Chris Vincent | University College London (original) (raw)

Papers by Chris Vincent

Syringe drivers are medical devices that are critical for end of life care. They deliver continuo... more Syringe drivers are medical devices that are critical for end of life care. They deliver continuous medication over extended periods of time. Their design contributes to the quality of experience for both patients and healthcare professionals. Little research has been published about the factors that influence the usability of this type of equipment for frontline users (i.e. those in direct contact with patients) and how equipment gets introduced. Understanding how syringe drivers are used in practice can help improve the design of equipment. 27 semi-structured interviews were conducted across acute hospitals, community hospitals and hospices (4 organisations in total). All participating organisations used the same type of syringe driver. It was found that frontline staff needed to adapt this equipment to fit the circumstances of use. The analysis provided examples of this happening for aspects relating to the appearance of the device (bags), accessories (batteries) and security (the lockable box).

We present findings of a UK study into how those involved in purchasing interactive medical devic... more We present findings of a UK study into how those involved in purchasing interactive medical devices go about evaluating usability, the challenges that arise, and opportunities for improvement. The study focused on procurement of infusion devices because these are used by various professionals across healthcare. A semi-structured interview study was carried out involving a range of stakeholders (20 in total) involved in or impacted by medical device procurement. Data was analysed using thematic analysis, a qualitative method designed to support the identification, analysis and reporting of patterns. In principle, health service purchasing was found to accommodate consideration of equipment usability. In practice, the evaluation process was driven primarily by engineering standards; assessment of local needs did not accommodate substantive assessment of usability; and choice was limited by the availability of equipment on the marketplace. We discuss ways in which purchasing could be improved through techniques that account for social circumstances.

Presented at Hfes 2014 International Symposium on Human Factors and Ergonomics in Health Care Chicago, Mar 17, 2014

In Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sage Publications, Sep 1, 2011

Abstract The design of systems affects the likelihood and nature of errors that people might make... more Abstract The design of systems affects the likelihood and nature of errors that people might make with them, and the ease of error recovery. If developers are to design systems that are less prone to errors propagating, they need to consider the users and user contexts. There are many techniques and resources available to support developers in this. In this paper we report on an interview study involving professionals from major manufacturers of medical devices, to better understand their development practices and the external forces that ...

In Itme 2011 Proceedings 2011 Ieee International Symposium on It in Medicine and Education Ieee Piscataway Us, 2011

The design of medical devices directly affects the way healthcare practitioners carry out their d... more The design of medical devices directly affects the way healthcare practitioners carry out their daily tasks. Users welcome design that takes into account the clinical environment, in which the device is operated and is compatible with their workflow. However, if the design fails to fit, the likelihood of errors increases, which will put patient safety at risk. In this paper, we report current practice related to UCD (User Centred Design) in the context of medical device, focusing on end user feedback mechanisms deployed in pre-market and post-market phases of the device lifecycle. The results of an interview and workshop study are reported, revealing shortcomings in current feedback channels. In reaction to these shortcomings, we discuss the advantages and feasibility of enabling automatic feedback channel in medical device design, to ensure the quality and the effectiveness of feedback.

British Journal of Nursing, Jul 1, 2014

In 2004, the National Patient Safety Agency (NPSA) released a safety alert relating to the manage... more In 2004, the National Patient Safety Agency (NPSA) released a safety alert relating to the management and use of infusion devices in England and Wales. The alert called for the standardisation of infusion devices and a consideration of using centralised equipment systems to manage device storage. There has also been growing interest in smart-pump technology, such as dose error reduction software (DERS) as a way to reduce IV medication errors. However, questions remain about the progress that has been made towards infusion device standardisation and the adoption of DERS. In this article, the authors report the results of a survey investigating the extent to which the standardisation of infusion devices has occurred in the last 10 years and centralised equipment libraries are being used in practice, as well as the prevalence of DERS use within the UK. Findings indicate that while reported standardisation levels are high, use of centralised equipment libraries remains low, as does DERS usage.

Clinical risk, 2014

Medical devices are essential tools for modern healthcare delivery. However, significant issues c... more Medical devices are essential tools for modern healthcare delivery. However, significant issues can arise if medical devices are designed for 'work as imagined' when this is misaligned with 'work as done'. This problem can be compounded as the details of device design, in terms of usability and the way a device supports or changes working practices, often receives limited attention. The ways devices are designed and used affect patient safety and quality of care: inappropriate design can provoke user error, create system vulnerabilities and divert attention from other aspects of patient care. Current regulation involves a series of pre-market checks relating to device usability, but this assumes that devices are always used under the conditions and for the purposes intended (i.e. work as imagined); there are many reasons for devices being used in ways other than those assumed at development time. Greater attention needs to be paid to learning points in actual use and...

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This study investigated the effect of stimulus height on the ability of horses to learn a simple ... more This study investigated the effect of stimulus height on the ability of horses to learn a simple visual discrimination task. Eight horses were trained to perform a two-choice, black/white discrimination with stimuli presented at one of two heights: ground level or at a height of 70 cm from the ground. The height at which the stimuli were presented was alternated from one session to the next. All trials within a single session were presented at the same height. The criterion for learning was four consecutive sessions of 70% correct

Proceedings of the 2012 Symposium on Human Factors and Ergonomics in Health Care, 2012

Proceedings of the international conference on Ergonomics & Human Factors 2012, Blackpool, UK, 16-19 April 2012, 2012

Journal of biomedical informatics, Jan 25, 2014

The focus of this paper is on the challenges and opportunities presented by developing scenarios ... more The focus of this paper is on the challenges and opportunities presented by developing scenarios of use for interactive medical devices. Scenarios are integral to the international standard for usability engineering of medical devices (IEC 62366:2007), and are also applied to the development of health software (draft standard IEC 82304-1). The 62366 standard lays out a process for mitigating risk during normal use (i.e. use as per the instructions, or accepted medical practice). However, this begs the question of whether "real use" (that which occurs in practice) matches "normal use". In this paper, we present an overview of the product lifecycle and how it impacts on the type of scenario that can be practically applied. We report on the development and testing of a set of scenarios intended to inform the design of infusion pumps based on "real use". The scenarios were validated by researchers and practitioners experienced in clinical practice, and thei...

Applied Ergonomics, 2014

Representations of archetypal users (personas) have been advocated as a way to avoid designing in... more Representations of archetypal users (personas) have been advocated as a way to avoid designing in isolation. They allow communication of user needs and orient teams towards user experience. One of the challenges for developers of interactive medical devices is that most devices are used by a wide variety of people, and that developers have limited access to those people; personas have the potential to make developers more aware of who they are designing for. But this raises the question of whether it is possible to deliver useful, valid personas of interactive medical device users. The aim of this research was to develop and test a rigorous, empirically grounded process of constructing personas, with the objective of reflecting on that process. Many challenges were encountered: we found that directly linking the personas to a user population was not possible and although personas were a useful tool for supporting communication and elicitation across disciplines, it was hard to make them representative when picking details that were relevant and checking accuracy. Checking the content resulted in disparate, possibly incommensurable, views. Despite this, the personas proved useful in supporting the transfer of knowledge across professional perspectives.

Prescription charts are not designed with the task of programing medical devices in mind [cf. 1].... more Prescription charts are not designed with the task of programing medical devices in mind [cf. 1]. This is surprising because we know that charts need to be consulted for programing values. This paper summarizes what we know about chart design, and then reflects on what we do not know. In order to design charts that facilitate programing, we need a better understanding of how they are used in hospitals. We cannot only ask nurses about how they use them since they may omit information about context and clinical practice. We discuss approaches that we plan to use to obtain the required understanding.