Reexamining the Exam Table (Design Phase)

Katelyn Nigus Design Phase

IAPD

Spring 2015

Kansas State University

Reexamining the Exam Table

Table of Contents

1

Introduction

2

Human Factors

3

Schematic Phase 2

Project Statement ........................................... 5 Goals and Objectives .................................... 6 Generative Intent ............................................. 8 Users/Stakeholders ..................................... 14 Function Structure......................................... 16 Environment .................................................... 18 Ergonomics ..................................................... 19 Early Work ........................................................ 22 Models ............................................................... 24 Overall Thoughts .......................................... 25

4

Development Phase

5

Sketches ........................................................... 28 Development Photos .................................. 32

Final Product

Orthographic Drawings ............................. 48 Renderings........................................................ 50 Marketing Strategy ...................................... 54 Final Prototype ............................................... 56

6

Results ................................................................ 60 Overall Effectiveness .................................. 61 Bibliography .................................................... 62

Closing Thoughts

3

1 Introduction Section Includes Project Statement Goals and Objectives Generative Intent 4

1. Reduce surface contamination

2. Reduce patient falls

3. Decrease medication errors

4. Improve Communication

7. Improve environmental safety

8. Represent the best investment (Furniture Design Feature, 2014)

Project Statement

Healthcare furniture and equipment has advanced in terms of providing increased patient comfort, accessibility, hygienic properties, and technological advances, while the modern exam table has remained relatively unchanged. In studying the established research, there are eight main goals for healthcare furniture research and development. These goals include:

Quality 5. Decrease stress and fatigue

6. Improve staff effectiveness, efficiency, and communication

By implementing these eight goals, an effective prototype of a new exam table can be created that is easy to use for doctors and nurses, as well as comfortable for the patients. Creating this exam table establishes a more supportive piece of furniture for the type of healthcare provided today, more accessible for various ages and sizes of patients, is constructed of hygienic materials for increased comfort, clean-ability, and durability, and ultimately assists physicians and nurses in carrying out their jobs. In doing so the prototype hopes to create a better holistic approach to the health environment and give the patient an overall more comfortable experience at the doctor’s office.

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Goals and Objectives

• Incorporate tools for nurses and clinicians to use without causing work related injuries • Design ergonomic adjustments to accommodate varying generations (especially the elderly population in transferring patients on and off the table)

2. Incorporate hygienic materials (fabrics, metals, and plastics) to assist in infection control and for ease of maintenance for nurses and clinicians as well as janitorial staff.

• Integrate anti-microbial technology within selected materials to increase the sterile properties of the material • Ensure minimal joints and connections of materials at surfaces patients will come in direct contact with

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Levels of Adjustability

1. Provide built-in adjustability for users of all capabilities.

3. Accommodate for new and changing technology within patient centered care specifically related to the exam room.

• Allow patients to incorporate personal technology into the healthcare experience to reduce error and further involve family or caretakers in the process • Ensure durability of integrated technology along with the ability to upgrade components as needed

4. Design an innovative and cost effective prototype with pneumatic functions for increased flexibility and expanded application.

• Allow the redesigned exam table to be available to the masses • Provide a new option to be integrated into healthcare systems to accommodate an aging population

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Generative Intent 8

Inviting Peace Emotional Harmony Enveloping Calm

9

Ascension

Balance

10

“There is nothing more genuine than breaking away from the chorus to learn the sound of your own voice.�

- Po Bronson 11

2

Human Factors Section Includes: Users/Stakeholders

Function Structure Environment Ergonomics 12

“Sometimes questions are more important than answers.�

- Nancy Willard

13

Users/Stakeholders

Geriatric Patients

Obesity: • •

Body Mass Index (BMI) of 30 or higher BMI of 40 or more is considered morbid obesity

Causes: •

Weight is affected by genetics, gender, physiology, biochemistry, as well as environmental, and psychosocial factors.

BMI:

Ages 65 and older

Participation in the workforce has made them the wealthiest generation

What do these two have in Common?

