Patient Safety Advocates Dr. Richard Griffith & Sean Hagen

Richard L. Griffith, DEngSci in EE, MD wandered about in his career not unlike John James. Physics, graduate work in electrical engineering, military service, medical school, head trauma research, residency in anesthesiology, private practice, academic practice, a decade in medical device development at Becton Dickinson, then back to medical practice/teaching, and now retired. At Becton Dickinson he first met industrial designers and recognized with genuine envy the power of their unique approach to problems. He tried to teach that perspective to residents in anesthesiology at the Albany Medical College, with very limited success. Richard and his wife created videos on the topic of patient safety, a couple of these are still showing on YouTube [search “battle of hospital medical errors”]. He eventually concluded that the institutions of medicine need expert help from actual industrial designers.

Dr. Richard Griffith & Sean Hagen

His nomination said: “Dr Richard Griffithis both an Engineer and an accomplished Anesthesiologist who appliesengineering safety principles to minimize medical errors and uses multipleengineering-based initiatives to improve medical practice.”

Griffithand Hagen Patient Safety Initiatives

When we contacted Richard Griffith about his patient safety nomination, he linked us to Episode #1 of a new Patient Safety video they placed on YouTube. The video talks about an approach to making health care delivery safer. We invite you to view this video. 

Health care professionals cannoteffectively utilize the perspectives of industrial design (ID) on their ownbecause they have been too firmly cemented into a very different paradigm ofresponses. When Richard counts his blessings now, he counts Sean Hagen and allthe members of this Task Force thrice.

When asked how this partnership with SeanHagen came about. He responded: Often new perspectives come from people who goto school for one thing and end up working in a different field. I suppose Ifit that mold. I studied physics in college, then went to graduate school inelectrical engineering, and finally decided I would see if someone might let meinto medical school. I eventually emerged as an anesthesiologist and thenmid-career went to work for Becton Dickinson and Company, (BD) the hugemanufacturer of the “nuts and bolts” of healthcare. People in healthcare rarelynotice BD products (syringes, needles, blood collection tubes, and such)because they use them so naturally every day assuming they will always be in ahospital drawer ready as needed. A great deal of work goes into keeping suchproducts up to the constantly expanding requirements of healthcare delivery.

At BD I found myself interacting constantlywith industrial designers, a new kind of professional I had never beforeencountered. I knew about engineers of all sorts, and about health careprofessionals, but not designers. We joked about the fact that when given a newassignment the industrial designers would run get their lawn chairs. Lawnchairs? Yes, they would get lawn chairs and go sit in them for hours to watchpeople doing whatever job the designers had been asked to tackle. Then thedesigners would create a wall of images showing each step of the task, somephotos, plus lots of drawings, lists, and diagrams, usually in a spectrum ofcolor coding’s. Why do they do all this? Well, the majority of neurons in thehuman brain’s cortex process images. Humans are good at images. Some argue thatall human creativity comes about visually. Einstein said that. Many composerssay they see their music before they hear it. Industrial designers workvisually.

Industrial designers are architects forproducts, processes, and experiences (everything not a building). They defineexcellence in a design when users need no training or instructions to properlyuse that product, process, or experience. They build the design to contain the“cues” or “affordances” necessary to make proper use happen. That aspect ofindustrial design makes them the experts in our society on “avoiding mistakes.”Obviously, we need them at the table when we set about to reduce errors inhealth care delivery. We all actually know that training does not eliminatemistakes, but design can. In the field of anesthesiology, training does notkeep me from turning the patient’s oxygen too low, the design of the machinedoes that.

After a decade at Becton Dickinson, I returnedto medicine as a faculty member in a teaching program in anesthesiology. Theresidents all had various research projects and I would try to give them anindustrial design perspective on their project. They would listen attentivelyto me but when I followed up weeks later, they would appear to have totallyignored everything I said. I assumed it was my teaching limitations, buteventually I came to understand that reading a book on the piano does not makeone a pianist, just as hearing about design perspectives does not make one anindustrial designer. The Agency for Healthcare Research and Quality created awonderful book in 2007, entitled Mistake-Proofing The Design Of Health CareProcesses. But that book does not turn health care professionals intodesigners. We actually need to get designers physically into the hospital andinvolved in the process of delivering medical care.

When I retired four years ago, I startedtrying to find an industrial designer who would help me involve designers inPatient Safety. I eventually found my way to Sean Hagen, founder of BlackHagenDesign located near Tampa, Florida. Sean at that time was the Head of theMedical Device Section of the Industrial Designers Society of America (IDSA).In 2016, Sean asked the Board of Directors of IDSA to get designers involved inPatient Safety. They agreed but asked Sean to put together a Task Force onPatient Safety to figure out exactly how to make that happen. We are stillworking on that.

Sean sees Patient Safety as an eco-systemwith lots of interdependent players and he wants to get his lawn chair out andfigure out how all the pieces fit together. I want to go straight to savinglives. The video represents my focus. Episode #2, still in the works, will talkabout ideas stolen from Drs. Larry Weed and Peter Pronovost for making medicalpractice less prescriptive and more informative.

We know Peter Pronovost mostly for his workin central line infections but he did many other things that proved groundbreaking. He required physicians with patients in his ICU to define goals inwriting for each patient each day with the nursing staff. That simple stepchanged everything. Suddenly the entire team could use their expertise to getthe patient to the goal rather than simple carry out orders. That is the topicof Episode 2.

Larry Weed recognized over 50 years agothat patients in Burlington, Vermont, commonly died on the wrong service in thehospital. For example, they died of a heart attack on orthopedics. He tried tocreate “road maps” for care to combat this. Those road maps were not unlike theprotocols Brent James created in Utah. I think Brent James made InterMountainthe safest hospital system in America.

Finally, we plan an Episode #3 that borrowsfrom the amazing work of Dr. Brent James. Dr. James created protocols thatencouraged both modification and evolution while reducing complications bymaking errors of omission almost impossible. Dr. James has retired but has leftus a talk on YouTube in which he says he tried to make InterMountain Healthcareinto a hospital system that will deliver community standard care even if thepatient’s physician enjoys a very lazy day. When not having a lazy day, thesystem helps make a patient’s healthcare extraordinary!

I want to recruit industrial designers to create tools that allow every hospital to deploy these strategies. Sean Hagen’s eco-system model will help make that happen, but we will also need the skills of industrial designers to get us to the place in Patient Safety we want to go.

Originally published in Issue 1, 2019 of MTM Magazine.