"uuid","repository link","title","author","contributor","publication year","abstract","subject topic","language","publication type","publisher","isbn","issn","patent","patent status","bibliographic note","access restriction","embargo date","faculty","department","research group","programme","project","coordinates"
"uuid:a565ae77-55f3-4e3c-b7a6-16b6dd9d510e","http://resolver.tudelft.nl/uuid:a565ae77-55f3-4e3c-b7a6-16b6dd9d510e","A design approach to achieve successful adoption of GoMedFlow in a hospital context","van Kampen, Demi (TU Delft Industrial Design Engineering)","Albayrak, A. (mentor); Vegt, N.J.H. (graduation committee); Kok, Petra (graduation committee); Delft University of Technology (degree granting institution)","2024","Digitalisation is becoming increasingly important in discharging the healthcare sector as our society ages, and long-term treatments of chronically ill patients are becoming necessary. However, adopting digital tools has not been smooth due to individual, organisational, and technical barriers. To overcome these barriers, a user-centred approach, co-creation, improved communication, and the involvement of the right stakeholders could help smooth the transition.
The GoMedFlow concept tool is a digital tool for healthcare professionals and organisational employees of the Reinier de Graaf Gasthuis that aims to improve the workflow of care processes and stimulate the use of digital tools. By creating a clear overview of care paths, improvements and digital tools can easily be noticed and implemented.
Using context mapping, stakeholders' wishes and needs were gathered at different levels of knowledge. A questionnaire revealed that stakeholders want to spend more time improving digitalisation, but not all have the time to contribute. Observations and conversations in the hospital uncovered insights into workflows and concerns, and generative sessions were held to dive even deeper and gather more insights. A design brief, including a design goal, was created to provide direction to the design process.
A co-creation session was held to involve stakeholders in the design process. Two groups provided ideas based on pre-created scenarios, and two different concept directions were created using Adobe XD. Before the concepts were created, a new corporate identity was created for GoMedFlow. Both concepts were tested during a care table and individually with stakeholders of care tables, and many insights were gathered. The second concept stood out more, but aspects of the first concept were still considered.
In order to finalise the concept of GoMedFlow, it is tested both during a care table and individually with stakeholders. The feedback and insights gathered from these tests are then combined to create the final design of the thesis. Additionally, a project journey is created to provide insights into the design choices made throughout the project. A roadmap is also developed to display the further steps that are required for a successful implementation of GoMedFlow. The thesis concludes with future research perspectives and a reflection.
This project was set up in three main parts to identifying opportunities for sustainable interventions in colonoscopy procedures for the EMC gastroenterology department. Throughout the project, a human-centered design approach was maintained. Research was done in literature on sustainability in healthcare and environmental impact of endoscopy, empirical context research and material flow analysis (MFA) in the form of a waste audit.
Based on circular strategies Reduce and Recycle, the research outcomes were synthesized into an intervention that aligns to the EMC's policy statements for sustainability:
- reduce waste with 10%
- increase recycling with 20%
Waste audit data was used as an input for co-creating with endoscopy nurses, where the focus was put on retrieving plastics from GMW because of their significant contribution to total emissions when incinerated (López-Muñoz et al., 2023).
Ideation was done in co-creation sessions to solve the problem of integrating waste segregation inside the complex environment of a colonoscopy treatment room for current system boundaries.
Outcomes
While it is ideal to implement higher R-strategies for designing out waste early on in the process, waste cannot be ruled out completely. Therefore, implementing a waste segregation system in the endoscopy treatment room presents an opportunity to enhance waste management in EMC and align with sustainability goals.
The proposal is a demonstration rather than a product concept, to show small incremental changes within the current system boundaries can help achieve the EMC goals. The intervention was estimated to reduce the weight of incinerated GMW with at least 40% with segregation of plastic products, and additional 16% by disposing of absorbent products in TONTO. Additional research is needed to determine the true recyclability potential of the plastics.
With the foresight of the implementation of new products in the system and a circular model where materials of these products have to be kept in the loop, the endoscopy nurses will be equipped and trained to accomodate these changes, and maintain sustainable practices.
The project approach was implemented using a context-driven design approach, consisting of Research & Analysis, Ideation, Conceptualisation and Evaluation. Literature research on the topic and its context is carried out, while further knowledge is gathered through contacts with sixteen Dutch and Kenyan medical professionals. In addition to individual interviews, two studies are conducted in the Dutch and Kenyan contexts. A six-week field trip to Kisumu, Kenya, during which ten medical professionals in three hospitals were visited, made it possible to ensure that the design truly fits its context. These medical professionals provided valuable input to the iterative design process and helped to shape the final concept design of the training system.
Further designing is enabled through prototyping, the use of decision-making methods and continuous iteration. This allowed new ideas to be generated, tested, and therefore new improvements to be made. Ultimately, new requirements could be identified, providing the opportunity to create even more valuable designs.
Future research should focus on further developing these designs, giving them an embodiment, and creating the possibility of actually implementing the training system in its intended context.
The healthcare sector faces escalating pressure due to its current inefficient practices in digital information exchange. The Integral Care Agreement (IZA) from the Ministry of Health, Welfare, and Sport (VWS) and overarching healthcare organizations is focused on creating a future-proof healthcare system. The Wegiz, introduced within the IZA, outlines standards for electronic data exchange among healthcare providers, with the focus on the Basic Dataset for Care (BgZ). However, the implementation of BgZ faces challenges, as insight in the influencing factors and facilitating interventions are limited.
Research outcomes
This research addresses this gap by employing literature reviews, (semi-structured) interviews, observations, and a thematic analyses within the healthcare ecosystem, specifically focused on the experience of medical specialists with the current organization of digital information exchange, to identify the factors affecting the BgZ implementation. A critical finding reveals a disconnect between macro-level legislation and micro-level healthcare practitioners, resulting in an oversight of the human aspect in decision-making and communication of changes. Furthermore, VWS encounters challenges in effectively engaging the target audience, according to medical specialists and organizational employees, leading to various disadvantages, including negative experiences with legislatively driven developments and a lack of awareness among healthcare professionals regarding BgZ and their pivotal role in the transformation. Furthermore, the limited awareness for standardization among specialists and the time and efficiency constraints are additional factors to be taken into account. Although, legislation is obliging interoperability between systems on a technical level, including the human aspect to evoke behaviour change towards standardization is currently limited. The cultural factors of the medical environment are challenging as well as autonomy and hierarchy is deeply rooted, which may influence the attitude towards change.
Design goals
The study emphasizes the need to involve healthcare professionals, starting with the first step of engaging physicians in the change process. To address this, a serious game has been developed with the primary goal of raising awareness about the urgency of BgZ implementation and encouraging active participation and collaboration by provide positive experiences of the opportunities the BgZ includes. The game, evaluated through sessions with the target audience, has proven to be an effective intervention, achieving its set objectives.
Recommendations
As a recommendation, the game should be implemented in an interdisciplinary manner, involving physicians, assistants, IT personnel, organizational staff, and policymakers. This approach aims to connect perspectives and foster collaboration. Ultimately, the game serves as a tool to bridge the gap between policymakers and healthcare practitioners by providing insights into each other’s perspectives, fostering a collective and collaborative approach towards successful BgZ implementation.
This thesis introduces a novel hybrid phaco handpiece design, eliminating the need for sterilization by adding a disposable to facilitate sterile use, combined with a reusable as driver of ultrasound. This product is the first step towards a proposed fully circular system. This project has a focus on reducing impact, while maintaining phaco functionality; it does so by testing for phaco ultrasound characteristics and functioning fluidics while addressing the challenges associated with sterilization. The design emphasizes quick, secure, and sterile assembly in the operating room (OR) while maintaining cost-effectiveness and minimizing environmental impact.
The hybrid phaco handpiece achieves its functional design by carefully managing the components responsible for ultrasound and fluidics. The internal sonotrode, driving ultrasound, is split between the disposable and reusable components, connected securely through a threaded interface. Fluidics are managed by splitting off before reaching the reusable part, employing a simple yet effective O-ring design in the disposable product.
Maintaining sterility in the OR is a critical aspect of the hybrid phaco handpiece design. Mechanical seals in O-rings provide internal sterile barriers, and a blister pack facilitates sterile interaction between non-sterile and sterile components. The contact-free assembly of the disposable into the reusable ensures a tight connection, validated by a torque ridge that breaks at a specified torque, offering a visual cue for successful connection. This usability design, validated with healthcare professionals, adds safety and fits the quick nature of cataract procedures.
The innovative sterile handover method is implemented through the packaging itself, acting as a sterile barrier between different nurses handling the disposable and reusable components. During handover, a pre-attached sterile tube sleeve is unrolled over the non-sterile component. This ensures a seamless and sterile transition during assembly, minimizing the risk of contamination.
A comprehensive functional analysis validates the hybrid design, ensuring it meets specifications. Insights gained from this analysis guide further mechanical tuning, particularly in aspects influencing ultrasound characteristics. Beyond functionality, the hybrid phaco handpiece design has environmental implications. By eliminating the need for energy-intensive sterilization procedures and reducing waste from disposable wraps, the design reduces its climate impact by 67% over the entire life cycle.
This hybrid phaco handpiece design represents a step towards a circular system in the field of cataract surgeries. Balancing functionality, sterility, and environmental impact, this novel approach not only provides new insight into sustainable phacoemulsification procedures, but also shows the potential of hybrid reusable and disposable products in healthcare.
This project examines the privacy and stakeholder landscape of health data sharing through an evaluation of interaction with patients. It uses a Value-Sensitive design approach (Friedman et al., 2002) to contextualize the privacy values in clinical research for patients, doctors, patient organizations, clinical researchers, pharmaceutical industries and data sharing platforms. Through this examination, it identifies lack of transparent data use and research practices as a hindrance to the use of health data on a data sharing platform. Transparency is examined through a patient-centric lens, wherein information and control over preferences of participation are found to be crucial. This evaluation further identifies roles of researchers and data sharing platforms for a transparent approach.
The project results in a concept termed ‘Negotiated Consent‘, which examines the use of data sharing platforms in offering individuals transparency. This is contextualized within patient consent for recruitment in clinical research, wherein data sharing platforms are responsible for data processing through the use of Federated Learning and Natural Language Processing. The stakeholder landscape for the same is defined in 3 functions for the platform- Access to Health Data, Patient Consent and Recruitment, and Data-Driven Insights. The results are tested through a study of the prototyped user experience of ‘Negotiated Consent‘, wherein participants emphasized ‘feeling more informed and in control’ in comparison to the current informed consent.
Whilst the study examines a patient-centric approach towards health data sharing for clinical research, it has limitations in addressing the multi-faceted reality of patient’s lives that informs their choices to enrol in clinical research. The further development of patient-centricity in the domain requires examination of motivations through a lens of disease-specific patient groups, demographics, and personal history with diseases (Hong et al., 2020) will lead to richer insights. Furthermore, Negotiated Consent is a proof-of-concept for dynamic consent (Mascalzoni et al., 2022), that demonstrates revision over participation choices within one moment of patient consent.
This project contributes to an understanding of the privacy and stakeholder dynamics for health data sharing. It illuminates a transparent approach to recruitment for clinical research through a collaborative effort that emphasizes on patient-centric approaches. Using a mutually responsible approach, data sharing platforms can lead the way for use of data in clinical research that simultaneously empowers patients to control their data through a negotiated lens.","Health Data; Privacy; Informed Consent; Data sharing; Machine Learning; Ethics of Technology; Health Tech; GDPR; Data donation; Value-Sensitive Design; Systemic Design; Design for healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:72aff18e-4bb7-40e6-b525-3999f679866a","http://resolver.tudelft.nl/uuid:72aff18e-4bb7-40e6-b525-3999f679866a","Standardisation in Healthcare Systems","van Veen, Aïcha (TU Delft Technology, Policy and Management; TU Delft Aerospace Engineering)","Grossmann, I. (mentor); Copeland, S.M. (graduation committee); van de Kaa, G. (graduation committee); Delft University of Technology (degree granting institution)","2024","The aim of this research is to gain an understanding of the balance between guideline standardisation and professional autonomy. This includes its impact on the safety and quality of healthcare. These are crucial aspects of providing good care as they can contribute to an overall healthcare system that is effective, reliable, and patient-centered. The reason for performing this research is the difficulty of finding a balance between guideline standardisation and professional autonomy. While guideline standardisation is crucial to ensure a structured approach to uniform care of high quality, professional autonomy is necessary to individualise this care for each patient. At times, the tension between these aspects arises as medical practitioners feel limited in their professional autonomy, but healthcare organisations require a structural set-up of healthcare systems to provide equal care.
By performing interviews with guideline developers, doctors, and patients, this tension and possible contributing factors were explored through a technical, human, and organisational perspective. The identification of a need for the inclusion of the psychosocial elements, research regarding sensitivity around professional autonomy, and structural changes is beneficial to get to a point where it is possible to identify a balance between guideline standardisation and professional autonomy and its impact on the safety and quality of care. While multiple points for further research are indicated in this study, these three factors contribute to improving the situation of both the tension itself and the discussions around it.
1.
Adapting the infection prevention protocol and behaviour of the staff;
2.
Separating infectious waste from general hospital waste;
3.
Redesigning the syringe itself;
4.
Optimising the filling process of syringes.
The final design is an optimised filling process for prefilled sterilised syringes (PFSs), based on circular strategies such as reduce, reuse, rethink and repurpose. Interventions include: eliminating a redundant sterilisation phase, reducing residual medication and changing from steam to gamma sterilisation. This resulted in decreasing the amount of waste, material, energy and water consumption, while offering similar convenience and safety for the staff and patients of the ICU.","Circular healthcare; Syringe; Environmental impact; Design","en","conference paper","Springer","","","","","Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2024-05-05","","","Applied Ergonomics and Design","","",""
"uuid:2d975386-a16a-4f4c-bb4e-e93fe38272db","http://resolver.tudelft.nl/uuid:2d975386-a16a-4f4c-bb4e-e93fe38272db","Building Understanding of Experience Design in Digital Health: Preliminary Results Based on Semi-Structured Interviews","Wang, T. (TU Delft Applied Ergonomics and Design); Qian, S. (TU Delft Responsible Marketing and Consumer Behavior); Zhu, Haiou (Loughborough University); Goossens, R.H.M. (TU Delft Human-Centered Design; TU Delft Applied Ergonomics and Design); Giunti, Guido (University of Oulu; Trinity College Dublin); Melles, M. (TU Delft Applied Ergonomics and Design)","Melles, Marijke (editor)","2024","Design is expanding its influence on shaping future healthcare. Ideally, designers apply human-centered design and human factors that introduce theory, principles, and methods to design to optimize people’s healthcare experiences in both digital and non-digital environments. To discuss and implement experience design in healthcare, consensus about experience design in healthcare is needed. Objectives: Therefore, the purpose of this study is to investigate designers’ views on experience design in health, and to uncover their understanding about three experience design concepts, i.e., user experience (UX), patient experience (PEx), and digital patient experience (dPEx). We conducted online semi-structured interviews study with convenience samples who met the eligibility. We used ATLAS.ti for an in-depth data coding following thematic analysis. 24 international designers of digital health solutions, either in industry or in academia took part in the interviews. We found the similarities and differences mentioned between healthcare design and non-healthcare design relate to (1) design principles, (2) user attributes, and (3) design contexts. Furthermore, the differences between UX, PEx, and dPEx can be mapped on five dimensions: people, contexts, purposes, means, and usage scenarios. These insights can help designers and human factors specialists build a common design language for experience design in healthcare. Our study can also assist designers and human factors specialists with experience design in digital health by pointing out the areas where design thinking generally is appropriate and the places where particular expertise in healthcare design is needed.","Digital patient experience; Healthcare design; Human computer interaction; Human-centered design; Patient experience; User experience","en","book chapter","Springer Nature","","","","","Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2024-05-05","","Human-Centered Design","Applied Ergonomics and Design","","",""
"uuid:d6ca4e5b-fb44-40d1-8ee6-f420653e5870","http://resolver.tudelft.nl/uuid:d6ca4e5b-fb44-40d1-8ee6-f420653e5870","Mijn Hulplijn: An intervention to empower youngsters in decision making in (j)-GGZ therapy","Kreuk, Davy (TU Delft Industrial Design Engineering)","Pasman, G.J. (mentor); Brouwer, W. (graduation committee); Delft University of Technology (degree granting institution)","2023","Extensive waiting times for youth Mental Healthcare have a significantly negative effect on youngsters well-being. The Ministry of Public Health, Welfare and Sport (Ministry of VWS) therefore commissioned Shoshin to research the cause of waiting times in order to address them. Shoshin is a social design agency that believes waiting times are not only the result of a shortage of staff, but also of inefficiencies and ineffective elements in the youth care system. They aim to make strategic interventions to create true system change (Haarlemmer et al.).
This thesis aims to support Shoshin in their mission to reduce waiting times for youngsters. Youngsters are defined as 16 till 23 year people in this report.
