Surviving Sepsis: A destination by design

If you find the design of forms a bit boring and are happy to delegate or leave to someone else, you might be interested to see the outcome I see fairly routinely from clinicians. I have changed the words used, as this is by way of illustration and not criticism of those who try!

Sepsis -form design image 1

With the prospect of a new financial reward, organisations are gearing up to meet the Sepsis CQUIN. But, with the target firmly set on collecting screening data, as opposed to delivering timely treatment, can this latest initiative be designed to do more? I think it can. And so I want to introduce you to some knowledge that all other safety critical industries learnt about a long time ago.

It’s to do with form design …

You might think it’s a little dull, but since you are going to do it anyway – why not put in a little extra effort for the sake of a better return?

So why the emphasis on form design? Well let’s start with the name. In many places the form has become known as the Sepsis Audit form – and herein lies a problem – the name indicates its primary purpose is to collect data, not on taking the right action for the patient.

And why am I concerned about this tiny detail, and indeed the many details of design? Well from where I sit I see clinicians dealing with a fast moving, uncertain and sometimes unfamiliar picture, sometimes working in a cramped and poorly designed places. Where diagnosis, decision and action is highly time sensitive and not without risk. Rapid assimilation of observations, quick decisions and fast, reliable responses are in order.

And our approach to designing for safety compares unfavourably with the approaches used in other safety critical industries – Take a look below and see if you agree…

Sepsis - form design image 2

This is the kind of stuff that all safety critical industries (except health) use routinely. So in our evidence based, scientifically informed world, why are we the outliers? It’s not like we knowingly harm too many people, because if we did surely we would take note. So could it be because we unknowingly harm more people than we can possibly imagine, and have not yet appreciated that there are things that can be learnt and done beyond being a good clinician?

I don’t know – but I am guessing the latter. What I do know is that as the burden of harm becomes ever more visible – in healthcare we are both out of line and out of step.

So, if you are thinking a new form is in order to ‘sort sepsis’, or know someone who is, here’s some places to look for ideas (and if you find more please share them with me, so I can pass them on!).

• A very short (3 min) film giving you an insight into the many aspects of human factors that affect our performance at work

• A longer (10 min) film introducing some principles of good form design using Paediatric Early Warning Score Charts as an example

• An extensive guide from Australia on design features that make charts safer and less safe