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PHD-DESIGN  December 2018

PHD-DESIGN December 2018

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Subject:

Re: Hubris and Health

From:

Chris Heape <[log in to unmask]>

Reply-To:

PhD-Design - This list is for discussion of PhD studies and related research in Design <[log in to unmask]>

Date:

Tue, 18 Dec 2018 10:59:06 +0100

Content-Type:

text/plain

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Hi,

You might be interested in seeing this health-worker, hand cleansing design solution by a former student of mine, Hân Pham.

http://www.yellowone-handsafe.com

Hân has also resolved a number of other social design challenges:

http://www.yellowone.dk

Best holiday wishes to all.

Chris.

-------------

from:

Chris Heape PhD
Design Research Consultant

research: design process - design education - design anthropology

SDU Design Research
Design Anthropology Group
University of Southern Denmark
Universitetsparken 1 · 6000 · Kolding
Denmark

PhD
https://www.dropbox.com/s/bj7ctwq7u4k2h3k/%2ADesign%20Space%2A%20A4.pdf?dl=0

On Dec 18, 2018, 10:38 +0100, Ken Friedman <[log in to unmask]>, wrote:
> Dear David,
>
> You wrote, "Yesterday, for not unrelated reasons I was refreshing my mind on the issue of hand washing by doctors and nurses. I was trying to track down some key dates that signalled when you were more likely to live than die when visiting a hospital or general practitioner. What struck me was that TO THIS VERY DAY, there is an ongoing battle to get doctors and nurses to wash their hands between consultations with patients. In the face of this evidence, we need humility."
>
> To me, this is a core issue involved in much of what we do — or hope to do — in every field. For several decades now, medical journals have published studies demonstrating the causal linkage between strict hand washing between patient consultations and better or worse health outcomes. Anyone who wishes to see the research, along with empirical evidence, can check Google Scholar. These key words work: “hand hygiene,” “hand hygiene compliance,” “hand hygiene compliance hospitals,” “hand washing,” “hand washing compliance,” and “hand washing compliance hospitals.” This article from the British Medical Journal offers a good summary … despite the fact that it was published two decades ago, the story it tells remains the same today.
>
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115132/ <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115132/>
>
> While I am aware of the problem, I see no evidence of any behavioural design intervention that seems to make a difference.
>
> Over the past century and a half of medical research and medical practice, the combined work of Joseph Lister, Louis Pasteur, Florence Nightingale, and Ignatz Semmelweiss gave rise to clinical guidelines that remain useful and effective today. When morbidity rates rise in hospitals, a frequent cause is the relaxation of strict hand washing routines before and after every patient contact, a clinical guideline that is anchored in sound research.
>
> When Ignatz Semmelweiss first asserted the need to wash hands before and after every patient contact, many physicians argued that this was nonsense that there was no evidence for germs. Many claimed that physicians were gentlemen and by definition they were clean and did not need to wash their hands. 19th-century physicians practiced surgery in street cloths complete with frock coats and ties. They smoked cigars during an operation. The leading physicians and surgeons of their day were impatient with the nonsense about hygienic practice antiseptic surgery and washing hands between each patient and the next. They argued that the silly notions of researchers such as Lister, Semmelweiss, and Pasteur was an insult to professional surgeons and physicians. There were massive fights between professional physicians and such leaders as Nightingale, William Alexander Hammond, and Joseph Barnes. You can measure the advancing debate in each case by a major reduction in mortality rates whether in civilian hospitals or in 19th century armies – where more soldiers died in camp of infectious disease than died on the battlefield.
> Today, everyone agrees with the need for strict hand washing — but hospitals cvontinue to struggle with behavioural change around an issue on which everyone agrees.
> Earlier this year I found myself in our excellent regional hospital. Because I had a problematic infection that staff couldn’t identify I was kept in isolation for a week. My room had a sink just insıde the door along with a hand soap dispenser and a disinfectant dispenser. While the medical staff were fairly good about using them not everyone washed their hands every time they left the room.
> It seems to me that we need a great deal more information about human behaviour if we are to design for behavioural change around health issues. This, in turn, means that designers require deeper understanding from the behavioural sciences. That said, and I speak as a person who did his doctoral work in human behaviour, I don’t see a great deal of evidence to suggest that anyone has been able to address problems such as this.
> While I share your frustration, I won’t reach for your gun. I’m afraid of meeting the same sad end as Buster Scruggs in the Coen Brothers new movie. For those who haven’t seen The Ballad of Buster Scruggs, you’ll find a few clips on YouTube.
> Warm wishes,
> Ken
> Ken Friedman, Ph.D., D.Sc. (hc), FDRS | Editor-in-Chief | 设计 She Ji. The Journal of Design, Economics, and Innovation | Published by Tongji University in Cooperation with Elsevier | URL: http://www.journals.elsevier.com/she-ji-the-journal-of-design-economics-and-innovation/
>
> Chair Professor of Design Innovation Studies | College of Design and Innovation | Tongji University | Shanghai, China ||| Email [log in to unmask] | Academia http://swinburne.academia.edu/KenFriedman | D&I http://tjdi.tongji.edu.cn
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> Ken Friedman, Ph.D., D.Sc. (hc), FDRS | Editor-in-Chief | 设计 She Ji. The Journal of Design, Economics, and Innovation | Published by Tongji University in Cooperation with Elsevier | URL: http://www.journals.elsevier.com/she-ji-the-journal-of-design-economics-and-innovation/
>
> Chair Professor of Design Innovation Studies | College of Design and Innovation | Tongji University | Shanghai, China ||| Email [log in to unmask] | Academia http://swinburne.academia.edu/KenFriedman | D&I http://tjdi.tongji.edu.cn
>
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