Specifically, the aim of this graduation project is to come up with a design that helps youngsters get more appropriate care. According to Van der Bijl-Brouwer (2021) systemic problems (such as problems in the mental youth care sytem) are interrelated and can therefore not be solved independently. Therefore reseach was conducted in various contexts regarding the youth Mental Healthcare system:
1) The organisation involved with decisions regarding the youth care system. (Macro context)
2) The process of getting into care. (Meso context)
3) The interaction between youngsters and their therapists. (Micro context)
These analyses showed that youngsters often feel unheard and are not included in decision making. Therapists rely too much on their own vision and focus too little on background/individual factors of the youngsters. This leads to missing the core of the youngsters mental problems, which contributes greatly to ineffective and inefficient care. The analyses also showed that youth Mental Healthcare (j-GGZ) therapists are the most promising target audience to design for. In fact, other therapists - such as district members or therapists of the child and family centre (CJG) - often do not have the skills to find the core of the youngsters’ mental problems as they are often not specialized enough.
Following these analyses, the design goal has been to empower youngsters in decision making during GGZ therapy. A “Mijn Hulplijn” app was developed that helps youngsters to actually give feedback and incorporate it into therapy. The app allows youngsters to think of their own needs and wants in therapy, and helps to actually incorporate this as well. Moreover, it provides background information that is relevant for the therapist in question. Furthermore, the app offers suggestions for alternative therapies and gives an overview of the youngsters’ healthcare history. This way, the app can improve the success of the therapy and the youngster-therapist interaction. To actually make and measure this impact, this study also provided a plan for implementation of the app.","Social Design; Youth mental healthcare; Design","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:c12d7822-2597-4ea9-9d6e-fa253eb46e8a","http://resolver.tudelft.nl/uuid:c12d7822-2597-4ea9-9d6e-fa253eb46e8a","Enhancing the Cybersecurity and Privacy of Medical Wearables: A User-Centred Approach","Spanninga, Paulien (TU Delft Technology, Policy and Management; TU Delft Engineering, Systems and Services)","Zuiderwijk, AMG (mentor); Hinrichs-Krapels, S. (graduation committee); Figueroa, C.A. (graduation committee); Delft University of Technology (degree granting institution)","2023","In recent years, the medical world has seen rapid digitalisation. Digitalisation of healthcare and the opportunities of remote monitoring can help to keep the healthcare system affordable and accessible. A promising application of remote monitoring is the use of consumer-grade wearables for clinical care. However, vulnerabilities leave consumer-grade wearables susceptible to cybersecurity and privacy risks. When the wearables gain clinical care functionality, increased risks are problematic for the success of the technology. This research examined this problem by analysing the role of users in the cybersecurity and privacy environment and the impact of human factors on the cybersecurity and privacy system of medical wearables. Vulnerabilities and associated risks were identified with the help of notions from human-centric cybersecurity. To establish a user-centred approach to tackle these risks, the user needs and limitations were examined by performing a quantitative survey research. Based on the results of the survey and the human-centric components of user, usage, and usability, guidelines for the user-centred approach were formulated. These guidelines were subsequently linked with the challenges and attacker-oriented and user-oriented risks to establish recommendations for medical wearable providers. Providers can use these to steer the design of the cybersecurity and privacy system and the structuring of the system environment. The research showed that by taking into account the needs and limitations of users, the cybersecurity and privacy system design can be more effective in tackling user-oriented risks. The research concludes that a user-centred approach to cybersecurity and privacy can contribute to the successful use of consumer-grade wearables for clinical care purposes.","Cybersecurity; Human Factors; User-centered; Wearables; Healthcare; Privacy","en","master thesis","","","","","","","","2026-01-01","","","","Management of Technology (MoT)","",""
"uuid:f243012c-1380-45d9-ae98-de6211defac1","http://resolver.tudelft.nl/uuid:f243012c-1380-45d9-ae98-de6211defac1","Hardware acceleration of artificial X-ray image generation","Knops, Per (TU Delft Electrical Engineering, Mathematics and Computer Science)","Al-Ars, Z. (mentor); Remis, R.F. (graduation committee); de Jong, Rob (graduation committee); Delft University of Technology (degree granting institution)","2023","X-ray imaging systems play an important role in the diagnostic process of various medical conditions. Generating an accurate artificial X-ray image has multiple advantages. It allows for flexible configurations during generation. The resulting images can reduce testing time and cost, help the training of surgeons, and increase the amount of data for artificial intelligence model training. The generation of an X-ray image involves the simulation of a raytracing algorithm through a data model. In this research, a naive approach to this problem is examined. It was found that this approach can be improved by implementing model parallelization, data caching, and data compression. The resulting algorithm is simulated and validated in a software environment. This is then implemented for both an Ultrascale+ and a Versal FPGA. The results show that the algorithm can achieve real-time X-ray image generation, matching the performance of currently used detectors, provided that the required memory performance is achieved.","FPGA; X-ray Imaging; FPGA acceleration; Hardware acceleration; Philips; Philips Healthcare; Image Generation; x-ray image generation","en","master thesis","","","","","","","","","","","","Electrical Engineering | Embedded Systems","",""
"uuid:596320e9-92d1-4337-b0be-77a61bc5b8fc","http://resolver.tudelft.nl/uuid:596320e9-92d1-4337-b0be-77a61bc5b8fc","Mechanical Recycling of Autoclave Laminated Plastic: Towards Sustainable Waste Management","Hansen, Mervin (TU Delft Mechanical, Maritime and Materials Engineering)","van Straten, Bart (mentor); Horeman, T. (mentor); Delft University of Technology (degree granting institution)","2023","Introduction: The environmental impact of singleuse medical plastics is a growing concern. One such plastic component, autoclave laminated plastic (ALP), commonly used in medical sterilization pouches, is typically discarded after use, but it holds potential for recycling. This research paper investigates the feasibility and effectiveness of mechanical recycling as a solution for ALP waste.
Methods: The study commences by analyzing the composition of collected ALP materials using X-ray diffraction analysis. Subsequently, recycling techniques,
including melting, and shredding, are explored and assessed.
Results: After multiple melting setups, the high-pressure melting setup, augmented by a continuous pressure spring mechanism, successfully yielded recycled ALP blocks that could be further processed into dogbone-shaped specimens. The results of the tensile tests revealed a Young’s modulus of 269 ± 85 MPa for the recycled ALP.
Discussion: These findings hold promise in the transformation of ALP waste into valuable recycled products, mitigating the environmental impact of single-use medical plastics. However, the study underscores the need for further optimization of the recycling process to enhance mechanical properties and overall material quality, ultimately advancing sustainability efforts in the medical sector.","mechanical recycling; medical sterilization pouches; Medical waste; Packaging waste; Plastic Waste; Polypropylene; Sustainable healthcare","en","master thesis","","","","","","","","","","","","Biomedical Engineering","",""
"uuid:ab5e13a7-3c65-4ab8-a1e2-a303e3c4e68c","http://resolver.tudelft.nl/uuid:ab5e13a7-3c65-4ab8-a1e2-a303e3c4e68c","Comparative Life Cycle Assessment of Disposable and Reusable Absorbent Mats: Paving the way for product redesign and informed decision-making to promote sustainable healthcare practices","Blank, Bastiaan (TU Delft Mechanical, Maritime and Materials Engineering; TU Delft Biomechanical Engineering)","Dankelman, J. (mentor); Diehl, J.C. (graduation committee); Jansen, F.W. (graduation committee); van der Eijk, A.C. (mentor); van Nieuwenhuizen, K.E. (mentor); Delft University of Technology (degree granting institution)","2023","Absorbent mats, abundantly used in hospitals, are integral to maintaining hygiene and cleanliness by effectively collecting and retaining patient's bodily fluids. absorbent mats are available as disposable and reusable products. In the Netherlands, predominantly disposable products are used, and approximately 23 million absorbent mats are employed each year. The abundant use contributes to the Dutch healthcare sector’s substantial impact to the country’s greenhouse gas emissions, waste generation, material extraction, water consumption, and land use. Hospitals and policy makers within the healthcare sector striving to implement environmentally sustainable practices, require current data for informed decision-making. Yet, only two studies have determined the environmental impact of absorbent mats; however, critical environmental metrics are lacking and detail on the contributions of life cycle stages are insufficient. This study addresses these issues by conducting a comparative Life Cycle Assessment, examining eighteen environmental metrics of both disposable and reusable absorbent mats. The primary objective is to not only assess the environmental impact across all their life cycle stages but also to facilitate the redesign of these absorbent mats to reduce their environmental impact. An in-depth cradle-to-grave Life cycle Assessment, utilizing the ReCiPe impact assessment method, was conducted to compare and evaluate the environmental impact of three different disposable absorbent mats and one reusable absorbent mat. The identification of major contributors to their environmental impact, combined with the application of eco-design strategies, facilitated the sustainable absorbent mat redesign. The Life Cycle Assessment findings indicate that reusable absorbent mats are environmentally superior compared to their disposable counterparts, even if the impact of disposable absorbent mats is mitigated by sustainable product redesign. The reusable absorbent mat demonstrates a lower environmental impact score in fifteen out of eighteen environmental metrics when compared to the disposable absorbent mats. The environmental impact of absorbent mats is largest in the use stage for reusable absorbent mats, and in the material production and manufacturing stage for disposable absorbent mats. The redesigned disposable and reusable absorbent mat concepts exhibit a reduced environmental impact, among other factors, attributed to product recycling. Both concepts facilitate recycling by utilizing a single material for the entire absorbent mat, namely wood-derived materials for the disposable redesign and polyethylene terephthalate-derived materials for the reusable redesign. This study has demonstrated the versatility of Life Cycle Assessment in aiding informed decisions-making and providing valuable insights for sustainable product redesign. The outcomes of the Life Cycle Assessment suggest that hospitals should transition to the use of reusable absorbent mats. Furthermore, the redesign findings offer valuable insights into the environmental benefits achievable through the recycling of medical products.","Life cycle Assessment; Healthcare decision-making; Absorbent mat","en","master thesis","","","","","","","","","","","","Biomedical Engineering","",""
"uuid:67f78225-c0dc-4d04-ac7b-088cddf23cbb","http://resolver.tudelft.nl/uuid:67f78225-c0dc-4d04-ac7b-088cddf23cbb","Enhancing Energy Efficiency and Sustainability in Healthcare: Implementing a Heat Exchanger for Carbon Footprint Reduction","Alkemade, Selwin (TU Delft Mechanical, Maritime and Materials Engineering)","Horeman, T. (mentor); van Straten, Bart (graduation committee); Delft University of Technology (degree granting institution)","2023","This paper addresses the urgent need to optimize the GreenCycl facilities energy utilization, by harnessing heat from the effluent of three thermal washing-disinfection machines into the preheating of cold clean water. Currently for every washing-disinfection cleaning program, 60 times a week, 105 liters of water with a temperature of 60 \degree Celsius is discharged in the drain. This is not in line with the goals setup by the government and the mindset of GreenCycl.
The study begins with a comprehensive analysis of the current situation, while documenting the properties and conditions. Subsequently concepts are generated with help of a morphological chart and a Harris profile is employed to select the most promising concept, this is further elaborated. Computational Fluid Dynamics (CFD) simulations are conducted to optimize the performance of the heat reclaiming system. Finally, the results of the CFD simulations are validated with experimental research.
By reintroducing 67\% of the effluent back into the heat exchange system, a continuous flow across the heat exchanger of 35 liters per minute can be established with an operation duration of 2.5 minutes per washing-disinfection machine. Resulting in the heat reclaiming system to only operate when cold clean water is flowing through the HEX. If implemented at the GreenCycl facility, this innovation could potentially save approximately 7600 kW of electrical energy and reduce Carbon Dioxide emission by 1129 kg annually.
This study not only addresses a pressing environmental concern but also offers an easy and efficient solution with significant economic and ecological benefits.","Healthcare; Carbon emission; Heat Exchanger; Sustainability; Washing machine","en","master thesis","","","","","","","","","","","","Biomedical Engineering","Evaluawaste",""
"uuid:b4897f13-362b-4918-91d5-f52849021786","http://resolver.tudelft.nl/uuid:b4897f13-362b-4918-91d5-f52849021786","Embodiment of a laparoscopic tower for the Kenyan healthcare context","Drilea, Ioana (TU Delft Industrial Design Engineering)","Diehl, J.C. (mentor); Oosting, R.M. (mentor); Persaud, S.M. (mentor); Delft University of Technology (degree granting institution)","2023","Limited access to surgical care in low- and middle-income countries has resulted in the loss of approximately 16.9 million lives annually, accounting for 32% of global deaths. This is more than tuberculosis, malaria and HIV combined.
Several factors contribute to this disparity, including the scarcity of surgical equipment. Despite the limited availability of equipment, a staggering 40% of donated equipment in sub-Saharan Africa is ultimately discarded in landfills due to its short lifecycle.
This is attributed to the lack of consideration for the local use context in the design of medical devices. For example, medical devices are not robust enough, can not be repaired locally due to lack of access to spare parts and might not function because of the harsh working environment. (i.e. fluctuations in the electricity grid).
Laparoscopy offers much shorter recovery times and reduces risks of infection, thus improving clinical outcomes and allowing individuals to return quickly, thus enhancing the livelihoods of families that might rely on a single source of income.
Recognising that equipment availability is an issue in hospitals, I designed EasyTower - a practical and cost effective design. EasyTower integrates an outer casing to securely store the devices required for laparoscopy, such as the diathermy, ENT drill, and insufflator. Seamless connectivity to an uninterruptible power supply ensures continuous operation through power outages.
The tower includes a laptop holder and a drawer for accessories. Instead of using the typical laparoscopic stack, costs are drastically reduced by using a laptop to replace the light source, screen and image processing, thus eliminating the need for expensive equipment, by connecting to a scope that works with a standard laptop or tablet.
EasyTower is designed to be mobile, thus ensuring equipment can be moved and utilised in various hospital settings as needed. It can easily be opened up and used directly. To reduce the risk of damaging the medical equipment, Easy tower folds into a safe, lockable storage space (like a flightcase), protecting equipment from frequent impacts with e.g. patient beds, thus ensuring a longer life span.
Produced from off-the-shelf components which can be easily procured in Africa, EasyTower can be produced locally and spare parts can be easily sourced, making it easy to repair locally. Easy tower reduces equipment needs and protects equipment from breaking, either due to impacts or due to electrical problems. In this way equipment can have a longer lifespan, thus preventing the equipment from ending-up in the landfill, contributing to a more accessible and sustainable healthcare system.","surgery; global surgery; laparascopy; Design for emerging markets; Kenya; Healthcare; healthcare design; LMICs","en","master thesis","","","","","","","","","","","","Integrated Product Design | Medisign","",""
"uuid:8c784c0a-3b40-40d6-ae6a-8412d959ef67","http://resolver.tudelft.nl/uuid:8c784c0a-3b40-40d6-ae6a-8412d959ef67","Modelling the Social Return on Investment: A System Dynamics Approach for the Support of Patients with Cardiovascular Disease","den Otter, Jeremy (TU Delft Technology, Policy and Management)","Hinrichs-Krapels, S. (mentor); Mouter, N. (graduation committee); Kwakkel, J.H. (mentor); Wigmans, J. (graduation committee); Verstraaten, I. (graduation committee); Delft University of Technology (degree granting institution)","2023","Cardiovascular diseases (CVDs) are a leading cause of death globally, causing 38% of all premature deaths. Providing care for the patients who survive is considered a priority for healthcare managers. In the Netherlands, 1.7 million people currently are diagnosed with cardiovascular diseases. After experiencing and surviving a CVD event, patients require support to get their lives back on track. However, over the next years, the number of patients is expected to increase to 2.6 million people, creating a burden on the healthcare system. Moreover, the costs of healthcare have been increasing over the last few years, decreasing the accessible and affordable for the patients to receive care. Intervention is needed to keep the quality of life of patients high. However, most interventions focus on the prevention of CVDs, with no attention to patients that already diagnosed with cardiovascular diseases. This research presents a model for the support of patients with cardiovascular diseases within the Netherlands. It is done in conjunction with Harteraad, a non-profit Dutch patient organisation that represents the interests of the 1.7 million patients. The model aims to explore the effect of interventions on the lives of patients while keeping the investment cost-efficient. To successfully answer the research question, four steps were taken. First, a literature study was conducted to find potential candidate interventions that Harteraad can implement. The results from the literature study suggest that the priority lies in interventions on physical activity, mental health and medication adherence. In the second step, a causal loop diagram (CLD) was built that maps the interventions to outcomes. For this research, the main outcome variable is the social returns on investment (SROI). SROI measures value creation on a social, environmental and economic level. Secondary outcomes include deaths, hospitalisations, and quality of life. All three of which are used to calculate the SROI. The CLD shows that the interventions affect the outcomes by improving patient behaviour. Whether that is in more exercise, seeking mental support or medical adherence. In the third step, a System Dynamics model was developed to simulate the economic effect of different interventions. Population data were retrieved from the Hartstichting, whereas data sources on input values were found in academic literature. The latter being a source of uncertainty, as healthcare systems across countries cannot be directly compared. So in the fourth step, uncertainties were incorporated into the SD model and tested systematically. The results for the simulation show that the SROI is positive for six interventions. As such, the recommendation is to invest in either of those interventions. More specifically, for physical activity, the efficient interventions are “Active-at-Home”, “Video Gaming”, and “Group-Based Training”. For mental health, the efficient interventions are “Care Coordination”, “Cognitive Behavioural Therapy”, and “Telemedicine”. Lastly, for “CombiConsult”, the recommendation is to offer additional mental support as well to create social return. Although the model is able to give insights into potential interventions, more research is required. The model is only a simplified representation of the real world. Data was either lacking or outdated, creating nuance in the model results. As such, the model cannot be used to give the optimal solution. These nuances thus need to be addressed in future research. Despite the limitations of the model, the research provides societal and scientific contributions. The research shows that system dynamics modelling is a suitable method to model the support of patients. Moreover, the model is able to determine if interventions are cost-efficient while increasing social benefits to the patient. This research furthermore adds a contribution by performing a systematic uncertainty analysis and so on, offering aid in robust decision-making. Lastly, the model is suitable to be used in different countries under different healthcare systems. As such, this research contributes to the research on patient support.","Cardiovascular disease; Social Return on Investment; Quality of Life; Healthcare Modelling; System Dynamics","en","master thesis","","","","","","","","","","","","Engineering and Policy Analysis","",""
"uuid:36771000-94ef-49bf-8a27-f072e48da221","http://resolver.tudelft.nl/uuid:36771000-94ef-49bf-8a27-f072e48da221","Bridging the Knowledge Gap: Improving the Information Provision for Hemophilia Patients","Eekelaar, Tjaisha (TU Delft Industrial Design Engineering)","Albayrak, A. (graduation committee); Dehli, S.R. (graduation committee); Mussert, C.M.A. (mentor); van Hoorn, E.S. (mentor); Delft University of Technology (degree granting institution)","2023","Hemophilia, a bleeding disorder, is divided into types A and B, resulting from coagulation factors VIII and IX deficiencies. The levels of these clotting factors in the body determine the severity of hemophilia. The classification includes severe, moderate, and mild hemophilia. Managing hemophilia involves options like on-demand and prophylactic treatment. A key part of managing this condition involves Hemophilia Treatment Centers (HTCs) as the primary healthcare providers for patients.
