For more than half a century, the airline industry has relied on checklists to help improve safety. Prior to every flight, a pilot visually inspects the outside of the aircraft and executes a preflight checklist from within the cockpit. These checklist reviews and enhancements have helped pilots avoid use errors, such as forgetting to configure a plane properly for takeoff.
In The Checklist Manifesto, Atul Gawande, a practicing surgeon who writes about his efforts to ensure good patient outcomes, extols the virtues of checklists used in multiple domains, including in his hospital’s operating rooms. He cites promising studies that show how a checklist can reduce the rate of postsurgical complications, such as infection by 36% and deaths by 47%, as compared with normal medical practice (see The Checklist Manifesto–How to Get Things Right ). Could a checklist help medical device developers produce user interface designs that are less likely to induce the use errors that lead to patient injury or death?
To date, user interface design flaws have been implicated in a disconcerting number of adverse outcomes. A checklist could help avoid the most common and readily detectable flaws, particularly when quality checking is followed up with comprehensive usability testing. With this in mind, we’ve put together a four-part checklist. It is unquestionably off-the-cuff compared with those developed in a more comprehensive manner involving contributions from multiple subject matter experts, peer reviews, and validation studies.
Therefore, if you question the checklist’s validity, you are exercising good judgment. However, the listed items are based on findings from thousands of hours spent observing people succeed and struggle to use medical devices when performing clinical work and participating in usability tests. The checklist is also generally consistent with the applied design guidance found in ANSI/AAMI HE75:2009, “Human Factors Engineering—Design of Medical Devices.”
Research suggests that shorter checklists are often more effective than longer checklists, helping pilots quickly obtain critical information in emergencies, for example. Although product designers do not normally encounter the immediate stresses faced by pilots, this article opts for brevity with four 10-item checklists. Each checklist addresses a different aspect of a medical device’s user interface, including its hardware, software, and printed elements (i.e., documentation), as well as its integrated performance.
To read this thought-provoking and very actionable article about checklists for design and tangible implementation of user interfaces—both software-based and physical appearance—click here.