korea university medical design report 2015 (1/8)
TRANSCRIPT
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Korea University Industrial and Information Design
2011220026 Kim yebin
2011220031 Park eunji
2011220035 Song chaelin
PRODCUT DEVELOPMENTOPERATING ROOM TEAM REPORT
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1. Overall Operating room Description
2. Stakeholder Mapping
3. Overall Operating room Issues
4. Obsevation - Indepth Interview - OR Observation
Contents
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- Surgical Process
- Equipment
- OR room area division
Overall Operating room Description
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Naver
, , , , . , , . , , , , , , , .
OR
Macro research about OR
Definition of Operating Room
Korea University Industrial and Information Design 4
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Indian Journal of Anaesthesia 2007;51 (3) : 193-199
Overall Procedure Operating roomAreas we can cover for teams topic
Macro research about OR
Korea University Industrial and Information Design
Preoperative Period Intraoperative Period Postop Period1. Decision for Surgery2 Presurgical Education3. Consent - Surgery4. Speciality Referral5. Schedule Case in OR6. Request Surgical Equipment7. Set up Preop Evaluation8. More diagnostic testing9.Adjuvant Therapy10. Preop Eval / Exam / Education -Nurse / Anesthesia11. Consent - AnesthesiaI12. nstruction to patients13. More diagnostic testing14. Gather information15. Confirm callsI16,dentify patients17. Match patient to procedure18. Nursing Preop Assessment / Exam19. Premedication20. Transport to OR
1. Transport to recovery area2. Transfer Care to PACU team3. Post op labs / Test4. Find / Act on test results5. Recover from Anesthesia6.Pain management7. Discharge from recovery area
Surgery Proceeds
systematic approach
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Surgeon
Operating table
lights
anesthesia cart
Electrodes (sticky pads or stickers)
pulse oximeter
blood pressure cuff
intravenous (IV) line
Anesthesiologist
Nurse anesthetist
Nurses
Who Are the Oerating Room Staff ? The Operating Room and Staff What Is Inside the Operating Room?
http://www.uofmmedicalcenter.org/healthlibrary/Article/89601
Macro research about OR
Overall Environemnt of Operating room
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Different Zone of OT Complex
OT(Operation Theatre) complexes are designed and built to carry out investigative, diagnostic, therapeutic and palliative procedures of varying degrees of invasiveness. Many such set ups are customized to the requirements based on size of hospital, patient turnover and may be speciality specific.
The Patient The Staff The Material
- Change rooms for all medical and paramedicalstaff with conveniences- Transfer bay for patient, material & equipments- Rooms for administrative staff- Stores & records- Pre & post-operative rooms- I.C.U. and P.A.C.U.- Sterile store
The Location and Flow should be considered Based on varying degrees of cleanliness
Connects protective zone to aseptic zone and has other areas also like
Includes operation rooms (sterile)
Disposal areas from each OR & corridor lead to disposal zone
Indian Journal of Anaesthesia 2007;51 (3) : 193-199
Macro research about OR
Designing Operation room
Korea University Industrial and Information Design
Protective zone
CleanZone
Disposal zone
Asepticzone
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Sub areas (excluding OT place)
Men and women change dress from street cloth to OT attire; lockers and lavatory areessential
Preferably adjacent to recovery room.
Staffroom
A definite area to be designated. It should be in a cool, clean room that is constructed of fire resistant materials.
Induction room (anaesthetic
room).
Post anaesthetic care units (PACU)
This area is planned for IV line insertion, preparation, catheter / gastric tube insertion, connection of monitors
The anaesthetic room will provide a more tranquil atmosphere to the patient than the OT. It should provide space for anaesthetic trolleys and equipment and should be located with direct access to circulation corridors and ready access to the operating room.
Holding area
This is important with respect to maintaining privacy, for changing from street clothes to gown and to provide lockers and lavatories for staff.
Pre-operative check in area (reception)-
The anaesthesia gas / cylinder
manifold room /storage area
Indian Journal of Anaesthesia 2007;51 (3) : 193-199
Macro research about OR
Designing Operation room
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This is designed to store large but lessfrequently used equipment in the OT.
This is planned to be built within the restricted area. Elbow operated or infrared sensor operated taps / water source is ideal.
