Decreasing the cognitive load within primary care with a human factors approach: Introducing a user interface design

Abstract

This is a master’s thesis project performed during the spring semester of 2020 at the Industrial Design Engineering program at Chalmers University of Technology in Göteborg, Sweden. The project was performed in collaboration with the department within the region of Västra Götaland which is responsible for public primary health care, Närhälsan. Medical harm is a severe consequence of work being performed inadequately within health care and is for the most part caused by high cognitive load on the medical staff, and not due to lack of medical knowledge. If the cognitive load is decreased, actions that can lead to medical harm or medical errors could be limited, consequently decreasing the material, staffing and economical resources within health care. The aim of this master’s thesis project is therefore to contribute to decreasing the cognitive load for medical staff at health care centres within Närhälsan. This project examines the cognitive load at a specific health care centre, assigned by Närhälsan. The cognitive load on the medical staff at the health care centre was investigated through a prestudy and a user study consisting of observations, interviews and booklets with tasks to be performed by the medical staff. All information and data collected were compiled and analysed based on the following cognitive aspects: mental models and expertise; attention, awareness and mental workload; emotion and performance; decision making; and errors and risks. Several problem cases were identified as having an impact on the cognitive load of the medical staff. The problem case of reading and documenting in the medical record and documentation system was chosen to proceed with, investigating the cognitive load on the medical staff within that problem case. The problem case was chosen since the software was a central part of the medical staff’s work and a design solution was possible to implement. The main finding was that all investigated cognitive aspects contribute and affect the cognitive load of the medical staff, not just one or some aspects. As result of the findings, a user interface design for a new medical record and documentation system with a “step-by-step” approach was developed. The interface was validated against compiled guidelines and personas established by the research and data analysis. A final concept was created that supports and guides the user in what should be done, as one solution to decreasing the staff’s cognitive load based on the analysed cognitive aspects. Due to the project being performed during the spring of 2020, the work process needed to be adapted to the global pandemic of COVID-19.