Wednesday, 29 September 2010

Endoscopy journal

https://www.thieme-connect.de/ejournals/toc/endoscopy

This is a journal for endoscopists and it is clear that there is a lot more to endoscopy than I at first thought.  If I am looking at providing a design intervention to the colonoscopy procedure I should look at how the endoscopist operates throughout their workday, look at their routine as well as looking at the steps the patient has to go through.

Maybe several staff members have to use the same workplace, examination room throughout the day for differing types of procedure.  What would be ideal, is to arrange a day where I can perhaps shadow a member of staff for a number of hours, in order to gain insight into how their daily game plan operates.

Colonoscopy brief outline

bmi healthcare colonoscopy, brief overview

This is a very brief outline of what a colonoscopy is by bmi healthcare, the private division of GHG General Healthcare Group.

A colonoscopy is a method whereby a physician known as an endoscopist will examine the inside of the large bowel of a patient for any problems using a long flexible telescope with an illuminating light.  Generally the colonoscopy is a safe invasive procedure with little to no side effects, in fact the patient should be able to return to his/her work or general routine with a number of hours, usually two or more. 




If required the patient will be given a sedative in order to relax them.  The only noticeable complication that can occur throughput the procedure is an allergic breathing reaction or heart irregularities causing trouble.

What is interesting, is the need for the sedative.  Is this because a particular patient physically needs the sedative in order for the procedure to go smoothly?  Is it because their not comfortable during the procedure, how is their body positioned in order for the endoscopist to complete his, her work.  What is the general environment, atmosphere in which the procedure takes place like, is t welcoming, comforting, clinical or sterile.

These are a number of factors that could begin to makeup an interesting investigation into the methods and environment of the colonoscopy procedure.

I have contacted the BMI Fernbrae Hospital in Dundee and will approach my local hospital for information and hopefully arrange an interview with some members of staff.

The Healing Environment Without and Within




This book provides a broad over view of topics dealing with medical humanities without and within medical environments.  It mainly covers the physical areas that patients may have to inhabit during illness or recovery.

The book discusses bringing outside arts within, performance and music and other forms of art, not what would appear to be permanent cures but positive none the less.  When I began reading this information I considered the word permanent and thought that it was an interesting word or sentence to use, because what is a permanent solution?  Personal identity and taste is constantly in flux.  The world of fashion for example rapidly changes from week to week.  A persons’ choice of furniture and fixture, perhaps even the entire layout of their home will evolve over the years.  In the world of medicine, doctors and scientists are constantly researching, developing and refining how to treat illness and disease.

So should the NHS adopt a similar semi-permanent, low cost, environmentally and patient conscious approach to their interiors.

“Physical appearance, geometrical forms, colours, fixtures and furniture affect the atmosphere of the ward.”

The importance of architecture and the built environment of the hospital covered in a chapter, serves as an introduction to further investigation.  The built environment can be measured and its impact is either positive or negative, very seldom is it neutral.

New hospital buildings are described in contrast against old hospital buildings within the book.  It is observed that the quality of treatment and staff is greatly improved within a modern, well-lit and designed hospital. Studies have shown that improving the built environment can achieve the positive of reducing the average amount of time a patient stays in hospital.  This benefits the patient and has obvious beneficial cost implications for the NHS.

When considering environment for hospital patients it is perhaps necessary to recognise that a future patient has a pre-existing social environment shaped by friends, family, personal interests and a variety of external variables including hobbies and activities.  Hospitalising a person, it appears is essentially removing them from their comfort zone.  Patients do not give up their hobbies simply because they are being hospitalised, albeit sometimes for a temporary amount of time.

The ability to have personal control over the environment is as important to patients as aesthetic and functional design throughout the hospital is important to staff, even if that control is limited.  Patients like the idea that they could participate in a social context but also retain autonomy and have their own personal space.  The ability to decide how much privacy or community they require is very important.
The views, opinions and experiences of patients and staff should factor into the future design of hospital environments.  It might be an idea to start interview sessions or begin an online submission of ideas, sketches and photographs in order to formulate a collaborative process of design with staff, former and current patients.  The idea is to look at each individual hospital environment as its own ecosystem but still part of a larger environment, and in nature an ecosystem is constantly adapting.

