A comparison of methods currently used in inclusive design.

Inclusive design has unique challenges because it aims to improve usability for a wide range of users. This typically includes people with lower levels of ability, as well as mainstream users. This paper examines the effectiveness of two methods that are used in inclusive design: user trials and exclusion calculations (an inclusive design inspection method). A study examined three autoinjectors using both methods (n=30 for the user trials). The usability issues identified by each method are compared and the effectiveness of the methods is discussed. The study found that each method identified different kinds of issues, all of which are important for inclusive design. We therefore conclude that a combination of methods should be used in inclusive design rather than relying on a single method. Recommendations are also given for how the individual methods can be used more effectively in this context.

Guidewire retention following central venous catheterisation: a human factors and safe design investigation.

BACKGROUND: Central Venous Catheterisation (CVC) has occasionally been associated with cases of retained guidewires in patients after surgery. In theory, this is a completely avoidable complication; however, as with any human procedure, operator error leading to guidewires being occasionally retained cannot be fully eliminated. OBJECTIVE: The work described here investigated the issue in an attempt to better understand it both from an operator and a systems perspective, and to ultimately recommend appropriate safe design solutions that reduce guidewire retention errors. METHODS: Nine distinct methods were used: observations of the procedure, a literature review, interviewing CVC end-users, task analysis construction, CVC procedural audits, two human reliability assessments, usability heuristics and a comprehensive solution survey with CVC end-users. RESULTS: The three solutions that operators rated most highly, in terms of both practicality and effectiveness, were: making trainees better aware of the potential guidewire complications and strongly emphasising guidewire removal in CVC training, actively checking that the guidewire is present in the waste tray for disposal, and standardising purchase of central line sets so that differences that may affect chances of guidewire loss is minimised. CONCLUSIONS: Further work to eliminate/engineer out the possibility of guidewires being retained is proposed.