Store room
Intra-departmental discussions, teaching and training sessions for staff (with audio-visual aids)
Laboratory ScrubroomSmall lab. with refrigerator for pathologist to be arranged.
Rest rooms
Offices for staff nurse and
anaesthesia staff
Seminar room
Sub areas (excluding OT place)
Indian Journal of Anaesthesia 2007;51 (3) : 193-199
Macro research about OR
Designing Operation room
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Stakeholer Mapping
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Medical team
Operating surgeon, resident, nurse
Anesthesiologist, anesthesiology unit nurse
Regular operation patient
Emergency operation patient
Patient Guardian
Macro research about OR
Designing Operation Stakeholder
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OPERATING ROOM
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Operating surgeonAssistants to the surgeon
Scrub person
Anesthesiologist Circulator
Biomedical technicians Radiology technicians
Indian Journal of Anaesthesia 2007;51 (3) : 193-199
Macro research about OR
Korea University Industrial and Information Design
Operating Team members
Operating Team members
Direct Indirect
Sterile Group Unsterile Group
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1. Perform surgical hand washing (arms are included). 2. Don sterile gowns and gloves. 3. Enter the sterile field. 4. Handles sterile items only. 5. Functions only within a limited area (sterile field). 6. Wear mask.
http://www.surgerymanagement.com/presentations/operating-room-scheduling.php
Macro research about OR
Korea University Industrial and Information Design
Surgeon
Assistants
Scrub Person
1. Preoperative diagnosis and care of the patient 2. Performance of the surgical procedure 3. Postoperative management of care
1. Help maintain visibility of surgical site 2. Control bleeding 3. Close wounds 4. Apply dressings 5. Handles tissues 6. Uses instruments
1.Registered Nurse 2.Surgical technologist 3. Licensed practical/vocational nurseThe responsibility of a scrub person is to maintain the integrity, safety and efficiency of the sterile field throughout the surgical procedure.
Operating surgeonAssistants to the surgeon
Scrub person
Sterile Group
Sterile Group Task
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1. Handle supplies and equipments that are considered unsterile. 2. Touches unsterile surfaces only. 3. Keep the sterile team supplied with supplies handled aseptically. 4. Give direct patient care. 5. Assist the sterile team members need with strict observation of avoiding contact to the sterile field. 6. Handles other requirements arising during the surgical procedure.The unsterile operating room members are not allowed to enter the sterile field to prevent
contamination.
Anestheslologist
Circulator
Technicians
1. Choice and application of appropriate agents. 2. Choice and application of suitable techniques of administration. 3. Monitoring of physiologic function. 4. Maintenance of fluid and electrolyte balance. 5. Blood replacement. 6. Helps in minimizing the hazards of shock, fire and electrocution. 7. Use and interpret correctly a wide variety of monitoring devices. 8. Overseeing the positioning and movement of patients. 9. Oversee the postanesthesia care unit (PACU) to provide resuscitative care until the patient has regained vital functions.
1. Monitor and coordinate all activities within the room. 2. Manage the care required for each patient. 3. Provides assistance to any member of the OR team with strict observation to avoid a break in sterility. 4. Creates and maintains a safe and comfortable environment for the patient through the implementation of aseptic technique.
Biomedical technicians, radiology technicians or other staff that might be needed to set up and operate specialized equipment or devices essential in monitoring the patient during a surgical operation
http://www.surgerymanagement.com/presentations/operating-room-scheduling.php
Macro research about OR
Korea University Industrial and Information Design
Anesthesiologist Circulator
Biomedical technicians Radiology technicians
Unsterile Group
Unsterile Group Task
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Macro research about OR
Korea University Industrial and Information Design http://www.surgerymanagement.com/presentations/operating-room-scheduling.php
Registered Nurse and surgical technologists that have a written hospital policy permitting the action.Second Assistant could be a registered nurse or surgical technologist. These staff should be trained and they mar retract tissues and suction body fluids to help provide exposure of the surgical site
A qualified surgeon or resident in an accredited surgical education program. The first assistant should be capable of assuming the operating surgeons responsibility in cases of incapacitation or accidents.
