Int J Med Inform - Flexibility in interaction: sociotechnical design of an operating room scheduler.

Tópicos

{ implement(1333) system(1263) develop(1122) }
{ design(1359) user(1324) use(1319) }
{ patient(2837) hospit(1953) medic(668) }
{ chang(1828) time(1643) increas(1301) }
{ can(774) often(719) complex(702) }
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Resumo

RPOSE: The purpose of this study was to learn about factors that influence the design and implementation of situated computing solutions that support hospital work. This includes social and technical aspects of the actual systems that will be implemented, as well as the appropriate design methodology for developing these systems.METHODS: Staff at a surgical department at a University hospital were engaged in a participatory design (PD) process to help solve a problem that was presented by the staff: scheduling of patients and surgery rooms, and creating awareness of the status of ongoing surgeries. The PD process was conceptually aided by a model that describes Medical Informatics Systems as comprising of three components, a service component, a technical component and a social component. The process included the use of ethnographic field work and iterative redesign of both technical and social components of the system after it had been implemented into day-to-day work practice.RESULTS: The PD process resulted in the creation of a system that was iteratively created over a period of about 2 years, and which then handed over to the IT department of the hospital and used by the surgical department for a period of about 1 additional year. The first version of the prototype that was implemented contained usability flaws that made the system difficult to use in time critical situations. As a result of observations and a redesign of the technical component and social component of the system a new version was possible to implement that managed to overcome this problem. A key feature of this second version of the system was that some responsibility for data entry validation was shifted from the technical component of the system to the social component of the system. This was done by allowing users to input poor data initially, while requiring them to fix this data later on. This solution breaks from "traditional" usability design but proved to be quite successful in this case. A challenge with the solution, however, was that the IT department could not understand the concept of systems being described as comprising of both social components and technical components, and thus they had difficulty in understanding the overall design of the system during the handover process.CONCLUSIONS: Situated computing can present a number of design challenges that may not be easy for designers and hospital workers to understand before a system has been implemented. Situated computing development may thus need to be aided by PD that includes both ethnographic observations and iterative redesign of the system after it has been implemented. Traditional data validation mechanisms may create poor system performance in cases where users are rushed to input data into the computer due to pressures created by other more critical work activities. In this case it may be better to rely on social mechanisms for correcting errors later on, rather than error catching mechanisms that reject incorrect data. It can be challenging, however, to maintain such systems over time, as IT-departments may lack skills and interest in social components.

Resumo Limpo

rpose purpos studi learn factor influenc design implement situat comput solut support hospit work includ social technic aspect actual system will implement well appropri design methodolog develop systemsmethod staff surgic depart univers hospit engag participatori design pd process help solv problem present staff schedul patient surgeri room creat awar status ongo surgeri pd process conceptu aid model describ medic informat system compris three compon servic compon technic compon social compon process includ use ethnograph field work iter redesign technic social compon system implement daytoday work practiceresult pd process result creation system iter creat period year hand depart hospit use surgic depart period addit year first version prototyp implement contain usabl flaw made system difficult use time critic situat result observ redesign technic compon social compon system new version possibl implement manag overcom problem key featur second version system respons data entri valid shift technic compon system social compon system done allow user input poor data initi requir fix data later solut break tradit usabl design prove quit success case challeng solut howev depart understand concept system describ compris social compon technic compon thus difficulti understand overal design system handov processconclus situat comput can present number design challeng may easi design hospit worker understand system implement situat comput develop may thus need aid pd includ ethnograph observ iter redesign system implement tradit data valid mechan may creat poor system perform case user rush input data comput due pressur creat critic work activ case may better reli social mechan correct error later rather error catch mechan reject incorrect data can challeng howev maintain system time itdepart may lack skill interest social compon

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