The HTC at Erasmus MC is one of the six centers in the Netherlands. It offers comprehensive care for adults and children with hemophilia and other rare bleeding disorders. In the pediatric department of Erasmus MC's HTC, children with hemophilia attend multiple outpatient clinic visits annually. During these visits, patients and their caregivers receive education about the bleeding disorder, its treatment, and potential consequences. However, grasping the information during these visits can be challenging, especially as most of it is conveyed verbally. This poses a particular difficulty for patients and caregivers with lower literacy levels.
To enhance the information provided to hemophilia patients and caregivers, HTCs must offer comprehensive support to ensure patients understand the information communicated during outpatient clinic visits. Improving information provision in these contexts aims to make significant progress towards a future where patient information and education are improved, resulting in better outcomes for those living with hemophilia.
This graduation project involved conducting research through literature reviews, analyzing materials, observing HTC's operations, and interviewing healthcare professionals, patients and their caregivers, and relevant stakeholders. The findings revealed several pain points regarding the current information provision. These areas include the information exchanged during outpatient clinic visits and the accessibility of provided information outside of these visits. Consequently, two solutions were developed: an information tool named ""Samen Spraak,"" designed to enhance information exchange between healthcare professionals and parents by introducing interactivity and structure during consultations. This tool is then detailed in a strategy outlining a digital solution's implementation roadmap.
Based on this developed tool and strategy, it is advisable to classify it under the Dutch Association for Hemophilia Patients (NVHP) for further implementation and testing. Future research could explore expanding the approach to other blood clotting disorders across all age groups.","Human-Centered Design; Information provision; Implementation; Healthcare","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:e8480d5e-2b76-4930-8cf0-b727e9036186","http://resolver.tudelft.nl/uuid:e8480d5e-2b76-4930-8cf0-b727e9036186","Enhancing the Transition from the Ideation to the Successful Market Entry of Emerging Medical Technologies: A Qualitative Research Approach","KYRKIMTZIS, APOSTOLOS (TU Delft Technology, Policy and Management)","Scholten, V.E. (graduation committee); van der Linden, N. (graduation committee); Vandekerckhove, P.B.M. (mentor); Delft University of Technology (degree granting institution)","2023","In an era marked by healthcare advancements driven by innovative technologies, the integration of emerging medical breakthroughs like VR, AI, and IoT has propelled the MedTech industry's exponential growth. Despite their transformative potential, navigating the MedTech commercialization pathway presents formidable challenges; new medical technologies either fail to reach the market or enter the market but do not add significant value to the health system. This study seeks to address this issue by comprehensively exploring the intricate dynamics that underlie the transition from ideation to successful market entry of emerging medical technologies. A thorough literature review accompanied by qualitative research with semi-structured interviews to gain insights from diverse stakeholders in the MedTech ecosystem, uncovering multifaceted perspectives that enrich the understanding of this complex process. The research identifies and analyses six dimensions crucial for the MedTech commercialization trajectory: organizational strategy, design strategy, business strategy, commercial strategy, marketing strategy, and post-commercialization strategy. The findings underscore the significance of factors such as a strong interdisciplinary startup team credible toward investors; careful designed strategies, influenced by input from patients and physicians and balancing internal control and collaborative development; a grasp of the MedTech ecosystem's value chain and early HTA to demonstrate the cost-effectiveness of the technology and guide a smart business strategy aligned with stakeholders’ incentives; safeguarding intellectual property ensures consistent revenue streams; strategically navigating the commercial pathways toward the professional care or the mass market; a strong marketing strategy to reach customer channels and boost sales and awareness; and adaptability to secure long-term achievements beyond the initial launch phase. Ultimately, the study develops a strategic roadmap that offers practical guidance to innovators seeking to navigate the intricate journey from idea inception to market success of emerging medical technologies. This research holds potential to foster smoother transitions and enhance the likelihood of successful market entry for emerging medical technologies, fostering a transformative impact on healthcare systems and patient outcomes.","MedTech; commercialization; emerging technologies; healthcare; strategic roadmap","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:005e6353-778e-433e-87bb-e8d25ec95e0d","http://resolver.tudelft.nl/uuid:005e6353-778e-433e-87bb-e8d25ec95e0d","Insights into the Circular (re)Design of Medical Wearbale Sensors","Bult, Matthijs (TU Delft Industrial Design Engineering)","van Heur, R.J.H.G. (mentor); Hoveling, T. (graduation committee); Delft University of Technology (degree granting institution)","2023","class=""MsoNormal"">This thesis presents recommendations based on a case study focused on thecircular redesign of a wearable, single use medical device. The study addressesa knowledge gap by offering insights into the circular (re)design for products.The proposed (re)design of the system leads to a substantial reduction of CO2emissions, with potential for further improvements.
Philips Healthdot
The Philips Healthdot, the subject to this thesis, is a medical wearablesensor designed to wirelessly capture bio measurements and transmit them tohospitals. Once used, the sensor becomes inactive and is discarded as waste.While similar reusable sensors exist, only two were identified during research.
Research
Literature research was conducted concerning the circular economy, its designstrategies and business models. A comprehensive analysis of the Healthdot’sproduct journey was performed, complemented by a fast-track Life Cycle Analysis(LCA). The LCA revealed the high CO2 impact of its electronics, highlightingthe importance of extending their usage. Based on the outcomes of theseanalyses, requirements and criteria were defined, which formed the foundationsof the proposed solution.
SecondSense
The proposed solution, SecondSense, consists of two components: SenseFlowand SenseCab (Figure FIXME & FIXME). SenseFlow describes the sensorlifecycle within the system, while SenseCab enables easy reprocessing. In theSenseFlow system, used sensors are collected, cleaned, and placed in theSenseCab for data removal, disinfection and charging.
Life Cycle Analsyis
A comparison between SecondSense and the original Healthdot was conductedusing an LCA (see Figure FIXME). SecondSense shows reductions in CO2 emissionsafter only three uses, with 45% and 60% reductions after five and ten uses. Theanalysis considered worst-case scenario, with a best-case scenario showing CO2reductions upwards of 80% after 10 uses.
Recommendations
The case study outcomes led to the following recommendations, intended as astarting point for designers and engineers developing circular solutions formedical wearable sensors:
1 Gain a solid understanding of the basic principles of the circulareconomy
2 Research circular design strategies and business models for the designchallenge
3 Determine what defines circular economy
4 First, determine how the system is going to be circular, then design theproduct so that it enables this system.
4a Take additional carewhen determining boundaries
4b Determine a detailed systemoutline
4c Analyse the system toformulate requirements
4d Integrate the classic designprocess into the circular system
5 Use fast-track LCAs for conceptual insights
6 Involvestakeholders in the design process.","circular economy; medisign; circular design; Wearables; Healthcare; Service design; reprocessing; sustainability","en","master thesis","","","","","","","","","","","","Integrated Product Design","DiCE project",""
"uuid:7f6e5e97-2bdd-4951-9900-f6332ec34290","http://resolver.tudelft.nl/uuid:7f6e5e97-2bdd-4951-9900-f6332ec34290","Enhancing the Experience of Pregnancy Detection: Design and Embodiment of a reusable pregnancy testing device","Dhar, Bhavika (TU Delft Industrial Design Engineering)","Dekker, M.C. (mentor); Persaud, S.M. (graduation committee); Mattsson, Alice (graduation committee); Delft University of Technology (degree granting institution)","2023","Pregnancy tests are the most used diagnostic test in the world where the market is expected to be worth $1.5 Billion. However, since its introduction to the market in 1976, it has experienced limited innovation. Despite its importance in providing crucial information about a significant life event, women continue to rely on outdated and limited options. The existing tests are often expensive or of poor quality, and their single-use nature fails to address the diverse need for sustainable practices. This gap in the market arises from a reluctance among established players to disrupt their stable revenue streams and a lack of investment in female health.
This master thesis intends to present a comprehensive investigation into enhancing the user experience of pregnancy detection and attempting to enhance its overall experience for its intended and unintended users. The project aims to address the limitations of existing single-use pregnancy tests and present an alternative option which would fit the current and future scenarios.
Given the costs associated with essential feminine hygiene products, such as sanitary pads, tampons, and other menstrual care items, as well as fertility products including contraceptives and potential expenses related to fertility treatments, women face a considerable financial burden that accumulates over time.
SureSign aims to disrupt the testing experience for women, providing them with a clear and user-friendly solution while trying to minimize the financial barrier associated with repeated testing. By offering an affordable and inclusive testing option, the product intends to empower women to make informed decisions about their reproductive journey. It envisions a future where women can test multiple times without worrying about the financial implications and sustainability impact, enabling them to confidently navigate their next steps based on accurate and reliable results.
The thesis is carried out in collaboration with Pharmista Technologies. Their role in this master thesis extends to providing initial market insights and to provide expertise in the technology behind potentially making the testing process sustainable - by making it reusable. They provide their existing knowledge about a patent sensor they develop, which in theory allows one to take multiple tests from a singular device. Their goal is to make this action of reusability take place at least 10 times.
The project is divided in two main phases: the research phase of the current scenario and subsequently a development phase for the future scenario. The research phase involves conducting user interviews to gain insights into user needs and challenges related to pregnancy tests. This phase also establishes if the requirement of reusable test actually exists. The project then delves into the embodiment phase which involves form factors related to the overall product experience. Drawing from the gathered insights, a user feedback oriented design process is employed to develop prototypes of the new pregnancy test, considering factors such as usability, accuracy, and ergonomics. The prototypes are evaluated through user testing, allowing for continuous loops of refinement.
The outcome of this master's thesis aims to not only push the field of pregnancy detection forward but also forge a significant stride towards sustainability within the femtech industry. This will be realized through the presentation of fresh perspectives aimed at enhancing the user experience, need for accuracy, and dependability of these devices. The findings will provide valuable recommendations for design refinements and the eventual market launch of this product for Pharmista. This holds the promise of uplifting the experiences of couples navigating their fertility path and women embracing sustainable approaches throughout their reproductive journey.","Embodiment design; Healthcare; Femtech; Sustainability; User research","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:a541ad96-58fa-4b82-8ce4-62d58a78e88a","http://resolver.tudelft.nl/uuid:a541ad96-58fa-4b82-8ce4-62d58a78e88a","Scheduling surgical specialties: Leveling the bed occupancy through stochastic master surgery scheduling","Nguyen, Thao (TU Delft Electrical Engineering, Mathematics and Computer Science)","van Essen, J.T. (mentor); Aardal, K.I. (graduation committee); Hart, K.P. (graduation committee); Staals, L.M. (graduation committee); Delft University of Technology (degree granting institution)","2023","This research addresses the operational challenges faced by the Sophia Children’s Hospital through a comprehensive analysis of its current state, literature review, and mathematical modeling. A model is created that produces a master surgery schedule, allowing for the allocation of patients to specific specialties, operating rooms, and days. Our aim is to maximize the utilization of the OR while also striving for a leveled bed occupancy and a balanced relative OR assignment for the specialties.
To address the uncertainty of future patient characteristics, we consider the surgery durations and the downstream to the nursing wards in a probabilistic manner. For the latter, we follow the approach of Schneider et al. (2020). For the first aspect, we devised a column generation based approach in which, assuming that individual surgery durations follow a log-normal distribution, we employ the
Fenton-Wilkinson method to estimate the distribution of the total sum of individual surgery durations. When this distribution is known, it becomes feasible to identify pairs of specialties with corresponding surgery counts that can be scheduled within our overtime restriction. The resulting model that includes this incorporation is referred to as the Log-normal Column model.
For our research, we use historical data provided by the Sophia Children’s Hospital. The data included properties about the patients’ surgeries and bed assignments. Due to the presence of errors in the data, we conducted preprocessing before utilizing it as input in our modeling. Additionally, we conducted goodness of fit tests to assess whether adopting the log-normal distribution for surgery duration was genuinely superior to the normal distribution. Our analysis revealed that, for the majority of instances, the log-normal distribution outperformed the normal distribution. This was the case for individual surgeries, as well as the Fenton-Wilkinson approximation for the duration of multiple surgeries.
We compared the performance of our Log-normal Column model to two other models which assume normality for the surgery durations. One is, similar to the Log-normal Column model, created with the column generation based approach, while the other is the model described by Schneider et al. (2020). The two column generation based approach models performed significantly better than the model proposed by Schneider et al. (2020). Furthermore, we compared our Log-normal Column model to the real-life situation with the help of a simulation.","Optimisation in healthcare; Optimisation; Master surgery schedule; Operating room scheduling","en","master thesis","","","","","","","","","","","","Applied Mathematics","",""
"uuid:0426a25b-09ba-4fa8-9d27-f4e555ab30ea","http://resolver.tudelft.nl/uuid:0426a25b-09ba-4fa8-9d27-f4e555ab30ea","Sound environment monitoring system in NICU/PICU","Lu, Guang (TU Delft Industrial Design Engineering)","Ozcan Vieira, E. (mentor); Goos, T.G. (mentor); Delft University of Technology (degree granting institution)","2023","This research project delves into the exploration of the sound environment within Intensive Care Units (ICUs), particularly focusing on Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU). It aims to enhance the understanding of sound events and their impact on both nurses' decision-making and patients' sleep behaviors. By recognizing the unique challenges of the sound environment in these specialized units, the project focuses on creating a soundscape evaluation metric, incorporating sound event detection algorithms, and simulating real ICU scenarios through synthesized audio. This approach seeks to facilitate better decision-making, foster communication among nurses, improve behavior, and enhance awareness of events within the patient's room.