They’re limited in mobility

A measure of an adult’s weight in relation to his or her height (kg/m2)

Bariatic Patients

A total of 3,287,500 Geriatric patients were admitted to the hospital in the past year

Major target market for health, retirement housing, financial planning, and appearance

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Retiring at a rate of 10,000 people every 24 hours * Sources: Geriatric, http://www.aarp.org/health/doctors-hospitals/info-03-2012/hospital-admissions-older-adults.html. Bariatric, NIH, NHLBI. 1998

Users:

Stakeholder: Patient

• Varies in visits from once a year, to once a month, to once a week • Spends little time when in hospital (Max. of two hours) • Major intended user of the exam table

Doctor

Nurse

• Spends the most intimate time with the patient

• Oversees overall health of patient

• Gains personal connection with the patient

• Acts as a go-between for doctor and patient

• Oversees diagnosis and treatment

• At hospital nearly on a daily basis

• At hospital nearly on a daily basis

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Patient

Function Structure

Person

Arrival to Hospital

Check In

Waiting Room

Exam Room

• •

•

•

•

•

Takes car or bus

• •

•

Doctor

•

Takes car or bus Potentially with friend or family member May have special restrictions before arriving (i.e. no water or food before visit)

Nurse

•

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Takes car or bus

• •

•

Signs in at check in counter Fills out necessary paperwork Goes to waiting room

• • • •

Sits in chair or sofa Look at phone or tablet Read a book or magazine Watch TV (if provided) Nurse calls patient and is taken to exam room

Check appointments for the day

Clocks in Check medical inventory for the day Check doctors appointments for the day

• • •

• •

• •

Looks over patients medical chart Calls patient in to be examines

• • •

En route to exam room patient gets weighed and measured Talk with nurse about current allergies and medications Potentially take off clothing Has choice to sit on exam table or guest chair

Check patients chart before going into exam Talk with patient about why they are here before starting procedure

Takes patients vitals Goes over any new allergies or medications Takes patients chart to doctors for viewing before doctor enters exam room

Physical Exam • •

•

• •

Follow Up Conversation

Doctor enter and introduces themselves Patient is moved from sitting up, to laying down, and being on their side during procedure Potential discomfort when moving through the procedure

•

Moves bed up and down to help examine the patient Checks breathing, heart rate, and other potential issues for visit

• •

• •

•

Gain an understating of diagnosis Talk about options of treatment, prescriptions or wellness Change back into clothes

Gives patient diagnosis Gives medication recommendations or potential treatments Writes potential prescription for patient

Payment

Leave

•

•

Go home or to pharmacy

• •

Log hours Updates patient chart Go home

• •

Go to check out counter Check with insurance Pay amount needed

•

• • •

Checks inventory before leaving Clocks out Goes home

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Environment

Standard Exam Room: Walls are bland with little information

Must use ADA forms of egress around the room

Exam table the focal point in the room

Acts as a hub of medical knowledge

Integrated technology helps provide great visuals on the walls as well as provide information to the patient Various seating options create a more free-flowing atmosphere

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Furniture becomes more inviting to use and has less of a clinical feel

Modern Exam Room:

* Sources: Standard, http://www.ada.gov/medcare_mobility_ta/medcare_ta.htm. Modern, http://www.steelcasehealth.com/application/exam-spaces/

Ergonomics

By looking at various relationships of furniture and equipment in the healthcare environment, it enhances the design process of the table.

Major takeaways from these measurements is the height and width of the examination table; taking into account some of the patient bedroom measurements and applying them to the new exam table.

Source: http://www.ada.gov/medcare_ mobility_ta/medcare_ta.htm

19

3

Schematic Phase Section Includes Early Work Models Overall Thoughts

20

“Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.�

-Dale Carnegie 21

22

Early Work

23

24

Models

Overall: • Understanding the ideal situation conceptually • Really get into user perspective • Entrance and egress • Table vs. Chair; different connotations

Overall Thoughts

Major takeaways from schematic review:

Design: • Good overall adjustable height proportions • Look at height adjustments with legs and feet • Play with the form of the circle more (go beyond a cylinder) • Look at padding on top so that it can act as a safety net and envelop patients • Show form models for how to sit in the chair

25

4

Development Phase Section Includes Sketches Frame/Proportioning Development Photos

26

“Try a thing you haven’t done three times. Once, to get over the fear of doing it. Twice, to learn how to do it. And a third time to figure out whether you like it or not.”

