Managing the emergency room

Last week, we finally finished our Interaction Design project, complete with mockups, report and everything. It is generally quite gratifying to do projects at the IT-university since they usually turn out to be a lot more tangible than what I’ve done at Comparative Literature and Anthropology.

For this course, I was in a group with three other students, and we’ve been doing basic “quick’n'dirty” fieldwork at the emergency room at Bispebjerg Hospital in Copenhagen, trying to spot any relevant problems that we can help solve through an IT-design. Having had some trouble accessing the field (there are lots of ethical questions to consider, especially since the staff is so busy that they hardly had time to talk to us), we did manage to collect some relevant data, and upon further analysis, we reached the conclusion that the way that information was being passed on between different members of staff (nurses, secretaries and doctors) was far from optimal.

We made an information flow storyboard [a 4 mb .pdf with Danish text only, sorry]. to describe how information is exchanged in the emergency room at the present. Based on that, we began our own design process to simplify or just make that process more intuitive.

And we began thinking big – basically trying to revise the entire system of information exchange from the bottom up, based on new ICT-technology, with a brand new digital journalling system (their current system had been installed in 1993 and was so ancient that it couldn’t even handle dynamic linebreaks. The secretary would actively have to delete the text and rewrite on two lines if she wanted to add just an extra word on a full line – something that happened quite often as doctors used dictaphones to record patient details, and often changed their mind later on the same tape). We had good fun trying various creative design methods to get the creative juices flowing, among others a “drama in design” workshop where we tried to act out the information flow, and then added our own suggestions for change and discussed them, slowly altering the flow and getting an idea of where the critical points of exchange lay.

Eventually we realized that it would be absolutely utopian to change the entire system of information. Instead, we tried to patch the current system into a proper working state by supporting its weakest point. As it is, the visitating nurse (the nurse receiving and diagnosing all the incoming injuries at the emergency room reception desk) is the nexus of information for the entire department. She has to receive the patients, fill out forms, pass the relevant information along to doctors and secretaries, delegate patients to the various treatment teams and generally have an idea of how many people currently are in the system. How long they’ve been waiting and how urgently they need treatment. Yet she only has a simple whiteboard to help keep track of all of this.

Our solution was to give each patient a coloured bracelet upon their arrival at the emergency room. This bracelet would contain a small chip that would send a signal to a digital map of the emergency room [another big .pdf file], which would monitor how many patients were in the system at a given time, and how serious their various injuries were (depending on the colour of the bracelet). The map would be a touchscreen that would allow the nurse to access relevant journal data on the individual patients. The whole point of the map would be that it would give the visitating nurse an easy way of managing and keeping abreast with what was happening in the emergency room. Both at a distance (since the map would be so stylized and easily readable at a distance to immediately give an idea of how many patients were in the system) and up close (for detailed information on the individual patients. The map in action would look something like this:

Once we had presented our product, we had to reflect on the entire process of reaching this final product. And this is what we’ll be doing for our exam in January. We produced a neat little report overviewing the process. My central contribution to that report was this cute little timeline graph describing how we had alternated between a converging and a diverging tendency in our design process. Diverging when we opened up for creative thinking, “out of the box”. Converging when when we narrowed towards a set problem or a set solution.

It’s very colourful, too.

Generally, I had good fun with this project. The big question, of course, is whether this product actually has any future in any emergency rooms. We have yet to present it to the good people at Bispebjerg, but I’m pretty sure that they’ll say that it is a luxury that they won’t be able to afford…