Utilizing an iterative process that involved technological exploration, algorithmic integration, and UI design, the project offers a novel perspective on sound quality within NICU and PICU settings. The main objective is to transform raw sound data into visually accessible formats for the nursing staff, while also addressing complexities like sound collection, data processing, information storage, deployment methods, and interaction design. The project culminates in the development of a functional product prototype that not only meets the initial goals but also reveals new opportunities and challenges for future exploration. The insights gathered contribute to the wider understanding of the sound environment within NICUs and PICUs, shedding light on potential improvements in patient care and nurse interaction within these critical healthcare environments.","UX Design; Soundscape; Healthcare Design; Sound design; Interaction design; Machine learning","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:b1e90b62-b66b-4b86-aaa4-5f7913f67b92","http://resolver.tudelft.nl/uuid:b1e90b62-b66b-4b86-aaa4-5f7913f67b92","Reducing waste and carbon emissions of single-use medical devices by reprocessing auto-injectors: Reprocessing the YpsoMate 2.25 ml auto-injector","Osorio Escobar, Mariana (TU Delft Industrial Design Engineering; Alliance to Zero)","Diehl, J.C. (mentor); Hoveling, T. (graduation committee); Delft University of Technology (degree granting institution)","2023","Single-use auto-injectors have been around for more than 40 years, serving as a safe and comfortable way of self-injecting drugs through the intramuscular route. But, as much as their design has improved the injection experience, their existence poses a threat to the environment. Like many other single-use medical devices, their production and disposal generate a great amount of waste and carbon emissions (Benedettini, 2022). This Master Thesis represents the joint effort of both Alliance to Zero and Delft University of Technology to transition current single-use auto-injectors into a circular model. The approach involves exploring one of the Circular Economy strategies - Reprocessing - and adapting it to the life cycle of the YpsoMate 2.25 ml auto-injector. By proving if the YpsoMate 2.25 ml can be reprocessed, a possibility for reusing other single-use auto-injectors opens up.","circular economy; Reprocessing; Healthcare; medical devices","en","master thesis","","","","","","","","2025-08-24","","","","Integrated Product Design","Approaching single use autoinjectors into circularity",""
"uuid:aefb8a02-ac76-4275-9b82-4a595e32d32c","http://resolver.tudelft.nl/uuid:aefb8a02-ac76-4275-9b82-4a595e32d32c","Responsible Innovation of Artificial Intelligence: at Erasmus MC","de Vries, Denise (TU Delft Industrial Design Engineering)","Goossens, R.H.M. (mentor); Morales Ornelas, H.C. (graduation committee); M.H., Vink (graduation committee); Delft University of Technology (degree granting institution)","2023","In this study, the aim is to find out how Erasmus MC can properly prepare for the AI Act. An iterative design approach was utilized to explore what AI project members may experience during this regulatory process. Several factors have emerged during this experimental study, including the allocation of responsibility, the importance of education and the connection of the medical, technical and legal domains. The complexity of the problem necessitates multiple solutions, which resulted in two designs, the concept of a service system and a roadmap. The service system embodies the needs of the target group, while the roadmap offers a pragmatic guide for the organization to prepare for the changes following the legislation for AI.","Artificial intelligence; Algorightm; Healthcare; Medical Device Regulation; impact assessment; Risk assessment; Quality Management System; Regulations; project management; safety","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:abbe1475-125b-47f9-9250-6b808f286e1c","http://resolver.tudelft.nl/uuid:abbe1475-125b-47f9-9250-6b808f286e1c","DrugWise: a sustainable approach towards reducing medicine waste in the operating rooms","van Amelsfort, Noor (TU Delft Industrial Design Engineering)","Diehl, J.C. (mentor); Paus-Buzink, S.N. (graduation committee); Kweekel, Dinemarie (graduation committee); Delft University of Technology (degree granting institution)","2023","-What-
Medicines are used for all types of surgeries in the operating room (OR). They are needed to provide safe and effective care. However, the use of medicines also results in waste. Research conducted by Barbariol et al. (2021) highlighted that a substantial proportion, ranging from 20% to 50%, of medications prepared in the OR ultimately remain unused and are consequently discarded. The Leiden University Medical Centre (LUMC) and ‘Nationaal Netwerk de Groene OK’ aim to minimize the waste of medicines at the OR.
-Why -
The environmental impact of medicines
Research conducted last year by RIVM presented that the contribution of chemical products, including medicines in particular, is responsible for 41.2% of healthcare CO2
Medicine scarcity
The ‘Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie’ (KNMP), presened that last year in 2022 the highest number of medicine shortage ever occurred. They predict that these kind of issues will only grow more in the further, so it is important to stay mindful about medication prescription, use and disposal.
Ethical obligation
Medication waste raises ethical concerns within the healthcare context. The waste of medications contradicts the principles of equity and justice, as resources that could have been allocated to patients in need are wasted.
-How?-
DrugWise
Consequently, a final concept called ‘DrugWise’ was devised. This sustainable approach targets medicine waste prevention in the OR through a holistic approach. DrugWise consists of five critical steps:
1. Measure the waste to gain an understanding of the current situation.
2. Prioritize areas for action based on the measurements.
3. Raise awareness amongst OR staff regarding the extent and implications of medicine waste.
4. Initiate action in four key areas: medicine use, prescribing practices, stock management, and disposal.
5. Evaluate the effectiveness of the interventions implemented.
The target audience of the approach is the Anaesthesia Green Team. The DrugWise approach was developed in collaboration with the primary stakeholders involved in medication use - anesthesiologists and anaesthetic nurses. This collaboration ensured that the solution was rooted in their practical experience and professional knowledge.
-Future steps-
Looking ahead, LUMC will serve as the pilot hospital for the DrugWise approach. Upon successful implementation and review, the intention is to broaden the reach to other hospitals, advocating for a nationwide effort in reducing medicine wastage in the OR.","Sustainability; Approach; Healthcare; Prevention; Sustainable healthcare","en","master thesis","","","","","","","","","","","","Design for Interaction","Medical Delta Sustainable Hospitals Lab",""
"uuid:f5fa50d9-94fb-4067-a40a-a2cb1423ddb1","http://resolver.tudelft.nl/uuid:f5fa50d9-94fb-4067-a40a-a2cb1423ddb1","The Impact of Vocal Communication and its Personalization on Intention to Use of Chatbots Using Behavioral Activation to Support Patients Experiencing Depression","Doan, Kevin (TU Delft Technology, Policy and Management)","Metoui, N. (mentor); Ding, Aaron Yi (graduation committee); Scholz, G. (graduation committee); Delft University of Technology (degree granting institution)","2023","The 21st century has seen a significant increase in the global prevalence of mental health problems, affecting almost a billion people. These conditions not only reduce the quality of life for individuals but also lead to stigmatization, discrimination, and social isolation. The COVID-19 pandemic has further exacerbated mental health issues, with depression and anxiety becoming the most common mental disorders among young workers. However, encouraging young adults to seek help for mental health is challenging.
To address this issue, the concept of digitalizing psychotherapies through mental health chatbot services is proposed as a potential solution. Giving the chatbot a voice to communicate is suggested to increase perceived trust and intention to use among users. A research question is posed: ""How does vocal communication and its personalization in chatbots affect the intention to use of young adults with depression?""
The study conducted an online survey using Qualtrics with three groups of participants: the control group (text-based communication) and two treatment groups (vocal communication, and personalized vocal communication). The chatbot followed a rigid script based on a psychotherapy protocol called behavioral activation. Data analysis involved Mann-Whitney U tests, ordinal logistic regression, and one-way ANOVA for randomization check.
Findings from the study indicated that chatbots communicating through speech did not significantly influence trust compared to text-based chatbots. Personalization of the voice did not increase trust based on emotions and even negatively affected cognitive trust. Both cognitive and affective trust were positively associated with the intention to use chatbots. Cognitive trust indirectly mediated the relationship between personalized vocal communication and intention to use.
The study contributed to existing literature by exploring the adoption of conversational agents for mental health support, focusing on young adults with depression. It also provided insights into the use of speech in chatbots and the impact of personalization on trust and chatbot adoption. Additionally, the study shed light on the adoption of mental health chatbots in developing countries, which lack access to healthcare.
From a managerial and societal standpoint, the study's findings have implications for companies developing chatbots for mental healthcare. The insights gained can improve the design of mental health chatbots, potentially easing the burden on mental health professionals and contributing to long-term societal well-being. Moreover, the study highlights the potential benefits of chatbot accessibility for users in developing countries with limited access to healthcare.
Overall, the research provides valuable knowledge about the adoption of chatbots for mental health support, voice communication, personalization, and its implications for various demographics and regions. It also raises ethical considerations, particularly regarding gender-based biases when using gender-specific voices for chatbots.","chatbot; depression; trust; adoption; intention to use; voice; speech; personalization; factorial design; between-subjects; survey design; design science; affective trust; cognitive trust; young adults; Mann-Whitney U test; ordinal logistic regression; behavioral activation; anthropomorphism; conversational agent; Quantitative analysis; healthcare; interaction effect; mediation; ChatGPT","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:5660b7d2-2bdb-4622-8872-5921e100cc80","http://resolver.tudelft.nl/uuid:5660b7d2-2bdb-4622-8872-5921e100cc80","Reprocessing used surgical instruments for veterinary healthcare application: A case study on surgical vessel sealing energy-based devices","Duzijn, Yannick (TU Delft Mechanical, Maritime and Materials Engineering)","Horeman, T. (mentor); van Straten, Bart (mentor); Delft University of Technology (degree granting institution)","2023","br/>With increasing healthcare demand, environmental concerns and waste management in healthcare, particularly in the operating room (OR), are significant issues. Disposable surgical energy devices, like vessel sealers, gain popularity in veterinary healthcare, but reusing them is officially forbidden by law and presents challenges. Objective: This research aims to clinically validate reprocessing the Ethicon HARMONIC® HD 1000i for safe reuse in veterinary healthcare. The study assesses the feasibility of using readily available disinfection methods and evaluates the device’s functionality and safety. The research’s scope is limited to a case study (functional analysis) on the Ethicon HARMONIC® HD 1000i. Methods: A comprehensive device analysis was performed using Hot Spot Mapping and Disassembly Map methods, followed by mechanical stability testing during sterilization conditions. A design update was proposed for easier disassembly. The functionality of 2x new, 2x reprocessed and 2x redesigned Ethicon HARMONIC® HD 1000i’s after reprocessing (disinfection, disassembly, reassembly, sterilization) was evaluated in a bench-top study. Tissue transsections on 120 cm pork fillets (6-11mm thickness) per device and pinch force measured with newly developed sensor (40 movements/device) were performed. Furthermore, 2 burst pressure measurements per device on frozen and embalmed artery sections were performed in collaboration with Amsterdam Skills Centre for Health Science. Results: In the disassembly analysis, 42 operations were needed, involving 40 parts and 10 steps with 6 tools. The disassembly time was 429 seconds (07:09 minutes) total. In tissue transsection, the new and reprocessed devices performed similarly, with mean task times ranging from 62.3 to 66.8 seconds. The redesigned devices had slower task times (averaging 196.1 seconds and 104.7 seconds) resulting in lower marching speeds (0.5-1.0 mm/s compared to 1.5-1.6 mm/s for new and reprocessed devices). In pinch force measurements the new devices performed best with average pinch forces of 19.1 N and 20.2 N. The reprocessed devices had slightly lower performance (16.8 N and 16.7 N), while the redesigned devices performed the worst with pinch forces of 5.6 N and 8.8 N, representing a significant drop in performance compared to the new devices. The burst pressure measurement tests showed that none of the devices were able to effectively seal the arteries, resulting in no pressure buildup. Discussion: Overall, reprocessed devices performed similarly to new devices in tissue transsection, showing the effectiveness of reprocessing. Achieved marching speeds by reprocessed and redesigned were considerable given tissue thickness differences, highlighting reprocessing’s potential to extend device lifespan. New devices had 15% higher pinch force than reprocessed, while redesigned had 63% lower force due to a weakened casing. Strengthening redesign and adding new jaw ends could improve modularity and power transmission. Burst pressure tests revealed all Ethicon Harmonic devices (new, reprocessed, redesigned) couldn’t effectively seal
arteries, likely due to frozen artery characteristics and tissue alterations from embalming. Conclusion: This study emphasized the potential of modular medical devices with improved disassembly time, demonstrating that a modular design approach combined with reprocessing strategies holds promise to ensure a more sustainable healthcare system. This research is a collaboration between the Technical University of Delft, Johnson & Johnson Netherlands and GreenCycl.
Keywords: ETHICON, harmonic, ENSEAL, Ligasure, ster- ilisation, reprocessing, medical instruments, healthcare, veterinary, redesign, modular, burst pressure, tissue transection, pinch force","ETHICON; harmonic; ENSEAL; Ligasure; reprocessing; medical instruments; healthcare; redesign; modular","en","master thesis","","","","","","","","","","","","Biomedical Engineering","",""
"uuid:005304c1-2b78-49d4-a938-134c78874e20","http://resolver.tudelft.nl/uuid:005304c1-2b78-49d4-a938-134c78874e20","Machine Learning and Causal Inference for the estimation of the effect of tacrolimus on kidney rejections","Borges Carioca Moreno Rodrigues, Inês (TU Delft Electrical Engineering, Mathematics and Computer Science; TU Delft Pattern Recognition and Bioinformatics)","Reinders, M.J.T. (mentor); Krijthe, J.H. (mentor); Delft University of Technology (degree granting institution)","2023","Tacrolimus is an immunosuppressive drug given to kidney transplant patients. A low concentration of this drug can lead to kidney rejection, but to our knowledge no research has been done to causally connect the two. This paper investigates the causal effect of tacrolimus concentration on kidney rejection occurrence using predictive analysis and a marginal structural model. The data utilized in this study was obtained from a randomized clinical trial conducted at the Erasmus Medical Center, Rotterdam. The challenges posed by limited data availability and class imbalance were carefully considered in designing the model structures. To investigate the predictive properties of tacrolimus related variables we compared results of Logistic Regression and XGBoost models on different sets of variables, yielding inconclusive results. To measure the causal effect of tacrolimus concentrations on the rejection probability, a marginal structural model was developed to estimate the causal effect of the percentage of hours spent within the target tacrolimus concentration range on the probability of kidney rejection. While a large amount of uncertainty remains, our estimates tentatively indicate a decrease as the percentage in rejection probability as the percentage of hours on target increased. Future studies are recommended to explore alternative datasets to enhance the confidence of the findings.","Causal Inference; Machine Learning; Healthcare","en","master thesis","","","","","","","","","","","","Computer Science | Artificial Intelligence","",""
"uuid:9d3f2286-d5f0-4d9e-b027-87386431c1c9","http://resolver.tudelft.nl/uuid:9d3f2286-d5f0-4d9e-b027-87386431c1c9","Music·Wave: Companion Product for Orthopedic Surgery Patients with AI -Generated Music","Wang, Ziyi (TU Delft Industrial Design Engineering)","Ozcan Vieira, E. (mentor); van der Maden, W.L.A. (mentor); van Velzen, Monique (mentor); Delft University of Technology (degree granting institution)","2023","Orthopedic surgeries are identified as one of the most noisy surgeries inside the OR (operation room). The highest noise sound level could reach up to around 130 dB, which is harmful to patients’ well-being and are likely to evoke negative feelings during surgery. In the previous study investigating the emotional experience of patients who receive spinal or general anesthesia in orthopedic surgeries, results showed that different kinds of sounds inside the OR could lead to fluctuating emotions for patients, such as nervousness, curiosity, and relaxation. Therefore, this project is mainly focusing on this user group and aims to improve their experience, especially regarding sounds inside the OR.
The research phase of the report includes two parts. The research in LUMC mapped out the patient journey, for instance, when, and how the design should intervene. Questionnaires for surgeons provided strong support for the rationale and effectiveness of musical interventions in this design project. Later on, the second part of the research, the one on AI music alignment proved that to some extent, AI generative model could understand the textual input with emotional descriptors, and output desired emotionally effective music that could influence the listeners’ perception. With this in mind, the design could refer to the circumplex model that Hevner and Schubert developed on music emotions to position the descriptors of specific musical emotions in two dimensions and achieve control of musical emotions in spatial terms.
The design concept mainly has two phases, the preference input phase, which allows patients to choose their favorite prompt list for the AI model to generate later on adding the emotional descriptors together as prompts; the music experience phase on the other hand, mainly happens during surgery when inside the OR, patients will be able to freely explore the music emotion variations during surgery with their favorite music styles (prompts). The design goal for the project would be to design a music companion product for orthopedic surgery patients who are undergoing spinal anesthesia. The product interaction aims to improve their emotional experience during the surgery period. The interaction should be distracting, desirable, and immersive for patients.
Once the general direction of the design concept is determined, the iteration phase began. The prompt input part is based on the brainstorming session and the co-creation session to develop an ideal interface for the experience. While for the music experience part, one of the three interaction ways will be chosen through the concept testing and evaluation procedure. The chosen concept will be further developed into the final concept - Music · Wave.
In the future, I imagine that the OR would be an immersive sensing space for the patients as well, so adding visuals into the whole design would be another vision, that maybe will be further designed in later projects. This project, however, would only give a rough glance into what the whole experience could be like in the future, and how the surgery soundscape could be reframed.
A systemic design approach is proposed for this study, combining mixed methodologies of qualitative, quantitative, and co-creation efforts with cross-disciplinary experts from six university hospitals, as well as the national Radiology association in the Netherlands. The steps towards framing, prioritizing, and embedding ESG into the Radiology workflow are consistently captured as research findings, concluding contextual insights on the ESG impact across the different levels of the system. These are represented as an ESG pyramid in this study. Identifying key ESG healthcare challenges and influential entities in the system offers a foundation for strategic dialogues on ESG goals definition. Additionally, an ESG healthcare ecosystem map has been developed to further understand the dynamics among key system stakeholders, on three main dimensions: financial, clinical compliance, and ESG. The perspective of embedding ESG in Radiology, within the Netherlands, is taken as a representative industry case study. Consolidation of clinical workflow data, operational insights, and current ESG context resulted in a cross-hospital view of Radiology ESG hotspots, dependencies, and opportunities. Interventions on ESG hotspots are then addressed and positioned, at corresponding decision power levels, within the larger system. Furthermore, a solution for integrated ESG value-impact measurement and continuous monitoring is proposed. Such a simplified and transparent way of working has the potential to increase awareness, drive collaboration, significantly reduce ESG spending and identify new circular value opportunities.
