Opportunities for Improved Device Design Based on Central Line Placement Practices: Contextual Inquiry Study

An intuitive kit that aligns with predictable human behavior and eliminates unnecessary multistep detours can reduce novice failure rates, cognitive load, and practice inconsistency, and it could also curb nonrecyclable waste from "backup" kits opened for a single missing item. By reframing CVC systems as sociotechnical solutions rather than static assortments of parts, the same design moves that minimize improvisation and coordination errors for physicians may also reduce dwell time and manipulation events for patients, thereby advancing the core triad of safety, procedural efficacy, and everyday usability. By examining how clinicians place central lines, this study reveals modifiable design flaws that perpetuate risk despite decades of procedural standardization. Contextual inquiry provides the evidentiary bridge between clinical imperatives to reduce complications and the practical realities of device use. Embedding such investigations at the outset of design and iteratively throughout product life cycles offers a path toward safer, more efficient, and more humane central venous access for both patients and providers.