Assistants
Classification of Assistants
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- Top problem with todays operating room
- Scheduling Issue
- Nursing Issue
- Case Issue
Overall Operating room Issues
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Safety Sterility Simplicity
Operating Room Safety Issues Operating Room Cleaning and Sterility Problems
Areas for improvement in operating room efficiency
Clutter/Lack of Space
Operating Table
The modern OR is quite small (typically 300 to 550 square feet), and was not designed for the proliferation of high-tech equipment that is used today.
The operating table is not fixed in place, and can become unstable or move accidentally during surgery.
Operating room cabinets are small, with limited capacity for stocking supplies. Current practice for re-stocking during surgery relies on availability of a circulating nurse who must leave the room to obtain required supplies.
Operating Room Efficiency Needs
Inefficient Re-stocking
Walls
Floors
Most operating room walls are painted plasterboard, which compromises sterility.Paint cannot withstand repeated high friction scrubbing so operating room walls are rarely scrubbed, and therefore even when the hospital reaches its highest level of cleanliness bacteria still reside on walls.
operating room floors are not sterile; infection is transmitted from room to room. Until now, no reliable and simplified mechanism for sterilizing an operating room floor has been available.
Superbugs in the operating room
Use of Walls
Operating Room Lighting
Operating room walls are not multifunctional, and are used only to mount X-ray viewing boxes and wall outlets.
They may poorly illuminate the surgical field, are difficult to maneuver, and compete for precious space needed for other intra-operative technology.
A lack of real-time information results in an environment that is inefficient, and sometimes risky, when the absence of accurate data leads to hospital errors.
Information Flow
Systems Integration
Operating Room Turnover time
http://www.optimusise.com/top-problems.php
Macro research about OR
Korea University Industrial and Information Design
TOP PROBLEMS WITH TODAYS OPERATING ROOM
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SurgerySchedule
The "optimal" design of an OR scheduling process is in many instances significantly different, depending on whether you are a:- Surgeon- Anesthesiologist- Operating Room Nurse- Administrator Hospital Bed
and AncillaryUtilization
Prodcutivity
Marketablilityof Program
Utilization
- Rooms- Anesthesia- Equipment- Nursing
- Surgeons-Anesthesiologists-Pre / Postop Units
http://www.surgerymanagement.com/presentations/operating-room-scheduling.php
Macro research about OR
Scheduling Affects the Entire Organization
Direct Costs
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The Runaway Patient
Someone close to the patient on the OR table turns around and suddenly the patients arm or leg flings out and knocks over a sterile tray. Or worse, the patient slips to the floor.The critical moments are when the patient is being positioned before the restraints are in place, and when they have been removed before the patient is transferred.
Bad Medicine
Nurses in the OR are often the last person to check on a medication before it is handed to a physician to administer. Or, the nurse may be directed to give the medicine without further inspection. There are a series of checks and balances in place to make sure this doesnt happen.
The Leftovers
It is a reality that things are sometimes left in a patient during a surgical procedure. The typical items are sponges and various tools. Because our bodies are so good at isolating foreign bodies, this may happen way more than is ever reported.
Hospitals put many processes and procedures in place to reduce the risk of infection. Again, good team work is the key. Whenever someone sees a potential issue, they should report it to be investigated. Its easier to correct the problem than treat a wounded infection in the patient later.
An Infectious Environment
Nursing and Risk Management
Nurses must know a number of techniques to be effective in the operating room. On top of that, they must constantly be on guard for those unexpected issues. Hopefully, they can be corrected early, so they dont become a more dangerous situation for the patient during and after surgery.
http://educationcareerarticles.com/career-information
/career-news/common-nursing-issues-in-the-operating-room/
Macro research about OR
Common Nursing Issue in the Operating Room
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http://www.surgerymanagement.com/presentations/operating-room-scheduling.php
Macro research about OR
Google GlassGoogle Glass is a wearable computer with an optical head-mounted display. Google Glass displays information in a smartphone-like hands-free format. Wearers communicate with the Internet via natural language voice commands
Korea University Industrial and Information Design
Google Glass
Indication of Operating information
Educational Purpose
Recording Operation in video
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- Technician Indepth interview
- OR Observation : Deep Brain Stimulation Surgery
- OR Observation : Microvascular Decompression
Observation
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Macro research about OR
Korea University Industrial and Information Design
Technician Indepth interview
Name :Affiliation: Date : 2014.04.14Place : KIST
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Macro research about OR
Technician Indepth interview
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Macro research about OR
Technician Indepth interview
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A. Procedure, Face , StepActivity - Motion . Step activity . DBS MER Step acticity MER Electrode 5mm activity , motion 5mm . Step , . Structure .