The outcomes of this research indicate that embedding ESG hotspots into the Radiology workflow should be approached in a holistic and systemic way. The ESG strategic design toolkit can facilitate relevant dialogues on the value and impact of ESG interventions across levels in the healthcare ecosystem, enabling hospitals and departments to effectively define ESG goals and programs. This simplifies complexity and provides consistency across the broader system hierarchy.","ESG; Sustainability; Circular Economy; Radiology workflow; Healthcare Ecosystem","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:d033ef0b-fd88-4055-acd2-341488571a70","http://resolver.tudelft.nl/uuid:d033ef0b-fd88-4055-acd2-341488571a70","Own your treatment space: A study about the feeling of autonomy in psychiatric clinics","Kalkhoven, Thijs (TU Delft Architecture and the Built Environment)","Miedema, E. (mentor); Lafeber, J.W. (mentor); Oorschot, L.M. (mentor); Spaans, M. (graduation committee); Delft University of Technology (degree granting institution)","2023","Psychiatric clinics where patients live are only used when the patient cannot
live on their own anymore. Stays are kept as short as possible and patients are
stimulated to reintegrate and live on their own again (GGZ Noord-Holland-
Noord, n.d.). For patients with the prospect of moving out again, this now often
fails, because the difference between living in a clinic and living in your own
home is too big. The architecture does not fully support aspects of giving and
taking autonomy, which can result in patients feeling helpless (Evans, 2003).
This research aims to make it easier for patients admitted to psychiatric clinics
to reintegrate into out-patient care and their own home, by finding ways in
which architecture can increase the autonomy that patients in clinics have.
For this research, the subject of feeling at home is taken from J. Habraken
(1961), who says that a place can only feel like a home when you are able to
build, to change it to your preferences. The paper by Golembiewski (2010) is
used as it directly posed architectural guidelines. There is no research yet that
combines elements of architecture and the built environment into guidelines
to increase the feeling of autonomy for patients admitted to psychiatric clinics.
Part of the research is done by a case study analysis, in which 5 psychiatric
clinics in The Netherlands will be ranked points in five different categories,
with a maximum of five points. The categories are: Room for activity within,
Activities in surroundings, Possibility to choose your whereabouts, Possibility
to personalize and Stigmatization. Another part of the research is done by by
interviews and observations in a Field Work. Three interviews were done with
members of staff and there have also been observations directed to finding
out people’s needs, wishes and relationship with the building.
The research resulted in 17 architectural guidelines that architects can use
in order to design psychiatric clinics and increase the amount of autonomy
patients have. Within the guidelines, there is a clash between those that make
sure safety and privacy is provided within the building and thosethat stimulate
social contact and activities. It is both important to comfort patients as well
as prepare them to live on their own.
Key words: Autonomy, personalization, temporary co-living, psychiatric clinics,
inpatient healthcare facilities, patient-centred healthcare.","Autonomy; Personalisation; Personalization; Temporary co-living; Psychiatric clinic; in-patient healthcare facilities; patient-centered healthcare","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Dwelling","","52.050073, 4.317714"
"uuid:619a9aa6-3940-47f4-ae37-ef3556ae2bb9","http://resolver.tudelft.nl/uuid:619a9aa6-3940-47f4-ae37-ef3556ae2bb9","LooS: co-producing youth mental healthcare","Oomen, Floor (TU Delft Industrial Design Engineering)","Melles, M. (mentor); Mooij, S.C. (graduation committee); Delft University of Technology (degree granting institution)","2023","The increasing waiting times in youth mental health care pose a significant challenge, driven by a shortage of specialists and external factors that complicate diagnosis and prolong treatment. Shoshin, a multidisciplinary strategic design and innovation agency, has developed a solution known as the Fit Op Weg Poli (FOWP) to address this issue for adult care at GGZ Delfland. This thesis aims to engage youth healthcare providers in the development of a youth FOWP.
To tackle the design challenge, the double diamond method is applied, involving extensive research and collaborative sessions. This process led to the development of LooS, a co-production framework tailored for young individuals aged between twelve and twenty-seven years old. Co-production for LooS leads to improved service delivery and increased efficiency, aiming to transform youth mental health care.
LooS incorporates several crucial elements to support youth mental health. An easily accessible well-being gym is provided, empowering young individuals to enhance their resilience and overall well-being. A walk-in centre offers a safe and non-judgmental space for peer interaction and support. The intake process involves a comprehensive assessment, and each young person is assigned a dedicated buddy who provides support throughout their recovery journey. Welcome packages are provided to manage expectations and offer essential resources, including e-health tools and information about the recovery process.
Recovery is facilitated through group sessions with a recovery coach, accompanied by the use of e-health tools for progress monitoring and exercises for continued growth. LooS aims to transition 20-30% of clients to a stage where therapy is no longer required, while those who still need therapy will receive specialised group therapy, after recovery.
In the case of a crisis, the program can be scaled up swiftly to provide immediate support. After a crisis, diagnosis-specific therapy will always be provided, and the recovery coach ensures continued aftercare. The aftercare is structured in layers, offering self-testing and a safety net for a smooth transition. Once individuals no longer require aftercare, they bid farewell to their buddy and continue working on their mental resilience in the well-being gym.
LooS is designed to be adaptable for implementation in multiple centres/locations across The Netherlands, allowing for widespread access to youth mental health care.
To support open discussions with healthcare providers, a visual aid called the “Praatplaat” and a brochure have been created. These tools highlight the impact of LooS on the care pathway and waiting times to enable engagement among healthcare providers to co-produce their own LooS centres. A comprehensive blueprint has been developed, providing a clear and structured guide for the co-development process of Shosin with healthcare providers.
In conclusion, LooS is a new approach to youth mental health care, focusing on proactive work on mental resilience, accessible support services, and collaborative engagement. By implementing LooS, the aim is to transform the youth mental health care system, reduce waiting times, and provide holistic care for youth. LooS offers a path towards improved outcomes and well-being, ultimately creating a brighter future for the youth of The Netherlands.
In the neighbourhood of Droixhe, Liege, this is no different. The site used to be inhabited by a thriving healthcare residence named ‘Les Murlais’, however, its thoughtless demolition erased not just the physical entity but also a caring architectural gesture that once shaped lives. The scar is still visible as the concrete pit was all that remained.
‘Une Centre de Vitalité’ is a design proposal seeking to redeem the qualities of ‘Les Murlais’ by addressing and implementing patient-based design with an ecological approach regarding the concrete pit as a layer of the site which should be respected. The design provides flexible spaces for the currently neglected healthcare practices of the neighbourhood and in addition spaces for physical activities and sports. A healthcare building in a residential area should not be a fenced-off place for illness but a place to regain strength and come together. The design proposes a nature-inclusive building with attention to biobased materials and forward-striving climate concepts.","Liege; Ghost; Healthcare; Sports; Ecology; Bio-based building materials; Earth Wind and Fire; Circular building","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Public Building","","50.64481020121996, 5.602851184343687"
"uuid:7b9395d3-a654-4a6e-8c98-35eb5901194e","http://resolver.tudelft.nl/uuid:7b9395d3-a654-4a6e-8c98-35eb5901194e","Towards a convergent approach to the use of data in digital health design","Pannunzio, V. (TU Delft Methodologie en Organisatie van Design)","Kleinsmann, M.S. (promotor); Snelders, H.M.J.J. (promotor); Delft University of Technology (degree granting institution)","2023","Digital health is a vibrant and dynamic field, encompassing subsets such as mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalised medicine. While digital health adoption has been markedly accelerated by the covid-19 pandemic (Inkster et al., 2020), an evolving body of research has focused on describing and addressing specific challenges related to the design and evaluation of digital health technologies (Pagliari, 2007; Murray et al., 2016; Blandford et al., 2018; Marvel et al., 2018). This research articulates a need for novel, interdisciplinary design approaches to digital health innovation, integrating disparate sets of requirements such as clinical soundness, user-centeredness, technical interoperability, and cost-effectiveness (Cornet et al., 2019). In this complex domain, design and health disciplines are called not only to collaborate with each other, but also to learn to work with digital data as the raw material fueling digital technologies. This dissertation explores such challenges through a series of exploratory research efforts at the intersection of design, healthcare and digital data. These explorations are conducted within the context of the Cardiolab, a Delft Design Lab born out of a partnership between Philips Experience Design and Delft University of Technology. Throughout the dissertation, knowledge in this domain is gained through a mix of literature reviews and project-based action research (Somekh, 2005). In this way, the relevant scientific literature is connected and put in dialogue with real-life digital health design practice.","Design for health; Design for Healthcare; e-Health; Design Approaches; Design Methodologies; Data-enabled design; Convergence","en","doctoral thesis","","978-94-6384-454-3","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:f4ea1623-2f84-47aa-a11b-5a3ac546825b","http://resolver.tudelft.nl/uuid:f4ea1623-2f84-47aa-a11b-5a3ac546825b","Another Demansion: Insight into the life of people with Young Onset Dementia and their relatives in order to design a care home facilitating them in their well-being","de Vette, Nikita (TU Delft Architecture and the Built Environment; TU Delft Architecture)","Miedema, E. (mentor); Lafeber, J.W. (graduation committee); Oorschot, L.M. (graduation committee); Delft University of Technology (degree granting institution)","2023","Dementia is a familiar brain disorder, generally seen as a disease of the elderly and care homes are designed as such. However, also people between 30 and 65 can get dementia, called Young Onset Dementia and are overlooked now in architecture. Due to the different life stage in which the disease occurs, these mainstream facilities do not fit their needs, resulting in a decreased quality of life. It is already known how to design a dementia friendly environment, what the different course and impact of Young Onset Dementia is and which supporting facilities in the first stages at home are needed. Knowledge about architecture for later stages of Young Onset Dementia is lacking. This thesis therefore identifies the spatial needs of this target group and their relatives, in order to design a care home that facilitates them in maintaining their quality of life. Important outcomes of their spatial needs are having a purpose, physical activity, social interaction with peers, having a break and expressing dividual elements. These are not met in reality and the institutional setting of care homes are founded to be not suitable too. Provided guidelines for designing a care home for people with Young Onset Dementia therefore focus on dignity and activity. It is important for them to keep an as normal way of living, where young people with dementia and their relatives are brought together and to have a meaningful day and activities.","Young Onset Dementia; Architecture; Quality of Life; Care home; Neuropsychiatry; Healthcare; Design Guidelines; Well-being","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Dwelling","",""
"uuid:71c0a354-20a6-49bf-93ec-659808fa4400","http://resolver.tudelft.nl/uuid:71c0a354-20a6-49bf-93ec-659808fa4400","Phoenix: Reborn into Community","Gürkan Saul, Romina (TU Delft Architecture and the Built Environment)","Miedema, E. (mentor); van Andel, F.M. (mentor); Lafeber, J.W. (mentor); Delft University of Technology (degree granting institution)","2023","","Healthcare; Psychiatric facility; Rehabilitation","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","","52.49123394364403,5.439740571790097"
"uuid:f7f549fa-3faa-469c-9803-6f0029afa8e7","http://resolver.tudelft.nl/uuid:f7f549fa-3faa-469c-9803-6f0029afa8e7","Designing compression garments with integrated sensors for enhanced monitoring & treatment","Hijlkema, Hidde (TU Delft Industrial Design Engineering)","Jansen, K.M.B. (mentor); Wang, T. (graduation committee); van Rijn, Marie Josee (graduation committee); Delft University of Technology (degree granting institution)","2023","Cardiovascular disease is one of the leading causes of death, representing 32% of all global deaths. The mainstay treatments are medical compression stockings (MCS) and physical activity. Although MCS has been shown to positively affect treatment and support disorder control (e.g. leg swelling), research shows incredibly low therapy compliance.
Throughout history, the involvement of digital technologies has greatly enhanced healthcare.
Nonetheless, developments are not embraced by the medical compression stockings industry yet. For instance, since the invention of medical compression stockings (with a graduated compression) in 1960, the design of medical compression stockings (MCS) has hardly changed.
This thesis explores the integration of sensors into medical compression stockings and aims to innovate current compression stockings by including wearable technology. The feasibility and viability of smart stockings are examined, and barriers are defined through a combination of interviews, literature and user observations. Findings are translated into design requirements.
Throughout the research, multiple problems have been identified, ranging from user dissatisfaction to product shortcomings.
For instance, MCS only have an expected lifespan of half a year. Yet, MCS are yearly reimbursed by health insurance companies. Also, wearing, product care, and health complications can even shorten the lifespan of MCS.
For the successful treatment of disorders, it is essential that MCS exert the correct amount of compression.
The presented smart stockings with the app address these shortcomings. The smart stocking is able to monitor the exerted compression of MCS. By constantly validating the product, users gain ownership over the quality of their compression therapy.
Aside from product validation, compression monitoring is translated into the level of fitness of the user. Increased compression (outside of the walking range) indicates an expanding circumference of the ankle. Together with a vascular surgeon, guidelines are discussed. The combination of the smart stocking and the app has the potential to give medical recommendations to users.
With the app, users can be rewarded for their therapy adherence and goals tailored to the specific user and their physical capabilities. Lastly, not every healthcare complication is immediately measurable through compression change. Therefore, the app can ask additional questions based on visible signs, this way it also coaches users to monitor their health.
The aim of this thesis is to investigate whether these issues stem from a deeper (Utilitarian) philosophical foundation of how health care is currently funded and to propose a mode of funding founded on Aristotelian principles that would be in support of freedom without adversely affecting (or even improving) costs, accessibility and quality
The analysis of the system of Managed Care (in Chapter 2) and its implementation in The Netherlands (in Chapter 3) suggests that the rising costs of health care may be related at least in part to the utilitarian foundation of this system (with its utility-maximising consumer and its profit-maximising producer who, in an oligopoly like the health-care market, is able to generate super-normal profits), in part to the heavy administrative load associated with Managed Care, and in part due to contracting practices. All of which also restricts freedom of choice.
Aristotle's ethics, specifically his \textit{Nicomachean Ethics}, underlines the importance of freedom (of deliberation) as the quintessential requirement for eudaimonia. If this were taken as the philosophical foundation for the health care system, then patients and health care providers would be able to make informed choices that align with their personal goals and values. This freedom of deliberation stands in stark contrast with protocolisation, standardisation and homogenisation that Managed Care brings. Such a system creates a 'monoculture' in which it is difficult to find discernible differences in price and quality, making it equally difficult to identify possible trade-offs between the two and implications of such trade-offs.
In Chapter 4 I propose a mode of funding Dutch health care that safeguards freedom of deliberation in health care that would be in line with the Dutch socio-economical environment and political system. The proposed Health Care system is a universal health care system with a single-payer that covers all health care expenses; where medical decision/treatments are made autonomously by client and practitioner without meddling/pressure/ruling by other parties who are not practising health care; where the funding of health care is a matter of transparent deliberation between all parties and a part of political discourse.
By prioritising freedom of deliberation, the proposed reforms address the limitations of Managed Care's utilitarian philosophy and offers a more human-centred approach to health care. A system that is based on Aristotelian philosophy creates an environment that encourages open and honest communication between all parties involved and is expected to improve all relevant aspects of the Dutch health care system and health itself. The suggested reforms are far reaching and may seem unrealistic. Its proper functioning would indeed require substantial social reform in all spheres of social life (economic, legal-political, and cultural), though they remain entirely in-line with Dutch socio-econo-political reality.
