End-User Input to Guide Design and Development of a DME Product
Robert Levy, Ph.D., Richard Nelson, B.A.
This paper is a case study of how end-user input was incorporated from the earliest stages into the design of a portable lifter for wheelchair clients who cannot or have difficulty transferring independently. Although a NIH SBIR Phase I funded project, the use of focus group style methods is applicable to the development of any product or service. The methods we used are described in detail and the key findings are reported that influenced the development of bench models and that will affect the Phase II project. Lessons learned and implications are discussed that will help innovators succeed with future design projects.
Key Words:
Product Design, Usability, Focus groups, Methodology
PROBLEM
Where in the product design cycle should you include end-user input? Many products reflect the creative and ingenious work of an inventor responding to a perceived need, but start off without end-user input. The importance of such input only becomes evident when there are unhappy consumers, safety/functionality concerns, no sales, or later in the product cycle when there is competition. We believe that in order to maximize the usability of a product a necessary component of the design process is to incorporate end-user input from the earliest stages of design, and continue throughout development of the product.
PURPOSE
In this paper we discuss the methods we used to obtain end-user input in the design and development of LifterMate, a DME lifter product for people who use wheelchairs for mobility and have difficulty or cannot transfer independently. For the lifter, there were three populations of end-users: the wheelchair clients, their caregivers, and the professional staff who work with the clients and caregivers.
Although the work was part of a NIH funded Phase I SBIR project, the methods are readily adapted to any end-user population. The costs can be minimal and the methods are straightforward.
METHODS
A focus group is the method that we used at four different stages during the SBIR Phase I project in which we went from conceptualization to the construction of bench models for which to demonstrate feasibility of our product. There is extensive literature on how to conduct focus groups. The essence is that in a comfortable setting approximately 6-10 individuals respond to a series of probe questions, preferably that require open-ended responses. There is typically a facilitator and a recorder.
The facilitator provides a context for a probe question. Participants respond to the probe question, possibly in a sequence going from one participant to another or with more open responding. It is essential that participants understand that there are no “right,” “wrong,” or “better” answers, that candor is appreciated, and that each person is heard. Before moving on to another probe question, the facilitator must let the time to respond to a probe extend long enough to exhaust the pool of immediate responses and tap into those that may be more creative or complex. The facilitator’s role is to facilitate, clarify, and move the process along, not to participate. A typical session lasts 60-90 minutes and provides time for approximately 5-9 probe questions.
Four focus groups, conducted at the facilities of the Easter Seals Rehabilitation Center, Evansville, Indiana, are described below. PowerPoint was used to provide guidelines for each session, present drawings as needed, and to pose probe questions. Except for (1) below, participants signed and reviewed “Non-disclosure” and “Informed consent” agreements. They also received a $20 stipend. The probe questions for each round are presented. Although they are similar, the point is to identify critical questions that can provide helpful information throughout the design process.
- Professional staff: Prior to submitting the Phase I proposal, 6 professional staff, e.g., physical therapists, occupational therapists, and group home supervisors, participated in a session to respond to the following probe questions:
- When using a lift device, what are design features that you like and why?
- When using a lift device, what are design features that you do not like and why?
- What are the most important safety features that any design must address?
- What are essential features for design that will optimize usability.
- Wheelchair clients and caregivers. Within the first month of the funded project separate sessions for wheelchair clients and caregivers were conducted. A session began with general questions that probed participants’ experiences with, concerns, and feelings about lifters:
- Tell us the lift devices you use/have used and what features you like in those lift devices
- Tell us what features you do not like … that cause you problems
- Tell us what safety features are essential
- Tell us what features and/or capabilities would make the lift “a pleasure to use”
Then participants viewed a series of LifterMate concept drawings and responded to additional probe questions:
- Tell us your initial response to each design
- Tell us what you liked about each design
- Tell us what you did not like or what might cause problems with each design
- Tell us what we should do to make LifterMate successful
- Tell us which design you preferred and why
- Wheelchair clients, caregivers, and professional staff. Approximately two months later wheelchair clients, caregivers, and professional staff participated in another set of sessions in which full-scale models made of PVC pipe were used to demonstrate the concepts. The probe questions were:
- Tell us your initial response to each model
- Tell us what you liked about each model
- Tell us what you did not like or might cause problems with each model
- Tell us what features and/or capabilities would make the lift “a pleasure to use”
- Tell us what safety features are essential
- Tell us what we must do to make LifterMate successful
- Tell us which model you preferred and why
- Wheelchair clients, caregivers, and professional staff. A final focus group was conducted two months later with the bench models. The probe questions were:
- What design features do you like about each model and why?
