Checklists: Why doesn’t everyone do it?
Tue, Jan 20, 09
Some years ago, just before going into surgery, a loved one asked me to place a sticky note on one of her knees so that the surgeon wouldn’t mistakenly operate on the other. I thought it was a bit too aggressive and didn’t. But I made sure to remind the surgeon and the lead nurse in person, looking into their eyes, that it was the right knee, not the left one, in half-jest.
Apparently, we weren’t the only ones who should worry about this, as The Independent reports:
Surgeons in England and Wales will be ordered today to carry out a safety checklist before every operation they perform, after a study showed it cut surgical deaths and complications by a third.
Described as the biggest clinical innovation in 30 years, the checklist is based on a set of seemingly banal questions but is set to become as essential to daily medicine as the stethoscope. In Britain alone, the new procedure could save hundreds of lives a year and 80,000 complications.
Estimated operations around the world approaching 250,000 per year, the stakes are enormous:
Atul Gawande, an American surgeon and associate professor at the Harvard School of Public Health, who led the study, said work was under way on further checklists for maternity and childbirth (to be published this year), heart disease, pneumonia, HIV and mental health. “It is one of those simple, unbelievably powerful ideas that will have an impact across medicine. Surgeons had assumed that doing well for patients was mostly about their skill. But there is now too much technology and too many patients for one person to deal with.”
He added: “When I talk to clinicians, they say: ‘we already do this stuff.’ The answer is: we are good at doing it most of the time, but we are not good at doing it all the time. We found some members of the team felt they were such low agents, they only felt responsible for their corner. Being allowed to say who they were [one item on the checklist] and hear the surgeon say what he expected made them feel part of the team. When you are not given a voice you turn your brain off.”
Over the years, I have trained and mentored many designers, developers and analysts. I’ve found it quite difficult to get them to first create and then methodically follow checklists. Some of the most egregious and preventable mistakes often result from failing to follow just a few checkable items. Not all mistakes harm people but end up wasting a lot of time, like when a developer was nearly in tears after spending an entire afternoon trying to debug an XML-to-PDF-to-print utility. The printer wasn’t on.
I have nearly given up on homo sapiens reliably executing checklists. So my design and management practice has moved on to analytics/rules driven system design where such failure is assumed and thus automated out of existence, without hopefully making the system too brittle. It’s of course harder to design that way up-front, but the pay-off is undeniably worth it, time after time .
Editor interview: Designing “Data Flow”
Fri, Jan 9, 09
Yesterday in Book review: World’s best info-design in “Data Flow” we explored an exciting new book on data visualization. Today we ask Gestalten Publisher and Editor in Chief Robert Klanten to comment on the current state of info-design and the genesis of Data Flow: Visualising Information in Graphic Design:
• Where did the idea of creating Data Flow come from? Any influences?
Information graphics are an interesting topic we have always been following. It has always been very much tied with websites, interactive and screen design, and now we felt there was enough new material to show how much it has matured in the last couple of years.
• Most people get exposed to info-vis in a limited fashion via their daily newspaper, newsweeklies, TV and other popular media. Specialized magazines, trade books, marketing collaterals, text books, etc. where more evolved forms of info-vis might be found are not mass marketed. Have you noticed if info-vis is making more inroads into the popular culture?
First there is a growing demand for information graphics but beyond demand I feel that the aesthetics are somehow en – vogue. I think that everybody is aware of how interconnected our lives have become through media and how the sheer amount of information, references and interests have exploded.
Maybe the deeper logic is that modern people feel more comfortable seeing themselves as a part of a huge network, much rather than being a slice of a pie chart. Everyone has to find new ways of defining and locating oneself – graphic design is somehow providing this trend with adequate visuals.
• There is a vast divide between template-based info-design coupled to digital data sources that generate our daily intake of info-vis and one-off creations that require long and painstaking work by dedicated info-designers some of whose work can be seen in Data Flow. Our digital tools are not yet capable of facilitating real-time, or even reasonably rapid, creation of rich and elegant visualization. Do you foresee a day when this gap might be narrowed?
This day is much closer than we all think. There is a huge demand for visualisation in technology, medicine, science, meteorology, etc and these solutions will make it in museums, onto fairs as well as other commercial applications. Computers are fast enough to handle the huge amount of data that is needed without causing delays handling the data. This is the key.
• In collecting your samples, have you noticed any differences among American, European and Asian approaches to info-design?
There are certain “folkloristic” preferences and traditions that always exists and become visible here and there. Britons are very image driven while continental Europeans are usually working with a reduced and clear structure and favour vector graphics. Americans expect “how to” instructions to come along with the information while Asians are keen to find out on their own.
But it can generally be said that the guys who have devoted themselves to this subject are very diligently trying to avoid local habits and try to react upon the expectations and the intelligence of the viewer much rather than trying to do something which is self-servingly stylish or traditional.
• I assume that some samples were eliminated from the book as they couldn’t fulfill the “Visual metaphors are a powerful aid to human thinking” criteria. With some samples, did you have any difficulty in drawing a distinction between the purely decorative but perhaps inspirational and informative but perhaps purely instructional?