In conclusion, this thesis argues that the Netherlands' health care reform should prioritise freedom of deliberation (the fundamental requirement for eudaimonia). As such individuals' well-being and values are prioritised, which is expected to have beneficial effects including reducing costs and improving the overall quality of care without diminishing access to it. Free deliberation and subsequent cooperation are thought to have more potential than competition.","Health Care; Aristotle; Philosophy; Healthcare; Managed Care; Economics; Netherlands; Ethics; Eudaimonia; Nicomachean Ethics; Policy","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:28c38358-a1ca-423c-97fb-841471138e56","http://resolver.tudelft.nl/uuid:28c38358-a1ca-423c-97fb-841471138e56","Developing Data-enabled Design in the Field of Digital Health","Jung, Jiwon (TU Delft Methodologie en Organisatie van Design)","Snelders, H.M.J.J. (promotor); Kleinsmann, M.S. (promotor); Delft University of Technology (degree granting institution)","2023","The research question of this doctoral thesis is: What can be the future impact of design (activities) in digital health, given the rise of data collection and analysis technologies? I answered this question on three knowledge levels: design vision, knowledge-generating approach, and design tool. In Chapter 1, I envision design activities for the collective computing era (an upcoming modern computing era with complex systems of massive social interaction through various connected computing devices) that data collection and analysis technologies are a part of. Based on the literature review and informants’ interviews, I developed a design vision that demonstrates the changes posed in design activities (design tasks, processes, and the designer’s role) due to the upcoming collective computing era, and provides guidance for adopting the changes. Consequently, the vision proposes that design tasks in the collective computing era move towards designing ‘complex system(s)’ and testing these within ‘society as a lab’. The vision’s guidance states that designers can approach these tasks by addressing communities and engaging with their data. In terms of the design process, the vision claims the ‘coexploration’ of the design problem and solution spaces. To tackle such change, the guidance suggests designers: the flexible combination and analysis of mixed data, working on social forces at a system level, and developing through multiple soft launches with modular designs. Finally, the designer’s role becomes conducting an ‘accountable implementation.’ The vision recommends approaching accountable implementation by incorporating a transdisciplinary vision of the value and control of the design output....","Design vision; Knowledge-generating approach; Design tool; Design for health; Digital health; E-health; Data-enabled design; Design methodologies; Design method; Machine learning for design; Design for Healthcare","en","doctoral thesis","","978-94-641-9760-0","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:58f4f7f7-72c2-4c2b-900b-471db2e629ae","http://resolver.tudelft.nl/uuid:58f4f7f7-72c2-4c2b-900b-471db2e629ae","Drivers and Barriers to the Implementation of the RRI concept in small and medium-sized enterprises in the Chinese healthcare industry","ZHENG, Jasmine (TU Delft Technology, Policy and Management)","Roosenboom-Kwee, Z. (mentor); van de Poel, I.R. (mentor); Delft University of Technology (degree granting institution)","2023","This article explores the implementation of the Responsible Research and Innovation (RRI) framework among small and medium-sized healthcare companies in China. The RRI framework has been widely discussed in Europe and the US but is still in the early stages of diffusion in emerging countries and economies. The lack of institutional support and enabling conditions in these countries make it difficult for SMEs to fulfill their mission of socially responsible innovation. Based on a single case study at Gaush Teleon, the article identifies 24 factors for implementing RRI in Chinese SMEs. It develops questionnaires to understand the diffusion of the RRI concept and the ranking of the influencing factors. The results of the data analysis show that policy factors are considered to be the most important influencing factor on the adoption of the RRI framework by Chinese SMEs, followed by organizational and financial factors. The study suggests that examining the alignment of Chinese society with RRI and exploring the feasibility of developing the RRI concept in China can help developing countries assess how emerging technologies and society can evolve together.","RRI; SMEs; China; Healthcare; Responsible Research and Innovation; Barrier; Driver","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:58bb3d8c-cca3-4786-9e60-ff0f6f2edb3a","http://resolver.tudelft.nl/uuid:58bb3d8c-cca3-4786-9e60-ff0f6f2edb3a","Stimulating waste separation in the Intensive Care Unit: Exploring opportunities for Circular waste streams","Pongrátz, Júlia (TU Delft Industrial Design Engineering)","Diehl, J.C. (mentor); Ruiter, A.C. (mentor); Hunfeld, N.G.M. (graduation committee); Delft University of Technology (degree granting institution)","2023","This design thesis explored the possibilities of recycling medical waste from the Intensive Care Unit of the Erasmus MC Hospital in the transition towards Circular ICUs. Through a combination of qualitative research methods, such as observations, interviews and waste audit, the medical context and the waste composition were explored. By selecting the most promising waste types for recycling, proposals for their collection and following parts of the waste journey were prepared.
In close collaboration with the main stakeholders and several sessions with the nurses, two directions for the final design were defined. Both solutions bring part of the waste stream upwards in the hospital waste hierarchy, ensuring better environmental scenarios in the short term. The first part of the design provides a process for separately collecting the packaging of special infusions bags used for dialysis. This process is aided by several physical and graphical tools which help the waste generating group, the nurses, to integrate the separation into their practices easily and correctly. The second part of the design promotes the correct usage of existing waste shredders through simplified rules and aided decision making.
By implementing the proposed solutions, nearly 10.000 kg of plastic waste can be derailed from incineration towards mechanical recycling, and 2000 kg of infectious waste can be saved from high intensity hazardous waste incineration. The overall environmental impact of the design is calculated to reach a reduction of 26.000 kg CO2 yearly and more importantly, poses an example to other hospitals, that recycling of their waste is a possible scenario.","Recycling; Circular design; Medical design; Waste collection; Healthcare; Sustainability","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:a808976d-31a5-40a1-bd14-e978f6e414ff","http://resolver.tudelft.nl/uuid:a808976d-31a5-40a1-bd14-e978f6e414ff","Optimising OR planning: Sequencing surgery groups while levelling bed occupancy","Vos, Kelly (TU Delft Electrical Engineering, Mathematics and Computer Science; TU Delft Discrete Mathematics and Optimization; Sophia Children’s Hospital)","van Essen, J.T. (mentor); van Iersel, L.J.J. (graduation committee); Staals, L.M. (graduation committee); Keijzer, M. (graduation committee); Delft University of Technology (degree granting institution)","2023","This research is conducted in collaboration with the Sophia Children's Hospital (SCH). The hospital wants to provide their patients with more detailed information about when a patient is approximately scheduled to have a surgery. The first step is to create a model which optimises the operation room (OR) schedule and indicates when different kinds of surgeries are planned. This information, combined with the waiting list, provides insight in when a surgery of a specific patient is scheduled.
In a hospital, different departments work together to treat the patient as good and efficient as possible. If a patient needs a surgery, not only an OR is needed, but also a bed at a ward which matches the patient's needs. The goal of this thesis is to use the different resources of the hospital as efficiently as possible. This is done by not only optimising the utilisation of the OR, but at the same time levelling the bed occupancy of the different wards. The levelling of the bed occupancy is done by minimising the maximum number of used beds at each ward. Because, if we minimise the maximum, we force that the patients are spread out more evenly over the day.
For each specialty, the patients are divided into patient groups based on historical data using a constrained $k$-means clustering algorithm. For each patient group, information is gathered about the length of stay (LoS) and the surgery duration of patients in this patient group. Next to that, the number of patients in a patient group indicates how often a patient group needs to be scheduled at least.
The probability distribution of the surgery duration is taken into account when deciding at which day, at what time, and in which OR a surgery is planned. A patient group can only be scheduled during OR shifts assigned to the corresponding specialty. At the same time, the levelling of the bed occupancy is taken into account.
After some constraints are linearised, this model can be formulated as a mixed integer linear program (MILP). However, the model has a large number of variables. Therefore, column generation is used to split the model into smaller subproblems per specialty. Some of the pricing subproblems take a lot of time to optimise. For that reason, we set some time limits both on the runtime of the pricing subproblems and the runtime of the entire algorithm. Column generation does not guarantee an optimal solution of our MILP. However, the objective value of our MILP improves over time, when new columns are added to the set of available columns. This indicates that column generation can be used to optimise our model.
In this thesis, several versions of the model are presented. For example, the schedule is different if the bed occupancy is calculated every hour or of every fifteen minutes. Next to that, the model can either be more focussed on maximising the OR utilisation or on levelling the bed occupancy.","Optimisation; Optimisation in healthcare; Column Generation; OR planning","en","master thesis","","","","","","","","","","","","Applied Mathematics","",""
"uuid:eeeded37-ec42-47e6-a25d-109bd326144a","http://resolver.tudelft.nl/uuid:eeeded37-ec42-47e6-a25d-109bd326144a","Designing a sustainable transition in the MedTech industry: An analysis of the current challenges for the implementation of the circular economy on surgical devices like the single-use endocutter","van Dolderen, Dorien (TU Delft Industrial Design Engineering)","Bakker, C.A. (mentor); Diehl, J.C. (graduation committee); Delft University of Technology (degree granting institution)","2023","This graduation project explored how the circular economy could be implemented for single-use surgical devices like the endocutter. Design for reprocessing appears to be the best strategy, but modular solutions should be considered when reprocessing the entire device is not feasible. The project followed a transition management approach; a sustainable future is envisioned for the industry, and through backcasting a radical but short-term feasible solution is designed which could help us move towards this future. Conceptual service design “MedFlo” helps healthcare facilities overcome barriers in the implementation of modular devices into their workflow and logistics, by providing access to a safe and complete inventory of devices. MedFlo can help decrease the environmental and waste footprint of medical devices, create more resilient supply chains, stimulate circular design initiatives and serves as an example of how the circular economy can be implemented in the MedTech industry.","circular economy; Healthcare; medical device; Service design; Sustainable transition","en","master thesis","","","","","","","","","","","","Integrated Product Design","DiCE project",""
"uuid:98bd84fa-0e4a-43ff-a0ba-c1f111aff44e","http://resolver.tudelft.nl/uuid:98bd84fa-0e4a-43ff-a0ba-c1f111aff44e","Healing by transforming: Creating the empowered healing environment","Koopmans, Jaap (TU Delft Architecture and the Built Environment)","Snijders, A. (mentor); Tomesen, P.L. (mentor); Jenkins, A.J. (mentor); Delft University of Technology (degree granting institution)","2023","According to the Rijksinstituut voor Volksgezondheid en Milieu (RIVM), there will be more focus on tackling the unhealthy effects of urbanization in the near future. This together with the presence of a large stock of vacant buildings and other developments within these urban areas and the challenges which are formed by the developments in healthcare brings up the potential to create so-called healing environments. Although, mostly situated within a natural context, the question could be how to implement the design approach of a healing environment into an existing building within an urban context and what values it could bring to the surrounding neighborhood. Especially when given an user-centered (holistic) approach. This graduation design project explores in which way this user-centered design approach can be optimised by implementing certain 'atmospheres' within an existing context of a building in the station area of Leiden.
The evidence for the tool consists of the 223 relations between the objectives and the assessment criteria (metrics) and 253 causalities of metrics that express the impact. There is a high heterogeneous perspective on the objectives of the optimisation of the performance of the OR and the criteria of assessing the quantification of (the optimisation of) the OR performance, which makes it harder to create a mutual vision on the OR performance. To achieve a mutual vision, a holistic view and consider all the perspectives, including the impact of optimisations, the HCPs should all share their perspectives on the objectives and the situation should be considered in its whole (Leinonen et al., 2008; Littlejohn et al., 2017). Therefore, the decision-making process could benefit of a decision-support tool.
In this study a new tool is developed, namely the Performance Operating Room Counselling (PORC-)tool. This tool provides a holistic view of the OR performance (optimisation), by displaying evidence of the relations between objectives and metrics and the causalities. It also supports a conversation, which could lead to a mutual vision (Littlejohn et al., 2017). The tool is based on the concepts flowchart, matrix table and Microsoft Excel, for respectively the roadmap, the information display and the running-programme. The PORC-tool consists of an Excel file, a brochure and a manual with a more elaborated version of the functionality and the steps. The PORC-tool provides a clear and structural overview with evidence, to gather information more easily, provides multiple perspectives on the OR performance and supports to gather more insight into the OR organisation and goals before the decision-making of the HCP. The PORC-tool should be validated in practice and the functionality should be approved by HCPs. In the future, the tool can also be extended on perspectives, field of interest, aesthetics and functionality. To conclude, the answer to the main research question is that the HCPs should be facilitated to consider the whole complex system in their decision-making process, and support the decision-making based on evidence and with a mutual vision.
It is no secret to hospital and public health managers thatresource shortages worsen pandemics. The importance of preparedness has longbeen recognized within the European Union. One of the current H2020 innovationprojects in this domain is PANDEM-2, aiming to improve pandemic preparednessfrom the side of resource management and sharing by creating cutting-edgedigital tools. As part of these tools, a system dynamics (SD) healthcareresource model is being developed, with the ultimate goal of embedding it in adashboard accessible to pandemic managers. This is done in order to supportmanagers in rapidly making evidence-based assessments and decisions, or as inthis thesis shortened, to provide situational awareness. In short, the specificproblem we were tackling was the exploration of how can pandemic preparedness canbe achieved via current healthcare resource models and how a specific resourcemodel (developed by a previous intern) can be used. First, to gain a generalunderstanding of the state-of-the-art models, we looked into the scientificliterature from two directions: We looked at how existing resource models work,are validated, and are used via literature review. For another perspective, welooked at scientific frameworks describing modelling and validation to informour methodology. Therefore, this thesis seeks to answer the question: How tosupport healthcare resource managers in acquiring situational awareness via anSD model? To gain a better understanding, we did a literature review first tounderstand how others approach the topic of healthcare resource modelling.
We first analyzed the existing scientific literature by apreliminary search, which was also used to construct a more detailed andrefined second search. In this second search, we used the PubMed database tosearch for articles containing the keywords hospital and healthcareresource, pandemic, model, validation, andsynonyms. Then the returned articles were screened for relevancy, resulting ina total of 25 healthcare resource models analyzed. Within these analyzed models(and articles), we found that the most common approach is using SD models, andthe second most common approach is using regression models. Roughly two-thirdsof the models fall into these two categories. Furthermore, we found that there isa stronger focus on hospital resources than public health resources and that nocommon approach is used for model validation. We also found that the articlesdemonstrating that the model is used to support real-life decision-making wereusually not about SD models; therefore, examining how to use SD healthcareresource models for decision support is not mainstream. We also found that themodel used in our research is novel in the sense that it encompasses resourceson a more detailed level than existing published models.
To further our understanding, we decided to answer ourresearch question by holding a workshop, where we examine how to communicatemodel outputs. While examining the relevant modelling methodologicalframeworks, we defined the tasks that need to be done in this thesis throughthe lens of the modelling cycle. We need to perform the tasks of verification,validation, and holding a workshop, which partly encompasses evaluation. Thenexamining the literature about verification and validation, we encountered theimplication of a well-known philosophical problem of scientific theories' formodelling: It cannot be demonstrated whether the model (or the theory) is atruthful description of the phenomenon.
To overcome this problem, in modelling, validation refers tobuilding confidence that the model is fit for its purpose. In this study, thepurpose of the model changed from describing the different mechanisms foundimportant to generate semi-realistic outputs to be used in the workshop;therefore, it had to be revalidated. This was addressed by performing aparticular set of relevant validation tests. The model passed verification andthen the validation for this purpose, so we continued with the workshop. Wedecided that in the workshop, we would use a presentation to communicateintervention opportunities for the pandemic based on the model outputs. Thenafter each intervention, the participants were asked to evaluate the easinessof understanding the output and to talk about what actions the presentedinformation inspire.
By holding the workshops, we found several relevant facts:First, it was found that the goal participants were searching for was to getrid of the perceived gap. This also meant they were searching for insights thatcould be used for operational planning purposes. Furthermore, the analysis doesnot need to stop at visualizing outputs. One of the participants indicated thatfurther analyzing the graphs is not as easy for them as for an analyst workingwith the model. We have also seen that participants tend to augment thepresented data with their experiences, which (unless explicitly presented)leads to assumptions about how the model works. Some participants also pointedout that the contact tracing part of the model is already outdated (in lessthan a year). We have identified some practical ways to avoid ambiguity whilecommunicating about healthcare resource models. First, we found that despitethe insights we gained by analyzing model outputs were not novel, thediscovered scenarios were still good discussion starters in the workshop. Thisis likely the mechanism of the scenarios acting as a reminder for passiveknowledge, which participants subsequently shared. Furthermore, extra careshould be taken to explain the context of how the data got generated, especiallyconcerning the model. As the presented data left some space for interpretation,participants sometimes had different assumptions than the ones coded into themodel. While these could be resolved in the workshop to some extent, this willnot be the case for the dashboard. Given some familiarity with the audience, itis possible to expect some questions and misunderstandings, which could beproactively addressed in a description or in a `frequently asked questions'. Wealso identified two presentation types that were easier to process thanpresenting key model outputs: The first option is to analyze key model outputsfurther than graphing and present the key insights (such as peak resourcedemand) in a tabular format. Alternatively, the second option is to build allvisualization on the same template and explain that template on the firstoccurrence in detail. In subsequent occurrences, it should be enough to pointout only the interesting parts and give participants time to process theinformation.
From another perspective, participants expressed a need fordata that can be used for planning purposes. However, given the uncertaintyabout the system, these, as we call consolidative models, cannot be constructedyet. While exploratory modelling is an alternative SD technique for addressingdeep uncertainty, it does not attempt to produce numerically accuratepredictions. However, from a novel perspective, the consolidative andexploratory approaches can be viewed as two ranges on the spectrum ofuncertainty about the modelled system. Viewed from this perspective, validationmeans reducing uncertainty about the system. Nevertheless, to achieve theconsolidative models, datasets about resource usage are needed, but as far aswe know, no such dataset exists. As data to create such datasets is probablyalready being collected for operational purposes, it is likely that thecollection and aggregation of these data are not happening. However, creatingsuch datasets comes with some challenges. There is a value trade-off betweenprivacy and preparedness through data collection, and the current datacollection techniques are unlikely to be unified. Overcoming these challengeswould need quite a significant upfront investment. To answer our originalquestion of how to support healthcare resource managers in acquiringsituational awareness, this thesis argues that, by far, the biggest utilitycould be achieved by strengthening data collection and aggregation, as itenables the possibility to develop surrogate models. However, as this requiresa significant upfront investment, question-driven exploratory models remain analternative way to address these uncertainties.","Healthcare; Resource; System Dynamics","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:eaf3a964-45b8-4ef2-89c1-96dc70022a90","http://resolver.tudelft.nl/uuid:eaf3a964-45b8-4ef2-89c1-96dc70022a90","Increasing Children’s Influence on Living with Hemophilia","Kerimoğlu, Ekin (TU Delft Industrial Design Engineering)","Melles, M. (mentor); Gielen, M.A. (graduation committee); Van Hoorn, E.S. (graduation committee); Delft University of Technology (degree granting institution)","2022","For hemophilia patients, a simple fall or injury can cause excessive bleeding, which if not handled properly can cause major disabilities and in extreme situations even death. Due to the insufficient blood coagulation factors in their system, a fun day can easily end in the emergency room. Children, by nature, are still learning how to move and navigate the world. Where an adult may know the consequences of their actions, a child may not be able to see that, and therefore are an especially vulnerable group. With many challenges in their daily life, children with hemophilia have a complex experience with the disease. In collaboration with Partitura and the Sophia Childrens Hospital, the goal of the project is to analyze the experience of severe hemophilia patients aged 0 to 8, visualize this in the form of a patient journey built from their perspective and find opportunities and patterns in the experience to eventually create a proposal for an intervention to improve quality of life.
