If you’re designing a bedpan washer, do you design one that nurses don’t have to wait for?
According to a newspaper report, BC’s Centre for Disease Control, or CDC, found that a British Columbia hospital had
bedpan-cleaning machines that take 13 minutes for each cycle.
If they wanted to ensure each bedpan got returned to the right patient, nurses had to stand by for the duration. […]
The BC CDC found the [bedpan washing machines] to be inconvenient and too time consuming.
As additional disincentive for nurses to wait out the 13 minutes, the newspaper says: “If you don’t load the machine exactly right, they not only don’t work, they sometimes spray aerosolized feces on you when the door is opened.”
Oh dear.
It’s easy to ask pointed questions after the fact, but here goes. Since nurses are too rushed to wait 13 minutes, would ethnographic study of hospitals have identified time pressure as a factor? Did researchers ask how long a nurse could or would wait for a bedpan washer? If the answer is “they won’t wait at all; they’ll go do something else,” then that reframes the design problem:
Can the machine track which bedpan gets returned to whom without relying on a nurse’s memory?
Can the machine clean bedpans so that it doesn’t matter to which patient they are returned?
These are very different design problems to solve. Other possible design questions to have asked:
Can the machine’s design prevent improper loading?
Can the machine not spray fecal matter at the person who opens it? Or, if this problem wasn’t predictable at the outset, Is the machine pleasant to use?
Can the machine be operated correctly by untrained users?
…and so on.
I’ve worked on projects where we thought we had the problem space clearly defined, and then—after exploring the design space and attempting to converge on a solution—realised that we had to redefine the problem and start over. I’d say that happens in about 20% of the projects I work on. I’ve also worked on a health product where we couldn’t change the hardware component, so we had to design a software and website solution to mitigate the hardware’s intermittent connectivity problem.
I don’t know anything about the design of the bedpan washer, above, but I understand that BC CDC implicated bedpans in the hospital’s outbreak of Clostridium difficile, and that the hospital switched to another cleaning method. The costs to the manufacturer are potentially horrendous. If the design team did everything right—including an iterative design process and early, user-involved testing—and still missed the mark, then they have my sympathy.
But now that they have a better understanding of the problem space—now that they know the “right” problem—they can design and build a better product.