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Macro research about OR
Technician Indepth interview
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Macro research about OR
Technician Indepth interview
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Technician Indepth interview
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Macro research about OR
Technician Indepth interview
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Macro research about OR
Technician Indepth interview
Macro research about OR
Korea University Industrial and Information Design
SWMSurgical Workflow Management WHAT ?
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Technician Indepth interview
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Technician Indepth interview
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Electnonic Medical Record
Macro research about OR
Technician Indepth interview
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EMRINSIGHTS?
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WORKFLOW
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Micro research about OR
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Aneasthetists Indepth interview
4 1Affiliation:
Date : 2014.04.22Place : 3
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Macro research about OR
Expert Anesthetists Indepth interview
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Macro research about OR
Expert Anesthetists Indepth interview
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Macro research about OR
Expert Anesthetists Indepth interview
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Macro research about OR
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INSIGHTS?/ ISSUES
Aneasthetists Indepth interview
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Micro research about OR
Aneasthetists Journey map
Korea University Industrial and Information Design
Checking Patient listChecking the OCS
Phone Communication
off the ORNew surgery
OCS delays Other new surgeryEmergency surgery
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Tasks
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Print the OCS paper - Scheduleissue
Running movement - Schedule issue
Phone communication - Communication issue
Delay, Cancle, Overtime - Schedule issue
Communication in OR - Sanitize issue
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2014.04.17
HFS (hemifacial spasm)
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Macro research about OR
OR Observation : Micro Vascular Decompression SurgerySession : C arm operation
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Macro research about OR
OR Observation : MicroVascular Decompression Surgery Operate Process & Issues
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Macro research about OR
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Macro research about OR
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Macro research about OR
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OR Observation : Micro Vascular Decompression SurgerySession : Overall Operating
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, (test stimulator) ,
Macro research about OR
Korea University Industrial and Information Design
OR Observation : Deep Brain Stimulation Surgery
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Macro research about OR
OR Observation : Deep Brain Stimulation Surgery Operate Process & Issues
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OR Observation : Deep Brain Stimulation SurgerySession : Brain Drilling
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OR Observation : Deep Brain Stimulation SurgerySession : C arm operation
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OR Observation : Deep Brain Stimulation Surgery Operate Process & Issues
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Affinity Diagram
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.
teaching
.
Communication
Communication
-Communication
68
-
.
chief
.
fix
.
.
.
. - -
.
- .
Macro research about OR
Affinity Diagram
Korea University Industrial and Information Design
4
.
OR cell phone
.
Scheduling
69
-
,
.
Sterile Group .
.
foot interaction
OR
.
.
.
vital checking
.
Macro research about OR
Affinity Diagram
Korea University Industrial and Information Design 70
-
.
TO .
pm3:30
.
Rule
Macro research about OR
Affinity Diagram
Korea University Industrial and Information Design
.
.
.
scheduling .
1. 2. 3.
.
arrange phone .
71
-
OCS system
.
.
.
.
TO
delay
.
delay 1. 2. 3. 4.
.
.
.
.
Delay
Macro research about OR
Affinity Diagram
Korea University Industrial and Information Design 72
-
Dashboard
Rule
Communication
-
Scheduling
Macro research about OR
Affinity Diagram
Korea University Industrial and Information Design
ISSUE and Description
Help Point
,
Issue
DashBoard
Arrange Delay
Scheduling
,
Scheduling
Sterile Group
Issue
Issue
73
-
Topic Direction
-
Macro research about OR
Topic Direction
.
.
.
vital checking
.
.
.
on on
.
4
.
OR cell phone
.
chief
.
.
.
.
stereo tactic ,
.
.
OR
.
availability .
OR cell phone.
cell phone .
.
.
teaching
.
.
chief
.
fix
.
.
.
.
. - -
.
- .
,
.
Sterile Group .
.
foot interaction
OR
.
.
.
vital checking
.
80
%.
.
.
.
.
.
.
scheduling .