A patient journey was created, in order to visualize this complex experience. The journey showed that there were definitely opportunities for improvement, giving an overview of the different touchpoints the patient goes through in the 3 main phases, (1) diagnosis, (2) treatment and (3) living with hemophilia.
The patient journey, as well as various methods of research including a literature review, observations in the outpatient clinic and interviews with healthcare professionals, parents and patients showed that children want to feel more in control of their disease, and have more structure/predicability in their experience with hemophilia. Especially the 3 main contact areas of the patient, (1) home, (2) the outpatient clinic and (3) the emergency room, provided room for these needs to be met.
Based on the research outcomes, a design goal was formulated for the creation of an intervention: To design an intervention for children with severe hemophilia aged within the range of 0-8 years, that helps empower them and help them better comprehend their journey with the disease, by providing structure, consistency and control. 3 concepts were created, all serving the different contact areas of the patient, with the overarching purpose of helping the child be more involved and active in his healthcare. The concepts were designed as seperate interventions, which can be combined and used together to strengthen each other by improving the patient experience in the different areas of the child’s life. The evaluation sessions, carried out with parents and healthcare professionals showed that the concepts had a lot of potential, and was met with great enthousiasm. This project concludes with recommendations for the next steps, for the implementation of the interventions and also further research opportunities in the experience of children with hemophilia. The next steps for the project will be to prepare for implementation, with interest to implement nationally, and eventually to aid in improving the patient experience of children with severe hemophilia, not only in the context of the Sophia Children’s Hospital but all patients of the Netherlands.","Patient Journey; Pediatric Hemophilia; Healthcare; Patient Experience","en","master thesis","","","","","","","","","","","","Design for Interaction | Medisign","",""
"uuid:e665b12f-3bb4-4ff8-b095-4388a8d0ba59","http://resolver.tudelft.nl/uuid:e665b12f-3bb4-4ff8-b095-4388a8d0ba59","Towards a Circular ICU: How to implement reusable video laryngoscopes at the ICU","Koot, Veerle (TU Delft Industrial Design Engineering)","Diehl, J.C. (mentor); Kleinsmann, M.S. (mentor); Hunfeld, Nicole (mentor); Delft University of Technology (degree granting institution)","2022","The healthcare sector uses a lot of on single use medical products, causing large amounts of CO₂ emissions and excessive amounts of waste. This project contributes to a circular Intensive Care Unit (ICU) by investigating the barriers and possible solutions for a transition from single use video laryngoscopes (VL) to (partly) reusable ones, in order to develop guidelines and best practice for the transition of other single use medical products to reusables.
To produce single-use products, raw materials are extracted, products are manufactured, used, and disposed of after using the product just one time. This is known as the linear economy or the ‘take-make-waste’ system, having a devastating effect on the environment. However, reusing medical products comes with organisational challenges. Concerns with patient safety, liability, the costs, and complexity of developing and maintaining in-house reprocessing infrastructure and logistics have left hospitals with a complex organisational challenge.
The research question for this project is: How can the ICU become more sustainable through overcoming organisational challenges hindering the implementation of reusable video laryngoscopes? With the sub-questions: 1. What are the barriers and enablers for implementing the reuse of video laryngoscopes in the ICU? 2. How can the reuse of video laryngoscopes be implemented at the Erasmus MC? 3. What could be the next step in transitioning similar products (to the video laryngoscope) from single use to reusable?
This design project was structured through three phases: Exploration, Analysis and Conceptualisation phase. Three product journeys were analysed: a single use VL, semi-reusable VL and a completely reusable VL. This project concludes, contrary to the original hypothesis, that barriers to for the implementation of reusable VL’s are minimal. The semi-reusable VL seems to require the least change from the organisation, but the fully reusable VL contributes better to the end goal of a fully circular ICU in 2030, notwithstanding its higher up-front cost.
For the implementation of the reusable VL it is essential to spark the actual implementation of the reusable VL and communicate with and facilitate stakeholders. The implementation processes need to be kickstarted through the set-up of a tender, followed by a pilot, pilot evaluation and expansion of the pilot in order to ensure proper implementation. After implementing the VL three other medical devices were identified to follow in the footsteps of the reusable VL: Laryngoscope blades, bronchoscopes, and scissors. Laryngoscope blades and bronchoscopes can be collected in the same place since the use-case of them is very similar to the VL. Scissors will require further research but follow a similar journey to and from the CSD.
This report brings value to the ICU of the Erasmus MC through identifying that the Erasmus MC has the resources and capabilities to implement the reusable VL’s, as well as presenting recommendations for the implementation process.
This research presents a novel model to explore the problem space. A multi-disciplined microsimulation model is presented that incorporates theories and data aggregated from individual health data, population studies, social network studies, and behaviour studies. To our knowledge, it is the first model of its kind. We used the city of The Hague as our case study, as we were able to use a treasure trove of individual health data to inform the model, and thus inform the answer to the research question. The model was developed to answer the research question:
How can behavioural interventions decrease the healthcare burden of cardiovascular diseases among women in The Hague?
Our methodology consisted of multiple phases. First, we conducted a literature study to identify
cardiovascular risk factors and entry points for interventions. Second, we developed health data models to be integrated into the microsimulation model. Third, we designed and implemented a microsimulation model and explored a plausible future cardiovascular health burden. Fourth, we looked at the impact of certain interventions applied to the entry points. The chosen interventions are based on the hypothesis that was derived from the literature read during the first phase. The hypothesis was as follows:
How can recurring interventions targeting diet, exercise or smoking behaviours decrease the healthcare burden of cardiovascular diseases among women in The Hague?
During the literature study we conducted, we made multiple findings. First, current studies seem to omit relevant risk factors for women, such as pregnancy complications. So far, studies primarily focus on men, even though that cardiovascular diseases are the leading cause of morbidity and mortality for women in the world. Second, studies that examine risk factors oversimplify the nature of the problem and neglect cultural, social and even biological context. The problem is complex and multi-faceted. Thus, it warrants a fitting approach, such as the one presented in this research. Third, there is too little evidence on the efficacy of interventions targeting behaviours that lead to an increased risk of cardiovascular diseases.
During the development of the data models, we found that the cardiovascular risk of a young female is significantly higher if she has multiple risk factors – something that is currently not mentioned in the cardiovascular guidelines. We also found that smoking is the most dominant modifiable risk factor. However, since, in the model we developed, exercise and diet behaviour affect a woman’s blood pressure, total cholesterol and blood sugar, indirectly, BMI may be just as, if not more, important. Our data model and our literature study thus confirm that these are important entry points that need to be exploited by interventions.
The simulation runs made the staggering revelation that, unless we do something about it, the future for women with regard to CVD looks bleak. The health issue is obstinate, and much of the prevention potential seems to be lost. The effects of many temperate interventions, such as education in schools, are negated, due to the oversaturation of unhealthy lifestyle behaviours. We also found that the effect of repeating interventions is more sustainable and long-term. However, our experiments implied that true progress can be made if extreme interventions are introduced repeatedly. Due to the intensity, it is unlikely the population of The Hague and additional stakeholders would approve of these interventions. We nuance the findings by the fact that the model is a simplified representation of the real world.
Choices were made during the design, and certain elements of human behaviour and of cardiovascular pathophysiology were omitted from the model. In some aspects, there simply was not enough data, such as on the effect of policies on a woman, but also how a woman is exactly influenced by her network and by external influences. These were some of the unknowns that could be addressed in future research.
This research concludes that there is an urgent need to introduce interventions that realise a sustainable, lasting change in the behaviours of women in The Hague. Three potential entry points are food intake, exercise, and smoking. Promoting healthier lifestyles is however only possible if we also address the social and cultural context. This model shows it is less effective to just change the behaviours of one woman, as social pressures may persuade her to fall back to her previous behaviours. We can set up women for success by involving her social network and as such decrease the barrier for her to permanently adopt a healthier lifestyle.
Erasmus MC has set up its own (online) care path for preconception care, Smarter Pregnant. This programme consists of online platforms for preconception screening and the outpatient clinic healthy pregnant (OCHP). OCHP is a counselling session for couples or individuals to make pregnancy as healthy as possible or to obtain the healthiest possible lifestyle to get pregnant. Most of the pain points occur when filling in and processing data in the Slimmer Zwanger's system. The current system of Smarter Pregnant is often not understood by patients and nurses have to process the data manually. This processing of data is perceived by nurses as monotonous - which is why nurses report that the work feels robotic. Moreover, there is less focus on delivering care and more on interacting with the system. As a result, patients have to search for more information on the internet, getting lost in the validated and non-validated e-health for conception. Therefore, the need for an authoritative and trustworthy source of information for the OCHP is great.
The specific focus of this study is on creating a trustworthy VA for OCHP. The dimensions of trustworthiness are leading for the interaction and thus the design of the Voice Assistant. There are three layers that were considered when creating the Voice Assistant for the OCHP; the user, the context and the technology. In the current context, trustworthiness is generated by taking responsibility and exuding expertise. Responsibility is something the nurse has to take on the word of the patient and partner. The trustworthiness of the nurse can be measured by his or her expertise. Expertise is considered a dimension of trustworthiness in existing models.
To decide what the VA had to look and sound like, several experimental prototypes were conducted during the context analysis and collection of existing theories and methods. These prototypes served both as validation of research, and to spawn further research. The results of these studies led to a final prototype.
Each test ended with a qualitative interview with the patient based on the dimensions of trustworthiness. To structure patients' responses to the VA, three research questions were formulated regarding; expectations, comparing human-to-human versus human-to-robot interaction and characteristics affecting trustworthiness. Because the context analysis revealed that in the context of OCHP, trustworthiness depends on expertise, this research question was reformulated specifically regarding expertise.
These themes helped accomplish and structure the overarching goal of the project: Forming principles on how trustworthy VAs can be designed for healthcare in the future. These principles form a set of pointers on how trustworthiness can be implemented in a VA for healthcare.
Philips, collaborating with Catharina Hospital Eindhoven and Eindhoven University of Technology (TU/e), has an oncology team called Eindhoven MedTech Innovation Centre (e/MTIC), working on a health care innovation regarding Pancreatic cancer enabled by AI (artificial intelligence) and Medical Image Guiding. This graduation project focuses on this pancreas use case; an integrated imaging workstation is being developed using 3D visualisation and enabling AI to enhance the workflow.
This graduation project focuses on improving healthcare professionals' user experience and interaction within an integrated imaging workstation. The project focuses on visually communicating tumour detection and vascular segmentation, resulting in better diagnosis and surgical planning. The aim is to eventually design a visual language (a design language system guideline) to improve the workflow and experience.
A user review was conducted using videos of user tests performed previously in the pancreas use case. This review led to the usability problems and the user needs of the 3D model in the pancreatic use case. A professional critical study was also conducted, revealing the prototype's strengths and weaknesses.
Eventually, a redesign for the 3D model was developed. This model is focused on showing resectability to improve the workflow. Moreover, uncertainty regarding the tumour size and shape is visualised as well.
Additionally, a DLS guideline for similar applications within Philips focused on medical 3D visualisation was designed at the end of this thesis.
Finally, 3D visualisation, enabled by AI, improves the workflow within a medical imaging workstation.
As a solution toward bridging this gap, this paper proposes the introduction of home de- livery vehicles (HDVs) to support HHC operations, in which the vehicles deliver resources required at patient visits in time for consultation. A mathematical formulation consider- ing the routing, scheduling, and synchronisation of caregivers and vehicles is presented, in which partial battery charging alongside hard visit and working time windows are key characteristics. A genetic algorithm (GA) is further developed to solve the proposed for- mulation, which is proven to perform efficiently in benchmark instances for the vehicle routing problem (VRP). Simulations were run on data generated synthetically by a sta- tistical model recreating the HHC needs of the London Borough of Islington. The results highlight the potential benefits of adopting such technology, resulting in an average re- duction of the required medical resources of 49.94% and a 19.23% reduction in costs with respect to standard operations using the same number of resources.
Overall, the most economical operating strategy for a HHC organisation was identified to be the purchase of a number of resources equal to the number of visits requiring said re- sources. Such an approach was found to decrease the costs per visit by 1.26% with respect to HDVs. The marginal amount, however, is expected to be diminished in the coming years due to factors not captured in the analysis such as the higher scalability of HDVs and their resulting potential to meet the anticipated growth in demand for HHC, the ex- pected decrease in the price of electric vehicle technology, the economic incentives offered to adopt said technologies, and the potential collaboration between caregivers and HDVs. These, alongside extensions to the proposed model such as non-linear battery charging, are proposed as future research avenues.","Home healthcare routing and scheduling problem; home delivery vehicles; genetic algorithm; Synthetic data","en","master thesis","","","","","","","","","","","","Mechanical Engineering | Multi-Machine Engineering","",""
"uuid:87dc87b9-4c92-414e-95e8-5c39682f855f","http://resolver.tudelft.nl/uuid:87dc87b9-4c92-414e-95e8-5c39682f855f","Evaluating the relation between spatial healthcare access and mortality during the COVID pandemic: Case Study from GOA State, India","Banda, Sercinho (TU Delft Technology, Policy and Management)","Verma, T. (mentor); Hinrichs-Krapels, S. (graduation committee); van Beers, Cees (graduation committee); Delft University of Technology (degree granting institution)","2022","In India the COVID-19 pandemic resulted in a nationwide lockdown from March 25, 2020 till the end of May 2020. During this time public and private transportation activities were limited, economic activities came to a standstill and healthcare resources were redistributed. India’s healthcare system faced problems prior to the COVID-19 pandemic such as insufficient availability, suboptimal healthcare services and high out-of-pocket expenditures. The exponential rise in patient care during the COVID-19 pandemic exacerbated existing problems in the Indian healthcare system while introducing new ones. Realizing optimal care during the health crisis became more challenging as the focus was on mitigating the spread of the virus. The absent of public transportation and the pressure on healthcare resources impacted the healthcare accessibility of different demographic groups. During this study we assessed how access to healthcare was influenced due to the policy interventions that were meant to mitigate the spread of COVID-19. The hypothesis is that healthcare access for different demographic groups was negatively impacted by the policies meant to curb the spread. In order to analyse the impact, we performed a case study in the state of Goa using the Network-based Health Accessibility Index Method (NHAIM). This gravitational model allows us to study the spatial distribution of healthcare resources in the state of Goa. Based on our findings we can conclude that healthcare access is unevenly distributed in the state of Goa. Furthermore, we concluded that there is no significant correlation between healthcare availability and the urban and rural mortality rate for the state of Goa. However, there is a significantly strong positive correlation between geographical healthcare access and the urban and rural mortality for the state of Goa.
Unfortunately, the healthcare sector has difficulties keeping up with the trend of digitalization in comparison with other sectors. This project aims to bring to light why the healthcare sector is struggling with the process of digitalization. Through this exploration it endeavors to design a solution with the intention of facilitating the digital transformation of the Reinier de Graaf Gashuis (RdGG). To keep the project scope limited it was decided to focus on digitalization of colorectal cancer care.
The following methods were used during the research phase of the project:
1) Conducting a literature review that explored the current state of affairs regarding digitalization in the context of colorectal cancer care and methods for digitalization of care processes.
2) Observing interactions between healthcare professionals and colorectal cancer patients and observing during meetings with different stakeholders in the RdGG.
3) Conducting interviews with colorectal cancer patients, healthcare professionals and organizational employees.
This led to the creation of a colorectal cancer patient journey map. The map displays the care process and reveals its ‘non-digital state’. The result showed that mapping a complete care process in a clear way is challenging. Most care processes are not linear or fixed; there are different treatment options and exceptional circumstances. It was discovered that there isn’t a journey mapping format available that is simultaneously comprehensive and user friendly.
The research outcomes revealed numerous factors hindering the digital transformation within the RdGG, some of which include:
1) The complexity of hospitals makes it difficult to keep overview over the process of digitalization.
2) Not all digital resources are perceived in a positive light, one reason being that they sometimes clash with existing workflows or care processes.
3) Patient journey maps and care pathways can help to prevent this from happening, but there are problems with the making of, managing and use of journey maps.
4) There are issues in the communication between healthcare professionals and organizational employees.
The following design goal was created:
Design an interactive journey mapping tool for care professionals and organizational employees at the RdGG, that helps to better comprehend care and digitalization processes, by offering overview, knowledge and easy communication.
This led to GoMedFlow. A design created to help hospitals transition into smart hospitals. It utilizes journey mapping as a facilitator for the digital transformation of healthcare. GoMedFlow offers:
1) Overview in the current state of affairs of digitalization of care processes
2) The opportunity to easily and cooperatively form, maintain and analyze care pathways and patient journeys.
