Supporting the Situational Awareness at the Emergency Department

Supporting the Situational Awareness at the Emergency Department

Gillis, Y.N.

Beekman, Q. (mentor)
Goethals, F. (mentor)
Romero Herrera, N.A. (mentor)

Industrial Design Engineering

Industrial Design

Design for Interaction

2017-03-24

The Emergency Department (ED) treats patients who have acute conditions and operates twenty-four hours a day, seven days a week. At the ED department at the University Medical Centre Utrecht (UMCU), the patients are treated in single rooms. There is not always direct contact between patients and the ED team, because the team is responsible for the treatment of several patients at the same time. Emergency nurses want to be more aware of what is happening or what may happen in the patient’s room. This project will focus on designing a product that supports the emergency nurses to maintain the Situational Awareness at the Emergency Department with the purpose to reduce incidents and to increase ‘patient safety & quality’. Primary research and user research generated insights about the complex field of acute care treatment and the impact of Situational Awareness on ‘patient safety & quality’. It is evident that when the ‘shared’ Situational Awareness of the emergency team among a single patient gets lost, ‘patient safety &quality ’ may be negatively impacted. During peak hours the Situational Awareness of emergency nurses is reduced. To avoid calamities, continuity in the flow of information and orders should be guaranteed. During peak hours, the emergency nurse feels insecure about the safety of the patients. The main goal of emergency nurses is to keep patients under their supervision safe by identifying risk conditions through constant observation and by intervening on time. During peak hours they get limited support to reach this goal. Based on this problem a design goal was formulated: Give emergency nurses a feeling of security if they need to leave their ‘stable’ patients in the room without their personal supervision due to attending higher prioritized cases during peak hours. To give emergency nurses a feeling of security, the design solution should focus on supporting emergency nurses by observing ‘stable’ high-care patients properly at a distance as to make the emergency team aware of risky conditions. The final design should facilitate the emergency nurses with easily access to patient information in real-time upon the beginning of their daily shift in order prioritize care effectively. Emergency nurses should feel supported by design in order to perform well and to save and take care of human lives. Different design exploration activities have shown that emergency nurses believe that technology (such as sensors collecting patient information and receiving effective patient information through notifications) has the potential to contribute to observing patients at a distance effectively. Innovative technology should save time by replacing current computer-interactions and they want to be exposed with information in a clear overview. After assessing three concept directions, it was confirmed that nurses believe in the added value of implementing new technologies if it can be used to keep insight into changing conditions of patients regardless their locations. Additionally, to fit the context of use, the concept should be cost-effective and should have the potential to diminish calamities & incidents. The combination of rapid prototype sessions with emergency nurses and literature research resulted in desired design features as reflected in the final concept. This means that the final design solution should be connected to the alert system of the ED with an integrated following-up system, the device carried by nurses should contain a combination of an alert display & additional information display and the user should have easily access to an overview of real-time trends of patient’s vital signs on demand. A device, named HOLO, was designed to support nurses to keep insight in the conditions of patients present. It allows emergency nurses to observe patients from a distance and to keep patients who are under their supervision safe. The innovative product feature of HOLO is the possibility to review the trend of patients’ vital signs at all parts of the department. If the vital signs are becoming risky, the device alarms the emergency nurse who has the ability to intervene in time. The top display allows to re-prioritize care effectively and a main display automatically gives additional information as a response to an occurring alert. The evaluation study revealed that HOLO has a major contribution to the nurses’ experiences as they feel that it supports them to keep insight in patients’ conditions, to become aware of risk changes from a distance, to understand the cause of the alert and to hand-over responsibilities easily. However, the HOLO was also intended to support nurses to re-prioritize care at any time. Yet this goal could not be reached due to the fact that patient information on the top display was not perceived as sufficient in all cases. Regardless of the fact that HOLO has his drawbacks and should be improved and further assessed in terms of feasibility and viability for further development, it can be concluded that HOLO fulfils the main project goal. This research resulted in a tangible concept that is desired by emergency nurses of the UMCU as they feel that it has the potential to support them in improving ‘patient safety & quality’.

co-creation
design
healthcare
emergency department
Situational Awareness
alarm fatigue
hospital

http://resolver.tudelft.nl/uuid:3a4047fd-19ca-4c8d-a13f-575fbff7597a

Campus only

Student theses

master thesis

(c) 2017 Y.N. Gillis