Australasian Medical Journal
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Everything a Medical Innovator needs to know about Software Development
Software development is hard enough for specialist software companies to get right. For people outside the industry it can be a minefield full of hidden surprises. This articles hopes to explain why software development is so hard, how to go about approaching a software development project, and how to get the best out of any collaboration with a development team. It should be read by anyone who is considering developing a software product, including websites, from a non-development
Taking the Stairs Instead: The impact of workplace design standards on health promotion strategies
Background Comprehensive health promotion in Western Australia has been conducted from the point of views of policy development, promotion, education and service delivery. Much of this recent work has been focused on supporting workplaces – but there has yet to be any real focus on the design of the actual physical workplace environment from a health promotion perspective. Aims This paper is aimed at highlighting the gap in health promotion knowledge by addressing how the disciplines of architecture and health promotion can work together to challenge the regulations that dictate design practice and ultimately bridge that gap for long-term change. The overarching aim is to undertake further evidenced-based research that will inform best practice in the planning and design of workplaces to reduce sedentary behaviour and increase opportunities for physical activity. Method Within this wide objective this paper focuses in particular on the idea of stairs-versus-lift movement strategies within office buildings. By examining building design guidelines from a health promotion perspective we expose a central dichotomy, where health promotion posters say “Take the stairs instead” whereas the language of building design suggests that the lift is best. Results From a design point of view, the National Codes of Construction (NCC), formally known as the Building Codes of Australia (BCA), the essential technical regulation for all building design and construction, primarily addresses the concepts of ‘egress’ and ‘travel distance’ for escape in the event of fire, and building access in terms of universal access. Additionally, The Property Council of Australia’s Guide to Office Building Quality prioritises lift performance criteria along with the quality and experience of lift use as a major grading factor. There is no provision in either set of standards for staircase quality and experience. Conclusion The stairs, despite being promoted as better life choice for better health, is not promoted through these building codes nor, consequently, through the building design in actuality. It is proposed that health promotion strategies could be coupled with design-led movement strategies in workplace design so that the promotional language, such as “take the stairs instead”, is balanced by the design language of the building
Bacteriophage types of methicillin-resistant Staphylococcus aureus in a tertiary care hospital
BackgroundPhage typing had been utilised extensively to characterise methicillin-resistant Staphylococcus aureus (MRSA) outbreak strains in the past. It is an invaluable tool even today to monitor emergence & dissemination of MRSA strains.AimsThe aim of this study was to determine the prevalent phage types of MRSA in south India and the association between phage types, antibiotic resistance pattern and risk factors.Method A total of 48 non-duplicate MRSA strains recovered from various clinical samples during January to December, 2010 were tested against a panel of anti-staphylococcal antibiotics. Phage typing was carried out at the National Staphylococcal Phage typing Centre, New Delhi. Out of 48, 32 hospitalised patients were followed up for risk factors and response to empirical and post sensitivity antibiotic therapy. The risk factors were compared with a control group of 30 patients with methicillin sensitive Staphylococcus aureus (MSSA) infection.ResultsAmongst the five prevalent phage types, 42E was most common (52%), followed by a non-typable variant (22.9%), 42E/47/54/75 (16.6%), 42E/47 (6.2%) and 47 (2%). Phage type 42E was the predominant strain in all wards and OPDs except in the ICU where 42E/47/54/75 was most common. Although not statistically significant, strain 42E/47/54/75 (n=8) showed higher resistance to all drugs, except ciprofloxacin and amikacin, and were mostly D-test positive (87.5%) compared to the 42E strain (32%). Duration of hospital stay, intravenous catheterisation and breach in skin were the most significant risk factors for MRSA infection.ConclusionWe found MRSA strain diversity in hospital wards with differences in their antibiotic susceptibility pattern. The findings may impact infection control and antibiotic policy significant
Why are healthcare services fuzzy?
BackgroundHealthcare organisations are an enigma to many people in- and outside the service. Organisational fuzziness is a common state, characterised by a lack of clarity, lack of awareness, lack of organisational knowledge, and the reliance on practice and custom instead of transparency. AimsThe objective of this study was to obtain a better understanding of what causes this fuzziness and provide an actionable description of fuzzy organisations. Such a description is essential to managing and preventing organisational fuzziness. Method We used a longitudinal case study in an integrated health- and social care organisation to obtain a thorough understanding of how the organisation functions. These in-depth insights allowed the identification of three generators of fuzziness.ResultsWe found that the three main generators of organisational fuzziness are change, informal organisation and complexity. Organisational fuzziness is thus partly due to the inherent complexities of human systems. However, also continuous change and the inability of the system to adapt its formal structures resulted in structures deteriorating or no longer being appropriate.ConclusionExisting approaches to explain unclear or absent structures in healthcare organisations by describing these organisations as complex adaptive systems (CAS) are too simplistic. While aspects relating to people and their interactions are indeed complex, fuzziness of structural aspects are often the result of continuous change and insufficient organisational capacity to adapt to it
Health promotion innovation in primary health care
Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC) practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication, education and training are now commonplace in many medical practices. The PHC sector has a small window of opportunity in which to become leaders within the current model of continuity of care by establishing their role as innovators in the prevention, treatment and management of disease. Not only will this make their own jobs easier, it has the potential to significantly impact patient outcomes
Innovating alongside designers
Building alliances with industrial designers offers health innovators a unique pathway to create new modes to serve their patients. Cross-pollination of ideas from the earliest stages of development in interdisciplinary research and development teams including major stakeholders and designers can lead to more meaningful and impactful innovations. A shift in future healthcare from cure to prevention will rely more heavily upon the individual. The home environment will house consumer medical devices that will carry out basic monitoring of the individual. While technologies are currently being developed to support this trend, there is a gulf that exists between the often-complex interfaces required by the highly specific functionality of products and the emotional needs of the target user. If a target user ‘feels’ a product was designed ‘just for them’ they are more likely to develop an emotional bond with that product. This manifests itself in the user engaging and interacting with the product. If a product, regardless of its high functionality, does not resonate with the user, this tends to result in product underuse, misuse and possible abandonment. When those products are related to a course of medical rehabilitation or treatment, these results could be translated to ‘more compliant’ and ‘less compliant’ and ultimately can impact upon how a person heals. Industrial designers focus on ensuring that both the functional and emotional needs of mainstream users as well as technical-expert-users are met. Design research provides the opportunity to bridge the gap between the functional requirements and the less tangible unmet needs of the user by exploring authentic human behaviour.This paper presents case studies of collaborative, interdisciplinary teams employing human-centred design and empathic research strategies (incorporating shared language, collaboration, ethnography, empathy and empathic modelling) to create real solutions that are responding to real needs of real users.The future is interdisciplinary. The future is bright.