time, but one particular technology was to truly astound me. A ‘PICC Line’ (Peripherally Inserted Central Catheter) is used to allow intrusive but surprisingly direct access to the very entrance to a patient’s heart. Ultrasound technology provides a real-time on-screen cross section of the arm in order to locate a candidate vein of just the right parameters and pinpoint its exact position so as to tune the length of an introducer needle and verify its insertion.
The tailoring continues outside the body where a humble paper tape measure (of the type familiar to any IKEA-goers) is used to size up the route from the insertion site up and around the shoulder and down into the heart. Further resolution of this is confirmed when the catheter, trimmed to suit my very own ‘vital statistics’ has reached its target, as observed via an ECG-type probe on the patient’s chest. This direct line allowed frequent blood samples to be extracted and medication to be delivered directly at the very heart of the matter by simply connecting the appropriate apparatus to its readily accessible point-of-entry. Open up and say ‘awe’!
Importance of clear and concise instructions
After being discharged I received training to self-administer my IV medication as bolus via this PICC line on a daily basis, wherein another aspect piqued my annoyance. The instructions presented were a combination of outdated, overly wordy documents; third generation photocopies peppered with grainy images that weren’t very well printed in the first place. Even the two conflicting booklets, between them, did not fully contain a comprehensive account of what was required of this here daunted patient.
Cue more confusion from the nurse’s intervention; ‘that’s not actually quite right as I find it much easier if you do this instead….’ So messy were my scribbled, redacted notes that I left the session bamboozled. Enough to warrant drafting a condensed, cleaned up version with a bit of home photography and editing on my laptop to create a clear, simple one-page crib sheet, leaving any future such patients in no doubt. As a first ‘contact point’ between a medical device or drug product and its often-apprehensive recipient, clear, concise IFU (Instructions For Use) unambiguously illustrating the steps required of the user are another area where a little thought and effort can massively enhance the user experience.

Waste not, want not
Another tacit challenge of today’s product designer is a want to minimise waste. Ideally, this applies to decisions made throughout every aspect of the design process, manufacturing strategy and supply chain.
By adopting circular design principles, we designers can minimise waste not only in the manufacturing process but also in the use and disposal phases of the product life cycle. We can strive to develop devices that can readily be returned, remanufactured or recycled, through careful material selection and consideration of both assembly and disassembly processes.
Within the medical industry, clearly there is an increased need to ensure sterility, that may conflict with this; never more so than when dealing with intravenous delivery to address what is termed an infectious disease. Every stage in the process warrants a cautious approach, leaving in its wake an eye-watering mountain of jettisoned packaging, sterile cleaning products and containers of mixed materials.
Ultimately, also a brim-full sharps container containing ‘yellow stream’ waste materials (i.e., those contaminated by both medication and potentially infectious blood) requiring to be incinerated in a bespoke authorised facility. What had always been a vague mantra to reduce carbon footprint was suddenly brought into ‘sharp’ focus by my overflowing bins.
In medical devices, more eco-friendly solutions can involve designing a reusable ‘platform’ architecture allowing mating of minimal localised components where only these come into direct contact with the patient and/or drug product. A utopia to aim for, often easier said than done, if not ‘a whole world of pain’.

My experience as an impatient in-patient was a powerful reminder of the importance of user-centred design. It certainly provided a new perspective on the challenges that are faced with minimising waste and optimising IFUs, complementing well-designed medical devices.
This is something we’re extremely passionate about at Shore – delivering whole design solutions that are intuitive and easy-to-use while driven by sustainability.
Whichever aspect of your project would benefit from Shore’s user-centred approach, let’s discuss.