UW HCDE Capstone Project sponsored by Seattle Children's Hospital.

This 6-month long project was a culmination of all the skills related to design and research that we learned and practiced in the Human-Centered Design & Engineering (HCDE) program at the University of Washington. In June 2017, we presented our final prototype, poster, and video at the HCDE Open House alongside other HCDE undergrads and masters students.

We were one vote away from winning the Best Design award out of 40 participating teams. 

View our team's project poster that we showcased at the Open House!

How can a mobile application increase safety, speed, and accuracy for anesthesiologists who are preparing for a regional block procedure?

Observational Field Study

"They think they know [what type of block to perform]" - Dr. Corrie Anderson, 30+ years of experience, Seattle Children’s Hospital

Through this 6-hour field study at Seattle Children's Hospital, we were able to observe and ask questions to the anesthesiologists while in the context of their work environment. We were able to see their natural process of preparing for a surgery and gain a better understanding of how they select the appropriate block based on the type of surgery, patient anatomy and health, and other significant factors. We synthesized our data into four categories: team interaction, preparation/process, app expectations, and pain points.

Using the findings from this study, we developed a survey with questions that would help validate these initial findings, identify common resources, and familiarize us with preparation methods. 

Survey

Through our survey, we sought to answer three main questions:

1. How do anesthesiologists prepare for regional blocks that they are unfamiliar with?

2. Do they use resources to prepare and if so, what types of resources do they use?

3. How often do they consult these resources?

Survey results showed that less experienced anesthesiologists (0-10 years) often used NYSORA (New York School of Regional Anesthesia), an e-learning system, as a preparation tool. Those with more experience (20+ years) rarely used any resources to prepare but when they did, they turned to their colleagues for help.

Not only did these findings help us develop interview questions to gather more details, but they also helped us narrow down our target user to those with less than 5 years of experience, or "novice" users.

Interviews

We interviewed two anesthesiologists - one with 3 years of experience and another with 28 years of experience. The goal of the interviews was to pinpoint what specific information in available resources is most valuable to their preparation process and what triggers their need to reference resources. 

Anesthesiologists reference both online and offline resources (colleague discussions) but the need for using these resources can depend on the amount of prep time given or their comfortability in performing that specific block. There are also many factors related to the patient that they must consider when determining the best course of action; sometimes, even deciding not to do a procedure that might harm the patient.

Sketching

After synthesizing and analyzing the findings from our research, we defined a list of components before doing some preliminary sketches to establish the general interactions and overall workflow.

Participatory Design Sessions

As part of our ideation phase, we conducted two participatory design sessions. The first was an ideation session with a third-year anesthesiologists at UW Medicine to determine a logical workflow, discuss our preliminary sketches and ideas, and generate expectations for content. 

The second participatory design session came after we iterated on our sketches and converted them into to a low-fidelity wireframe. We consulted our stakeholder through a cognitive walkthrough of our app and were able to confirm some of our design choices while also defining areas of improvement. 

Prototyping

Taking the ideas and findings from our participatory design sessions and research, we iterated on our wireframes and produced a low-fidelity, interactive prototype that we used to test the participants in our usability study.

Usability Testing

To evaluate the design, workflow, and interactions of our prototype, we recruited six participants and tested them in the anesthesiologists' break room at Seattle Children's. They were given three tasks to complete, followed by six post-test questions to assess their overall experience with the prototype and to identify areas of improvement. 

Based on the analysis of the usability study and some additional guidance from our sponsor, we aimed to improve the labeling and include additional educational information, interactions on the diagram, and the different orientations of the diagram. 

Select the region of the surgery

• Select the appropriate surgical region from a full body diagram with anterior and posterior views (back and front) of the body

This allows the user to focus on the specific region and view blocks that are only relevant to that area

Compare the nerve coverage and distribution of the most relevant blocks for that surgical region

• View a list of regional blocks that are relevant to the specified surgical region

• Compare the nerve coverage and distribution for each type of block across each tissue layer - dermatome (skin), myotome (muscle), osteotome (bone)

• Each block covers a variety of different nerves, which are mapped to a specific color and displayed on the diagram. The grey region represents nerves that are not covered by the block

• Know exactly which blocks completely cover the surgical region

This assists the user in making the the most well-informed decision about what block they need to perform for any given surgery based on anatomy

Study the details of a specific block

• Dive into a specific block and view additional information about that block including ultrasound images, contraindications (specific situations in which a drug, procedure, or surgery should not be used), techniques, video demos, recognized risks, etc.

There are a lot of other factors beyond anatomy that the user needs to take into consideration when deciding on the right block. This provides all the available, relevant information that the user might need to take into account to decide on and prepare for an anesthetic procedure