- What design features do you not like about each model and why?
- What are the most important safety features that alterative designs must address?
- What are essential features for LifterMate to be useable?
- Which model do you think you would feel most comfortable using and why?
- Which model do you think you would feel least comfortable using and why?
At the end of each session, confidentiality was emphasized and any questions answered. Many participated in more than one session. The recorder recorded verbatim the participants’ comments and then transcribed the notes and prepared a summary of major points.
RESULTS
The end-user input fell into broad categories:
- Specific preferences about designs: These helped eliminate many design concepts
- General concerns about lifters and lifter use: The single most important concern is safety and ease of use, especially because of caregiver turn over
- What to emphasize as we go from a bench model to a prototype (SBIR Phase II): Nuts and bolts ease of use concerns such as making it fail safe, training materials such as manuals or DVDs and, as always – stability, stability, stability.
LESSONS LEARNED AND RECOMMENDATIONS
- In our first session with wheelchair clients (2 above), several clients were not of our target population in that they had the upper body strength to transfer independently. Their input was not useful. We were careful in later rounds to only recruit wheelchair clients who could not or had difficulty transferring independently. In other words, make sure that the participants are representative of the actual end-user population(s).
- Originally it was planned to have homogeneous focus groups, that is, only caregivers or clients or professional staff since it was thought that the presence of one population might inhibit the responses of another. We did not find that to be the case when convenience and availability “forced” us to have heterogeneous participation in one of the rounds. Therefore, for the last round the session was open to all populations.
- Facilitators who are members of the project team need to work hard to not talk too much.
- End users are appreciative of the opportunity to participate in the design process for products that may improve the quality of their lives.
- There was funding to support conducting these focus groups and we encourage building mechanisms for obtaining end-user input into any similar grant or contract; however, we believe that the procedures can and should be used with any attempt at product design and development. The minimal requirements are:
- Representative end-users is the single most important requirement.
- A facilitator and recorder. The facilitator should be someone who is neutral to the participants, e.g., not in a position of authority.
- A stipend is to compensate for inconvenience. We provided $20 for this Phase I project but plan to raise that to $50. Sandwiches and soft drinks were provided at all sessions.
- Schedule to meet the end-users convenience. Offer sessions at different times. We found 11:30 am – 1:00 pm and 7:00 pm – 8:30 pm worked well.
- As needed, have “Non-disclosure” and “Informed Consent” forms. The procedures reported here were reviewed by an Institutional Review Board and were found to satisfy the requirements for Exemption 2. We considered the first round above (1) an Expert Panel rather than a Focus Group since the participants were employees within the organization asked to give input based on their experiences. Because of that we did not consider it necessary to have IRB review. Err on the side of caution with regard to Human Subjects Protection.
- Ensure and expect confidentiality.
- Make sure all voices are heard.
- Remember the goal is good product design. The facilitator must pay close attention to responses and be prepared to probe deeper if a potentially valuable insight is emerging.
- Finally, the inclusion of end-user input from the earliest stages of product (or service) design will increase the likelihood of success; in fact, it may be essential.
REFERENCES
Not applicable
ACKNOWLEDGEMENTS
The research reported in this paper was supported by NIH SBIR Phase I Grant 1R43HD056605 to Criterion Health, Inc. The Easter Seals Rehabilitation Center, Evansville, IN and the Center for Assistive Technology and Environmental Access, Georgia Tech, Atlanta, GA are collaborators on the project.
CONTACT
Robert M. Levy
Criterion Health, Inc.
6321 Tanglewood Rd.
Terre Haute, IN 47802
(812) 894-2120
(812) 240-4687 mobile
bobl@criterionhealth.net