1. 2. 3.
.
arrange phone .
OCS system
.
.
.
.
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delay
.
delay 1. 2. 3. 4.
.
.
.
.
.
TO .
pm3:30
.
Communication
-
Scheduling
4 task
Rule
Delay
.
OR .
.
.
Multiple Monitor
Korea University Industrial and Information Design 75
-
.
- .
.
.
OR
.
Macro research about OR
.
availability .
cell phone .
.
OR cell phone.
Topic DirectionCheck Point Dash Board
Dashboard & System for OR Communication
Record PreparationShareMoving Line
Communication- Notice
-
OR
.
Korea University Industrial and Information Design 76
-
Micro research about OR
Topic Direction
Korea University Industrial and Information Design
Hospital OR Scheduling Contextual Awareness OR Specic Information Awareness
Aware-Media ?
.
.
, , ,
. Video streaming technology .
.
Awaremedia
.
Theoretical Research Aware-Media
78
-
Macro research about OR
System for OR Nurse
OR Nurse
Topic Direction
Korea University Industrial and Information Design
INSIDEDashboard for Other stakehoder
OR Nurse, Anesthesiology Resident, ( )
OUTSIDE
Target Stakeholder
PreoperativeStep.1
IntraoperativeStep.2
PostoperativeStep.3
Record System Dashboard
80
-
Monitoring Computer
5
Eletrode Equipment
6Operation Theater Operation Room
Check Point Dash Board
Topic DirectionCheck Point Dash Board
Description Of Check Point Dash Board
Macro research about OR
Korea University Industrial and Information Design 77
-
Micro research about OR
Korea University Industrial and Information Design
The overall system is based on a distributed architecture shown in the picture The AwareMedia architecture is an example of an hy-brid collabora-tive architecture, which uses a peer-to-peer architec-ture for routing video between participating clients, and a client-server architecture for distributing information on operations, sta-tus information, location, etc
AwareMedia - A shared Interactive Display SupportingSocial, Temporal, and Spatial Awareness in Surgery
Jakob E. Bardram, Thomas R. Hansen, and Mads SoegaardCentre for Pervasice Healthcare, University of Aarhus
Aabogade 34, 8200 Aarhus N, Denmark
{bardram, thomasr, madss}@daimi.au.dk
Topic DirectionTheoretical Research Aware-Media
79
-
Macro research about OR
Topic DirectionWireframe
Korea University Industrial and Information Design
Record System Check Point Board
(, , , , )
(, )
(,, )
OR no.1
9.7 Inch2048 * 1536 px
81
-
Macro research about OR
Topic Direction_OutsideWireframe
Korea University Industrial and Information Design
OR (, )
OR no.1
OR no.1
OR OR availability
OR , Stakeholder
PreoperativeStep.1
IntraoperativeStep.2
PostoperativeStep.3
82
-
Korea University Industrial and Information Design
Macro research about OR
Topic Direction_OutsideWireframe
(, , , , )
(, )
(,, )
OR no.1
, ,
Dashboard main information
OR Dashboard ,
Sub information Bar notice
83
IntraoperativeStep.2
PreoperativeStep.1
PostoperativeStep.3
-
Korea University Industrial and Information Design
Macro research about OR
Topic Direction_InsideWireframe
OR no.1
OCS system fomat
tab ( - )
, module tab
1
1
2
3
4
5
2 3 4
84
-
Korea University Industrial and Information Design
Macro research about OR
Topic Direction_InsideWireframe
OR no.1
1
1
2
3
4
5
2 3 4
OR no.1
1
2
3
1
85
-
First Draft
-
Korea University Industrial and Information Design 87
Macro research about OR
Design WorkCheck Point Board + System
Opening Screen
Preoperative Intraoperative
Preoperative Preoperative
Outside Check Point Board
Inside system
-
Korea University Industrial and Information Design 88
Opening Screen Preoperative
Macro research about OR
Design WorkCheck Point Board
-
Korea University Industrial and Information Design 89
Preoperative Intraoperative
Macro research about OR
Design WorkSystem
-
Macro research about OR
Design WorkSystem
Preoperative
Inside system
90
-
Thank You
1._Intro-Interview2.Obervation_3.Analysis_Affinity Diagram4._Topic Direction