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August 1, 2019

UW Division of Design faculty, Seattle Children’s physicians collaborate on more effective anesthesia cart organization

Anesthesia is a delicate, complex process, and for patients undergoing surgery, the administration of medications at the right time and dosage can be a matter of life and death.

How medications are arranged on an anesthesia cart for administering to patients during operations has historically tended to vary depending on the anesthesiologist and how and where they were trained.

But in recent years, physicians at Seattle Children’s Hospital have worked with design faculty members in the University of Washington School of Art + Art History + Design’s Division of Design to come up with a better, safer, more reliable way to order and use drugs on an operating room’s anesthesia cart.

It’s called the Anesthesia Medication Template, and is a standardized, three-dimensional arrangement of critical medications informed by workflow that makes identifying drugs easier and thus increases patient safety. It was created by Axel Roesler, UW associate professor of interaction design, in cooperation with Dr. Eliot Grigg and other physicians at Children’s, using best practices in design, and has been tested and refined over the years.

“Historically there has never been a recognized standard for presenting or organizing anesthesia medications in a workspace,” Grigg wrote. “Some workspaces are cluttered and filled with extraneous, distracting items. Others may be organized but in an esoteric way that other providers would not quickly recognize, especially in an emergency.”

The Anesthesia Medication Template, he wrote, is an attempt to combine design expertise with “our unique clinical workflow” to create “a standardized layout that makes identifying anesthesia medications easier and increases patient safety.”

Grigg was lead among several authors — including Roesler — of a 2017 paper about the design and its effectiveness in a two-year study in the journal Anesthesia and Analgesia. The two also co-wrote an editorial in the same journal in 2018 about the need for “a new vision,” such as the template in handling anesthesia medication.

Now, Roesler is lead author on a new paper about the Anesthesia Medications Template in the International Journal of Design. Grigg is a co-author as are fellow Children’s physicians Drs. Lizabeth Martin, Faith Ross, Sally Rampersad, Charles Haberkern and Lynn Martin. Another co-author is Magnus Feil, a former UW art faculty member now at Arizona State University.

The template was made live for operating room use in 2014. Roesler wrote that with about four years of data available, the device “has nearly eliminated syringe swaps and miscalculation errors at Seattle Children’s Hospital over its first 2.5 years in use and it has reduced the incidence of medication-related harm.”

Grigg added that a fifth year of data has since been gathered, “and the same trend holds.” He added, “I think we had one or two syringe swaps during that time, when they used to happen every few months.”

Roesler wrote: “Such a sustained reduction in errors in the operating room is almost unheard of with a single, analog device. This has had an enormous impact on the overall safety of providing anesthesia at Seattle Children’s Hospital.”

“The complementary design knowledge and understanding of anesthesia workflow could only be integrated by the close collaboration between designers and anesthesiologist and [the] interdisciplinary teamwork in multiple phases of this project.”

He said the device is now in use in all 19 operating suites at Seattle Children’s Hospital, and is being adopted by other hospitals in the United States as well.

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For more information, contact Roesler at roesler@uw.edu or Grigg at egrigg@uw.edu.

Tag(s): Axel Roesler • College of Arts & Sciences • School of Art + Art History + Design • Seattle Children's Hospital

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