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Outcomes, which are the result state or condition from a process or intervention, are essential elements of healthcare system design and an important indicator of performance. They are included in well-known system analysis frameworks such as the Systems Engineering Initiative for Patient Safety (SEIPS) and Cognitive Work Analysis (CWA). However, fewer practical approaches exist for understanding and communicating interactions among healthcare outcomes. This study applies a novel mapping method as a practical approach to collect, aggregate and visualise interrelations among multiple healthcare outcomes. Graphic facilitation mapping sessions with eleven healthcare providers and ten patients with chronic conditions were conducted. Participants created outcome interrelationship maps following a six-step process. Two outcome-based network visualisations were synthesised using network analysis. This outcome-based approach advances how we frame healthcare systems, focussing on accommodating multiple stakeholders' visions, understanding interrelations, and defining trade-offs. This practical approach may complement frameworks such as SEIPS and CWA. Practitioner summary: The presented outcome-based mapping approach can facilitate the understanding of outcomes as part of the interrelated healthcare system. The approach allows the discussion and integration of different stakeholders' outcome priorities to identify critical elements and better inform the development or adaptation of healthcare systems. Abbreviations: SEIPS: engineering initiative for patient safety; CWA: cognitive work analysis; HFE: human factors and ergonomics; AH: abstraction hierarchy; POTS: postural orthostatic tachycardia syndrome; DRM: design research methodology; FA2: forceAtlas2; HbA1c: glycated haemoglobin; NHS: National Health Service; UK: United Kingdom.

People with aphasia often have reading impairments that affect participation in daily activities. Text-to-speech (TTS) devices are technology-based supports that can facilitate processing of written materials. The purpose of this study was to gather information about the reading behaviors and TTS technology perceptions of people with aphasia who had first learned about system features and options. Sixteen people with chronic aphasia participated in single, one-on-one instructional and guided practice sessions using TTS systems. They answered close-ended questions about current reading behaviors and materials and ways they believed these would change given TTS system access. Participants reported reading at home and community locations. Most read calendars, newspapers, magazines, and mail. Participants who did not read lengthy materials - such as newspapers, magazines, and novels - indicated their interest in these materials would likely increase given TTS support. Although participants did not predict substantial comprehension changes given TTS support, most expressed interest in the technology after learning about it. Thus, people with aphasia perceive TTS systems as helpful for comprehending lengthy materials. Given modest predictions about comprehension benefits, presenting TTS as one of several support strategies is an appropriate recommendation.

Sound level measurement is used to assess sound within any environment, never more so than in hospitals. This is due to the negative effects that high sound level can have on patients and staff. However, other ways of exploring sound and the soundscape within the hospital context have been used: sound art has conveyed the experiences of heart transplant patients. Art may act as juxtaposition to objective sound level measurement but the two fundamentally attempt to depict attributes of the soundscape. Using theory from design and concepts from art a framework is presented for designing a positive soundscape experience. This is not through the addition of sound per se but through creatively communicating the information contained within a soundscape to enable the everyday listener to interpret a cacophony of hospital sounds more positively. In representing visual communication of sound as a design object, a new way to explore sound may exist.

Work on the perception of urban soundscapes has generated a number of perceptual models which are proposed as tools to test and evaluate soundscape interventions. However, despite the excessive sound levels and noise within hospital environments, perceptual models have not been developed for these spaces. To address this, a two-stage approach was developed by the authors to create such a model. First, semantics were obtained from listening evaluations which captured the feelings of individuals from hearing hospital sounds. Then, 30 participants rated a range of sound clips representative of a ward soundscape based on these semantics. Principal component analysis extracted a two-dimensional space representing an emotional-cognitive response. The framework enables soundscape interventions to be tested which may improve the perception of these hospital environments.

Computer-based representations of products offer potential time and cost savings in the early design stages of new product development. As technology progresses they offer considerable scope for co-designing, giving users a voice early in the design process. However, few studies address how users relate to such models. A laboratory-based study was conducted with 13 older users (six men and seven women) to investigate their understanding of model formats used at an early stage of prototyping (i.e. on-screen digital images and physical rapid prototyped (RP) models). The results indicate that users were able to identify the basic purpose or function of a familiar product from the 2D line drawings. However, perceptions of size, weight and materials were poor, particularly with a less familiar product. Essentially, finished RP models and 3D colour computer-aided design images were found to communicate products more completely to users and therefore useful for eliciting feedback. Unfinished models were found to...

There can be a tendency, even within companies who practice concurrent engineering, to limit customer involvement to the initial and final stages of the new product development process only. This invites the possibility that the customers' opinions will be lost or at least diluted during the intermediate stages of the process. A joint research project involving Loughborough University and the Central University of Technology, Free State has provided evidence, through several case studies, that physical models created via rapid prototyping enable the customer to be involved throughout the development process. The benefits associated with using physical models are discussed, showing that these models have a unique role to play in promoting customer involvement. The authors propose the method termed Customer Interaction with Functional Prototypes, which has been implemented during several new product development projects carried out in both academic and industrial environments. At present, the Customer Inter...