Ergonomics in intensive care Applying human factors data to the design and evaluation of patient monitoring systems

Abstract

The condition of a hospital patient in intensive care may change rapidly; if this change is not noticed and acted upon equally rapidly, the patient may be in mortal danger. At present, the patient's condition is recorded by means of hand-completed charts. These charts, however, fulfil the function of storing and presenting diagnostic data less than adequately. A programme of work was initiated to design a data input and display interface for use in a computer based patient monitoring system. One such device had already been developed at the hospital as a first step in the process of replacing the chart method. This first device was found to be unacceptable in many human factors aspects. A new interface device was designed that was consistent with human factors recommendations. Experiments were conducted in which the two interface devices were compared for performance and preference. The new device was better than the original one; and was preferred to manually completed charts.

The application of ergonomics to this problem required very careful attention. It was a delicate task to find that allocation of function that relieved the clinician of tedious and repetitive work and which maximized his interpretive functions. This was done by means of discussions with clinicians, by asking for their expert opinions of drawings, mock-ups and prototypes, and by involving them in the making of decisions. This discussion and interaction was maintained at all stages of the project to ensure the high acceptability of a sound design.

Areas of further work in this programme are discussed, and the importance of presenting the results of ergonomic work in a tangible form is emphasized.