“Architectural styles, like medical certainties, change over time.”

This book was written in 2003 so it is interesting to investigate further and discover what advances have or have not been made.

Monday, 27 September 2010

Minimalist Intervention



I read this article in the recent issue of Wired Magazine and found it relevant to the current research.  The article is about philosopher James Wilk who utilises 'minimalist interventions' to change work environments including medical environments.  It is an experimental process.

Saturday, 18 September 2010

Electrocardiogram

In the next couple of weeks I should have finalised a tour of a cardio-respiratory department.

When discussing the nature of the study, the subject of an ECG recording was brought up.  And althought this is off topic, it is interesting to investigate a wide view of problems.  An Electro cardiogram is a test that measures the hearts electrical activity.

The issue that arose during the discussion was that ecg cables often become tangled.  This means that hospital staff have to spend time detangling what has been described as a 'birds nest' of cabling, thus distracting them from the important job of monitoring readouts and attending the patient.

There does appear to have been some break throughs in this area, as evidenced by a company in the USA, their website has testimony from a number of staff.

http://www.ekgcable.com/testimonials/

Aside from preventing the cables from becoming tangled and damaged (they are expensive to replace), the equipment offered here helps interpret where each cable/electrode should be attached to the body.  This ability to read quickly where each electrode should be placed greatly improves the patients level of stress as they become more comfortable in the hands of the hospital staff.

The tour should prove interesting because if this product is a design or cost issue for hospitals then there could be room for an improved cost effective design.

First hand experience of this department will also prove useful in experiencing the environment for both the patient and the staff members.  To see the route the patient/staff member takes from the entrance of the building to the waiting room, toilets, consultation, operating room etc will prove invaluable in this current study of de-threatening, de-intimidating of hospital equipment and situations.

It should also be interesting to hopefully gain an insight into how a hospital appropriates and breaks down its budget, regarding equipment, patient comfort and many other factors.

Expect and update on the cardio-repiratory department in the coming weeks and more literature on the subject shortly.

Monday, 13 September 2010

David McCandless: The beauty of data visualization | Video on TED.com

David McCandless: The beauty of data visualization | Video on TED.com


A student studying bio-medical science suggested an idea for providing basic medical information for the general public. The general public without proper guidance can be misguided as to which medicine to take for which ailment, leading to prolonged illness or other problems.

I recently saw a talk on Ted.com by David McCandless which proved very interesting in relation to how important information can be. Because we are bombarded by a variety of visual information on a multitude of different mediums on a daily basis, it is harder to present facts and data in a way that can encourage the viewer to stop and take in the information. Presenting this information in a visually dynamic and understandable way is an important task.

Having watched this talk I immediately bought David McCandless book 'Information is Beautiful' which as so far proved both interesting and entertaining, the best of both worlds. So perhaps a dynamic information chart or map could be created representing symptoms and medicines or even an app for the iphone to guide a person to the correct choice of medicine.

Where this chart, poster or pamphlet would be placed could be very interesting especially for those people who don't have access to internet or iphones.

About this blog

This blog is designed to act as a catchment area and a springboard of ideas, a blank slate to post problems and potential solutions to issues that pertain to a medical or surgical situation.

The initial start of this investigation is to begin looking at how to make surgical equipment within medical situations less intimidating.  This can also be applied to the environment of the procedure, the waiting rooms or even how information is presented to people, be they patients, members of medical staff, trainees, or the general public.

At the foundation stage of this research, a wide net is cast in order to gather as much information as possible, ideas and designs that work for something completely different outside the world of medicine may prove useful in providing alternative routes of design and solutions to particular problems.  Inspiring talks and papers from professionals within their field will be posted and I invite people who read this blog to comment, critisize and suggest alternative ideas.