I think we tried to cover the subject in its entirety from instruction to inspiration. There are examples in the book that might use the aesthetics of information graphics without being “informative” in a classical sense. There are other examples that are trying their best to create / discuss new possibilities of visual display. It is quite subjective to determine where one thing begins and the next thing starts and in some cases we have decided to leave this decision to the reader.
We are not delivering a final verdict but try to see this book as a launch pad that provides the reader with enough knowledge and theory and open questions.
• Were there perhaps more patterns beyond the six that you focused on (datasphere, datanets, datascape, datalogy, datanoid, datablocks) that you may have found too restrictive, specialized or amorphous?
Yes, absolutely. Just like information graphics, we had to build an editorial container and include as much information (chapters, types of applications) to create consistent and instructive examples and exclude more freakish approaches for the sake of remaining legible.
Book review: World’s best info-design in “Data Flow”
Thu, Jan 8, 09
“Visual metaphors are a powerful aid to human thinking.”
That is the very first sentence of the foreword to a gorgeous new book on information visualization Data Flow: Visualising Information in Graphic Design. In just nine words it captures both the boundless possibilities in making data comprehensible to humans as well as the inability of info-designers to dictate the outcome, as the meaning is always in the eye of the beholder. Info-designer’s principal job is to contextualize data by creating metaphors and hope to ignite thinking. Info-vis is thus condemned to forever straddle the divide between inspiration and instruction.
The book which publisher Gestalten kindly sent us for review is anchored by (IDEO partner) Ferdi van Heerden’s foreword followed by designer interviews, short editorials and contextualizations adjacent to the best collection of contemporary info-vis samples currently available in a book format.
Data Flow surveys a huge swath of the landscape of data metaphor and identifies six gateways which organize the book’s chapters:
- Datasphere – circle as the perfect but elusive shape
- Datanets – networks of cause, context and relationships
- Datascape – spatial flow, context and order of data
- Datalogy – physical expression of the metaphor for our senses
- Datanoid – reflections of ourselves for emotional relevance
- Datablocks – data structured and simplified for comparability
Searching for a “data language” is a common thread throughout the book:
If we can show data as blocks, spheres, rivers, nets, or landscapes, we open up a new and rich visual language through which the external world is brought into our internal world of understanding. In other words, we communicate.
DataFlow also underlines the tension between using accessible info-design vocabulary and complexity:
Design is not just about making things simple. In fact, there is a complementary relationship between simplicity and complexity that influences design choices to produce surprising and informative data diagrams. By shaping their view on data, designers can choose to introduce a level of complexity that allows just the right amount of contrast to drive profile, focus and definition. The choices determining this delicate balance — called simplexity — are highly dependent on the context and audience for the resulting data presentation.
The ever-present danger of that tension is the overtaking of comprehension by composition:
A professional, visually literate audience will relish a higher sophistication and subtlety that can be delivered with sublime elegance. However, access to ever larger databases can seduce the designer into placing complexity, and the challenge of bridging the gap between information and its expression, at the very forefront. Software tools such as Processing [website] have made it possible to give shape and meaning to massive amounts of information, yet in many cases the tool becomes the message.
Among the 250 pages of meticulously reproduced samples, it’s also easy to see that sometimes the scales tilt away from comprehension/instruction towards composition/inspiration, and even towards decoration.
Occasionally, it’s hard to gauge the full-impact of large pieces, both in size and detail, because they are scaled down by the constraints of a printed book page — one longs for a zoom-in button. An interactive format would have obviously allowed a more layered engagement, tying selected samples back to such info-design sources as Tubular Graphics (Tokyo) and Stamen Design (San Francisco). And yet there’s something immensely satisfying about having a single, portable source that captures what’s current and curious about data representation in one place.
DataFlow is that rare collection that elevates the discussion on info-design from wow! to introspection.
Read our interview with Gestalten Publisher and Editor in Chief Robert Klanten on the current state of info-design and the genesis of Data Flow.
Daily question: Brains on the mind?
Mon, Dec 22, 08
From The Museum of Scientifically Accurate Fabric Brain Art:
This is the world’s largest extant collection of anatomically correct fabric brain art. Inspired by research from neuroscience, dissection and neuroeconomics, our current exhibition features three quilts with functional images from PET and fMRI scanning and a knitted brain. The artists are Marjorie Taylor and Karen Norberg. Techniques used include quilting, applique, embroidery, beadwork, knitting, and crocheting. Materials include fabric, yarn, metallic threads, electronic components such as magnetic core memory, and wire, zippers, and beads.
While our artists make every effort to insure accuracy, we cannot accept responsibility for the consequences of using fabric brain art as a guide for functional magnetic resonance imaging, trans-cranial magnetic stimulation, neurosurgery, or single-neuron recording.
In case you’re wondering about non-mushy brains, Bachy’s Figured Maple Brains:
I can produce figured wooden brains customized to reflect your abilities, research interests or particular features of your own brain, working from fMRI scans as DICOMS or NIFTI files.
What happens to “art” when it’s “scientifically accurate”?
Daily question: Forest. Trees.
Mon, Nov 17, 08
From Running the Numbers art project where cognitive distance is stripped from pedestrian statistics: every 30 seconds 106,000 aluminum cans are consumed in the U.S.
Will you drink less now?
