Users as Designers: How People Cope with Poor HCI Design in Computer-Based Medical Devices

Abstract

In this paper, we examine how users interact with a computer-based infusion device adapted for terbutaline infusion to treat preterm labor in women experiencing high-risk pregnancies. This study examines: (1) the HCI deficiencies in the device as related to this context of use, (2) how the device characteristics increase the potential for error, and (3) the tailoring strategies developed by users to insulate themselves from failure. Interviews with nurses and bench tests of the behavior of the infusion device in different conditions identified several HCI deficiencies: complex and arbitrary sequences of operation, mode errors due to poor differentiation of multiple operating modes intended for different contexts, ambiguous alarms, getting lost in multiple displays, and poor feedback on device state and behavior.

Get full access to this article

View all access options for this article.

References

Cook

R. I.

Potter

S. S.

Woods

D. D.

McDonald

J. S.

(1991). Evaluating the human engineering of microprocessor-controlled operating room devices. Journal of Clinical Monitoring, 7:217–226.

Cook

R. I.

Woods

D. D.

Howie

M. B.

(1990). The natural history of introducing new information technology into a dynamic high-risk environment. Proceedings of the Human Factors Society, 34th Annual Meeting.

Cook

R. I.

Woods

D. D.

Howie

M. B.

(1992). Unintentional delivery of vasoactive drugs with an electromechanical infusion device. Journal of Cardiothoracic and Vascular Anesthesia, 6: 238–244.

van Charante

Moll E.

Cook

R. I.

Woods

D. D.

Yue

Howie

M. B.

(1993). Human-computer interaction in context: Physician interaction with automated intravenous controllers in the heart room. In Stassen

H. G.

, editor, Analysis, Design and Evaluation of Man-Machine Systems 1992, Pergamon Press.

Norman

D. A.

(1988). The Psychology of Everyday Things. Basic Books, New York.

Sala

D. J.

Moise

K. J.

Jr. (1990). The treatment of preterm labor using a portable subcutaneous terbutaline pump. Journal of Obstetric Gynecological Neonatal Nursing, 19:108–15.

Woods

D. D.

(1994). Automation: Apparent Simplicity, Real Complexity. Keynote Address, Proceedings of the First Conference on Automation Technology and Human Performance. Erlbaum.

Woods

D. D.

Johannesen

Cook

R. I.

Sarter

(1994). Behind Human Error: Cognitive Systems, Computers and Hindsight. Crew Systems Ergonomic Information and Analysis Center, Wright-Patterson AFB, OH.