-Virgil Thompson 27

28

Process Sketches

29

30

31

32

Frame/Proportioning

Foot Rest Detail

33

34

Working with Metal

Slip Rolling/ Forming Metal

35

36

Spot Welding

Attaching L-Brackets

37

38

Mock Up

Jack Fabrication

39

40

Welding

Footrest

41

42

Footrest Mock Up

Upholstery

43

44

Finishing

45

5

Final Prototype Section Includes Orthographic Drawings Renderings

Prototype Photos Marketing Strategy 46

“Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.”

- Saint Francis of Assisi

47

Orthographic Drawings

40.12 58.00 4.00

20.02

36.00

17.99

15.98 8.00

11.66

18.44

1.98

1.00

35.92

50.15

36.00

16.00 3.50

17.80

22.67

2.63

2.15 5.51

째 7 39.4

3.00 30.00

48

31.00

5.94

1.00 3.79

0.50

2.00

22.64

4.89 1.98 6.87

49

Renderings

Fully Condensed Seating Position

50

Fully Extended Table Position

51

52

Material Selection

Easy grip arms: 3D Printed Black matte plastic

Vinyl Upholstery: Momentum Textiles, Beeline Collection

Extended Foot Rest: Telescoping Square Steel Tubing & Painted Plywood

Shapes: Slip Rolled Polished Steel

Lift Mechanism: Pit Posse ATV Jack

53

Marketing Strategy 54

Redact

Reduce and take Action

The Redact Exam table is an efficient piece of furniture that helps to reduce patient anxiety as well as help caregivers take action in giving the best possible care to their patients. Along with its various functions to provide optimal patient comfort, Redacts ability to be mobile helps with caregiver efficiency. Its compact size creates a great space saver in examination rooms while not diminishing the quality of the physical exam.

Before:

After:

55

56

Final Prototype

57

6

Closing Thoughts Aspects Include Results Overall Effectiveness Bibliography

58

“I have been impressed with the urgency of doing. Knowing is not enough; we must apply.

Being willing is not enough; we must do.�

- Leonardo da Vinci 59

Results

Throughout this past year the development of this product has made leaps and bounds. As a result the promise has been kept in creating an effective prototype that is easy to use for doctors and nurses, as well as comfortable for the patients. This new product will hopefully help pave the way of new thinking when designing for an exam space and eventually redefine the way people envision going in for their yearly check-ups. In the end this piece helps exemplify a more holistic approach to the health environment and gives patients an overall more comfortable experience at the doctor’s office.

In terms of overall effectiveness we must look back at the eight goals provided by Furniture Design Feature. In reviewing these goals six out of the eight goals were applicable to the piece (seen on next page to gain context). This in depth look helps users feel more comfortable in the space while caregivers are not as stresses or fatigued during long hours at the office. The overall prototype is effective in creating a new and better experience within the healthcare environment.

From its conceptualization to final prototype the journey has helped me as a designer open my eyes to better understand working with a particular client and user. The level of detail, not only in research, but as well as in building the product; gives me new awareness of my skill set and how to use that to its fullest potential. Hard work and passion is what ultimately got me through this project. I can only hope that I feel just the same when working on the next project that comes my way in my future endeavors.

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Overall Effectiveness

Quality

61

Bibliography

User/Stakeholders: Hartley, S.W., Kerin, R.A., Rudelius, W. (2014) Marketing 12th Edition Foltz-Gray, Dorothy (2012, March 1) Most Common Causes of Hospital Admissions for Older Adults. Retrieved from: http://www.aarp.org/health/doctors-hospitals/info-03-2012/hospitaladmissions-older-adults.html Gable, L., Mucheno, E., (2012, August 25) Understanding the Special Needs of the Bariatric Population: Design, Innovation, and Respect Kim, H. (2009) Universal Design: Meeting the Needs of the Bariatric Population Environments: “Access to Medical Care for Individuals with Mobility Disabilities”, Published by U.S. Department of Justice: Civil Rights Division, Disability Rights Section. Accessed 2/10/2015 from: http://www.ada.gov/medcare_mobility_ta/medcare_ta.htm “Exam Rooms that Empower People” Wellbeing: A Bottom Line Issue. 360, Issue 67. Accessed 9/17/2014 from http://360.steelcase.com/wp-content/uploads/2014/01/360Magazine-Issue67.pdf Ergonomics: “Access to Medical Care for Individuals with Mobility Disabilities”, Published by U.S. Department of Justice: Civil Rights Division, Disability Rights Section. Accessed 2/10/2015 from: http://www.ada.gov/medcare_mobility_ta/medcare_ta.htm

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