Designing care bundle documentation to support the recognition and treatment of acute kidney injury: a route to quality improvement
- Submitting institution
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The University of Reading
: B - Typography and Graphic Communication
- Unit of assessment
- 32 - Art and Design: History, Practice and Theory : B - Typography and Graphic Communication
- Output identifier
- 53391
- Type
- C - Chapter in book
- DOI
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- Book title
- Design for Health
- Publisher
- Gower
- ISBN
- 9781472457424
- Open access status
- -
- Month of publication
- May
- Year of publication
- 2017
- URL
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- Supplementary information
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- Request cross-referral to
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- Output has been delayed by COVID-19
- No
- COVID-19 affected output statement
- -
- Forensic science
- No
- Criminology
- No
- Interdisciplinary
- No
- Number of additional authors
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8
- Research group(s)
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- Proposed double-weighted
- No
- Reserve for an output with double weighting
- No
- Additional information
- The chapter describes collaborative, designer-clinician research with the renal team of Royal Berkshire Hospital in an initiative to:
– improve detection and treatment of acute kidney injury (AKI) by revision of the hospital’s AKI care bundle documentation
– build awareness of the bundle across clinical disciplines.
Black was the project lead and main author of this paper. Contributing authors are members of the clinical team, and designers who worked on the visual organisation of the materials.
Previous approaches to the challenge of identifying and treating AKI in existing documentation and research literature showed no evidence of an information design approach to assessing clinicians’ use of documented information in their decision-making. This research covered new ground by engaging with existing documentation users, from different clinical disciplines, and using a sequence of techniques to:
– elicit their insight into why current awareness was low and documentation inadequate
– gather feedback and refine prototype documentation as it was developed, so that it was tailored to their decisions and activities.
The research showed the design solution needed to accommodate the complexity of AKI care and remove impediments to lower status disciplines (nurses and care assistants) initiating the bundle, while at the same encouraging non-specialists to involve specialist, renal team doctors where patient symptoms indicated this was appropriate. A small-scale simulation trial, compared existing documentation with redesigned materials, suggesting the redesign was effective in guiding trainee doctors and nurses in appropriate response (including referral) according to presented symptoms.
The chapter’s conclusions extend beyond those specific to design for AKI care, to wider issues in designing documentation for complex clinical decisions and processes. They include specific recommendations to focus on effective functional, rather than promotional, documentation and to use design to elucidate process detail rather than removing detail that may be needed, particularly, by non-specialist clinicians.
- Author contribution statement
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- Non-English
- No
- English abstract
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