3) Aid to effectively implement digital resources in care processes, assuring digital resources fit well within the care processes.
4) Easy communication between different stakeholders in the RdGG; healthcare professionals and organizational employees
Using GoMedFlow results in an efficient deployment of employees and resources in the future.
This study advances the body of knowledge in the field of digital transformation by identifying the barriers to and enablers of business transformation as well as the role of IT technology as an enabler of business transformation. By creating a theoretical framework for barriers and enablers of business transformation with IT technology as an enabler, it empirically studies Philips to undertake a case study and offers a basis for theory building. On the subject of business transformation, a literature review utilizing the five-step grounded theory methodology was carried out. According to the literature study, this research highlights four primary barriers facing business transformation: organizational, knowledge, financial, and technical. Strategy, people, process, data, and technology are the different categories for business transformation enablers. The theoretical framework for this study is developed using the results of this literature review. A case study is performed on the digital transformation journey of Philips by identifying the IT technologies of the acquired firms that are part of Philip’s healthcare transformation portfolio. This research captures the goal of business transformation while identifying the barriers and enablers of business transformation at Philips by conducting inductive qualitative research by interviewing. Analysis of data is carried out by following the steps stated by Miles & Huberman (1994) and using content analysis to analyze the interview data. The results of this study show that At Philips, the organizational barrier has emerged as the most pervasive barrier to business transformation. This study demonstrates that Philips' organizational structure, or the way they are set up, is a significant impediment to business transformation. The matrix organizational structure of Philips makes organizational change challenging. According to researchers, business transformation begins with establishing a strategy and achieving the organization's aim. According to the research, this strategy is misleading, and that any business transformation strategy should be developed by first comprehending customer demands before being in line with the intended outcome of the business transformation. According to this study, people with proper experience and knowledge in the field of business transformation are the key enabler of business transformation. This study supports the resource-based hypothesis, which contends that an organization has a great chance to outperform its rivals when it possesses strategic resources that can provide it an advantage in the market and could even help it generate sizable profits. This research examines three important IT technologies provided by the acquired companies of Philips, namely Tomtec, RDT, and Capsule technologies as resources that can enable business transformation. According to this study, Philips' business transformation was made possible by the IT technologies' significant contributions to the company's sales and revenues following the acquisition of these companies. By integrating these IT resources into other products in their portfolio to facilitate business transformation, Philips can further develop these technologies and achieve their objective of becoming a fully solutions-based firm. However, the findings of this study also suggest that IT technologies have not yet reached their peak value since Philips lacks the competencies and innovation culture to fully utilize these technologies and add value as a result of preexisting limitations.
Enliven aims to develop a virtual peer mentor support platform for YAMHIE to bridge these waiting times. This thesis explores the design process and development of a concept with the following design goal:
To Enable young adults with concerns about their mental health issues to engage with a peer mentor through interaction in a virtual reality environment while waiting on the professional health care, with the aim to support them in addressing their problems.
The design process involved participatory design methods like contextmapping, co-design sessions and prototyping. The tools used for prototyping consisted of Minecraft to design the virtual environments, Figma and paper prototypes.
The outcome of this project is:
A design concept:
1) consisting of ten virtual environments that can be used to design a virtual peer mentor support platform.
2) An experiential prototype to demonstrate the intended interactions between YAMHI and peer mentors of some of those environments (6 of the 10)
As an addition on the side:
3) Because the platform does not exist yet, a manual to support the design team to further integrate these environments in their platform has been created.
Cross-domain recommender systems aim to bridge the gap between domains where such interactions are plentiful and domains with relatively little interactions for the new users, using transfer learning techniques. However, while privacy concerns in single-domain recommender systems have been studied extensively, the same does not apply to cross-domain systems where multiple domains collaborate. Privacy is essential in settings such as healthcare, where rating information is sensitive and prone to leaking patient medical history to third parties. Existing works lack an efficient design that provides sufficient privacy while generating recommendations.
This thesis presents a privacy-preserving cross-domain recommender system with partial user overlap. We first propose a privacy-preserving matrix factorization approach with differential privacy and multiparty setting to serve as the base of our cross-domain design. Our matrix factorization design with privacy is easy to adopt by existing systems, incurring negligible overhead, and requires no modification to existing factorization implementations. Next, we show the privacy-accuracy trade-off in our base method with experiments over the MovieLens dataset. Finally, in the cross-domain setup, we demonstrate that adding privacy to the proposed scheme has a minimal predictive performance loss, essentially providing privacy for free.","Matrix Decomposition; Differential Privacy; Recommender Systems; Cross Domain; Healthcare; Privacy Preserving Machine Learning","en","master thesis","","","","","","","","","","","","Computer Science | Cyber Security","",""
"uuid:606beb9b-a618-45cf-8fc8-44066333b41e","http://resolver.tudelft.nl/uuid:606beb9b-a618-45cf-8fc8-44066333b41e","Dementia in the Built Environment","Klein Kranenbarg, Kyra (TU Delft Architecture and the Built Environment)","Jürgenhake, Birgit (mentor); van Andel, F.M. (graduation committee); van Deudekom, A.B.J. (graduation committee); Delft University of Technology (degree granting institution)","2022","","Dementia; Dementia care; dementia friendly; Health; Healthcare; Well-being; Architecture; Dwelling; neighbourhood; aging society","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Dwelling","",""
"uuid:aa0b6083-97d1-4b39-b101-5039449672b1","http://resolver.tudelft.nl/uuid:aa0b6083-97d1-4b39-b101-5039449672b1","A Restorative Last Mile Towards The Erasmus Medical Center, Rotterdam: Improving the quality of last mile reachability and arrival, by assessing societies' opinions on urban stress and restoratives, and digitally researching scenarios by the use of personas","Moesker, Rosalie (TU Delft Architecture and the Built Environment)","Harteveld, M.G.A.D. (mentor); van der Spek, S.C. (mentor); Hoogenboom, J.J.J.G. (mentor); Delft University of Technology (degree granting institution)","2022","The Erasmus Medical Center (EMC) campus is working on an intensification of functions for the new Masterplan of 2050. Since densification is only possible vertically due to the enclosed location, there is an increase of 5000 employees and only 650 physical parking spaces, leading to lessened accessibility by car. Simultaneously, vehicles are restricted from the city itself to make Rotterdam more livable by taking away car lanes and decreasing speed. While moving through the city, recent patient journey research shows, that patients are worried until they reach the main entrance and do not feel relieved by the current way of traveling towards the Erasmus MC. These findings lead to researching which mobility scenarios are possible and suitable for inclusive accessibility to the future EMC Campus and how spatial interventions can relieve stress during the last mile in Rotterdam and arrival at the masterplan site.
This is done by assessing perceptions on urban stress and restoratives and digitally researching scenarios by the use of personas. Personas are created to react to mobility aspects, resulting in a multi criteria analysis. The motivations summarized are basic needs, personality lifestyle preference, disability, and stress and restorative level. A procedural model in Houdini of the mobility network of Rotterdam, including future scenarios, is used to assess the behavior of the created personas traveling towards the EMC Campus by calculating the weighted sum per route. The output of the simulations shows the taken route, the chosen mode, and the stress and restorative level at arrival from specific personas. The most suitable and preferred routes based on the 4 motivations show significant differences in stress and restorative levels. Spatial aspects in the city influence mental health and design requirements can be advised to minimize urban stress. Previously collected city restoratives and urban stressors are being evaluated by 65 participants in an online survey. Doing stressor and restorative spatial implementations in the simulation shows how personas prefer different routes to potentially improve their wellbeing. Design requirements of the Masterplan can be based on how certain personas perceive the environment differently from others. For people approaching the building by car, it could be more beneficial for the stress and restorative level to have a more monochrome facade and for people approaching the building by slow traffic to have a fine grain facade. The digital model gives a perspective on where the individual personas approach the campus, which influences the master plan differently from all angles. What do persona based design requirements on urban stressors and restoratives derived from digital simulations mean to the design of our future cities?","Travel behaviour; Multi Criteria Analysis; Procedural Modeling; Urban Stressors; Restoratives; Personas; Mobility; Healthcare","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Urbanism","","51.9100181, 4.4659629"
"uuid:a7e051e5-0e2e-4a98-bc09-6999195f510f","http://resolver.tudelft.nl/uuid:a7e051e5-0e2e-4a98-bc09-6999195f510f","Facilitating healthcare using smartwatches","Cavalini, Ricardo (TU Delft Electrical Engineering, Mathematics and Computer Science); Hassan, Ibrahim (TU Delft Electrical Engineering, Mathematics and Computer Science); Pouwels, Thomas (TU Delft Electrical Engineering, Mathematics and Computer Science)","Abdi, Bahareh (mentor); van der Veen, A.J. (mentor); van Puffelen, R.M.A. (graduation committee); Sarro, Pasqualina M (graduation committee); Delft University of Technology (degree granting institution)","2022","This report entails one of two subsystems in a joint project to provide a web-based platform for smartwatch data acquisition, for applications in healthcare. In this work, we design and implement algorithms for human activity recognition using various machine learning approaches and test them on data acquired online as well as using our own developed platform. Together with the web-based platform, this provides a solid base for more research using data gathered from smartwatches. The human activity recognition is implemented first using a classical machine learning approach
with feature extraction and a random forest classifier. Next, both convolutional neural network and a recurrent neural network are implemented using Tensorflow [1]. We further perform several tests to investigate: (i) the optimal segment size with respect to classification accuracy, (ii) the effect of filtering and preprocessing on the classification results, and (iii) the best classifier for activity detection.","Healthcare; smartwatch; Artifical Intelligence","en","bachelor thesis","","","","","","","","","","","","Electrical Engineering | Circuits and Systems","",""
"uuid:84dc9c43-f334-44b2-845d-ea0f4214bc93","http://resolver.tudelft.nl/uuid:84dc9c43-f334-44b2-845d-ea0f4214bc93","Facilitating healthcare using smartwatches: Smartwatch data acquisition platform","Sluijs, Marijn (TU Delft Electrical Engineering, Mathematics and Computer Science); Poll, Robbin (TU Delft Electrical Engineering, Mathematics and Computer Science); Liao, Shijie (TU Delft Electrical Engineering, Mathematics and Computer Science)","Abdi, Bahareh (mentor); van der Veen, A.J. (mentor); van Puffelen, R.M.A. (graduation committee); Bol, E.W. (graduation committee); Delft University of Technology (degree granting institution)","2022","This report details the design and implementation of a subsystem providing a web-based platform for smartwatch data acquisition. A smartwatch application is developed to read out the accelerometer, gyroscope and heart rate sensor on the smartwatch and transmit the sensor data to the platform. A platform is developed to receive the data and store it in a database. Recordings can be downloaded from the platform to use in research of human activity. The platform presents the type of activity the smartwatch user is doing using machine learning models, by integrating the other subsystem. Multiple tests have been performed to analyse and improve the performance of the system. The battery life of the smartwatch has been tested using various settings in the smartwatch application to determine the most power-efficient settings.","Smartwatch; Healthcare; Sensors","en","bachelor thesis","","","","","","","","","","","","Electrical Engineering","",""
"uuid:a2a7292e-18ff-4161-b516-699b604b4b3e","http://resolver.tudelft.nl/uuid:a2a7292e-18ff-4161-b516-699b604b4b3e","Bringing digital scribes into orthopedic consultations: Towards AI-assisted clinical documentation","Magyari, Reka (TU Delft Industrial Design Engineering)","Secomandi, Fernando (mentor); Morales Ornelas, H.C. (graduation committee); de Rave, D. (graduation committee); Delft University of Technology (degree granting institution)","2022","Clinical documentation takes up 40% of clinicians’ time. To ease the administrative burden of clinicians, digital scribes offer the potential to automate clinical note taking. Digital scribes are intelligent documentation softwares that combine automated speech recognition (ASR) and natural language processing (NLP). Digital scribes transcribe clinician-patient consultations and convert the conversation into structured clinical notes. Attendi, the client is developing a digital scribe for orthopedics: the Assistant. Hip arthrosis consultations have a well-structured anamnesis, therefore a promising use case for the digital scribe.
This Master thesis investigates the clinician perspective of implementing the Assistant. Literature was reviewed to understand the problem space and the design implications of the enabling technologies. Core concepts in human-AI collaboration such as system transparency and human control were identified to design for hybrid documentation. Also, the perspectives of recording consultations were translated into values for hospitals, clinicians and patients. The findings lead to both mutual benefits and tensions for the clinician-patient relationship and obstacles for implementation.
To contribute to developing the Assistant, user research was carried out in context by shadowing orthopedic surgeons to see their day-to-day workflow and understand the current cycle of clinical documentation. Several surgeons were interviewed to gain more in-depth views about the digital scribe. As synthesis, personas and journey maps were created both for a typical consultation cycle and a daily workflow. From the research phase, a list of user requirements were gathered in order to aid the design phase and future development. Finally, the envisioned user journey is presented in a service blueprint with the developed interface of the Assistant.
into account local cost, usability and maintenance challenges, and ‘modular’
device designs can be one way of overcoming these challenges. However,
despite research into the design advantages of these devices, the adoption
challenges have not yet been investigated.
This research aims to make the adoption of modular laparoscopic instruments possible in LMICs, starting in India with four types of local hospitals. It aims to find the various actors and factors, including stakeholders that play a role in making this technology successfully adopted in India. The study involves desktop research to analyse LMIC markets with respect to surgical instruments, followed by qualitative research to identify barriers and facilitators to the adoption of these instruments in the Indian context. For this, we will conduct interviews and observations with experts and practitioners developing and using laparoscopic instruments in Indian hospitals. All findings will result in a case study that combines all findings and concludes with a framework that covers all aspects related to the successful adoption of modular steerable laparoscopic instruments with
interchangeable end-effectors","Adoption of Innovation; Low-resource healthcare context; Surgical instruments; LMICs; India; Healthcare; Strategies; Barriers and drivers; Frugal innovation; Stakeholders","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:43847119-1007-45f2-8323-baec216c54a3","http://resolver.tudelft.nl/uuid:43847119-1007-45f2-8323-baec216c54a3","Design for Philips Grooming Product Return Experience","Fan, Xingyu (TU Delft Industrial Design Engineering)","Bakker, C.A. (mentor); Mugge, R. (mentor); Delft University of Technology (degree granting institution)","2022","With the rapid rise in consumption and production, natural resources are becoming increasingly scarce. As the prevalence of the linear economy leads to neglect in the product end-of-use (EOU) phase, moving towards a circular economy (CE) can maximize the product value by recovering and reusing.
As one of the circular strategies applied by some industries, the take-back program could enable a company to take back used products from consumers and reintroduce them to the production cycle, thereby facilitating the CE. However, if consumers rarely bring back EOU products, manufacturers can hardly close the loop (Ellen MacArthur Foundation, 2013).
This thesis project collaborates with Philips, aiming to motivate Philips Grooming consumers to return used products to Philips so that devices can be recycled or refurbish. However, consumers rarely return the device. Therefore, this project intends to explore how an effective take-back program can be developed to change Grooming consumers’ behaviour towards returning.
Fogg behaviour model is the key methodology supporting the project research. It was used for exploring the relationship between users’ behaviour and the influencing factors, thereby providing valuable insights for the design direction. Taking Fogg behaviour model as a starting point, service safari, benchmarking, and in-depth user interviews were conducted to understand the service context and target group behaviour. The data obtained from these activities were further analysed, synthesised, and formulated to executive design directions.
This project ends up with a final service concept, “Philips Grooming Take-back”, which applies various design interventions and service strategies to create a painless and seamless divestment experience for users by meeting different values that each individual needs. The concept could also create long-term value for Philips, other stakeholders, and the environment. In addition to the service concept, this project has addressed systematic design opportunities and requirements for behaviour change in the Grooming divestment context, which could be potentially leveraged for other relevant initiatives of Philips Personal Health.
Research was done to understand better the current waste created by the ICU. A set of challenges derived from the research were used to ideate on different systems which could improve the ICU sustainability. It was decided to further detail a system that allows reuse of intubation devices, articulating the first pilot around a specific product, the video laryngoscope. This video laryngoscope is used to intubate patients. It is composed of various plastics and electronics and has a relatively high procurement cost. Nevertheless, it is a single-use device, disposed of and incinerated after a few minutes of use.
Ideation on a system enabling a safe and hassle-free reuse of the video laryngoscope at the ICU with a lower environmental impact was done. Two pilot systems were proposed:
The first proposal, reduce, enables Erasmus MC to reuse the current video laryngoscope in use at the ICU. Adding a removable plastic cover to the device enables reuse of the device. By not binging the device in direct contact with the patient, fewer reprocessing steps will be required since fewer microorganisms will get in contact with the video laryngoscope. The second proposal, reuse, offers the complete reuse of a modular video laryngoscope. The main body would be, likewise the first proposal, reprocessed after not having been in contact with the patient. A hardcover would surround the product and would be redesigned to allow reuse and traceability of the number of reprocessing cycles it has gone through. Reprocessing in both proposals could be done at the ICU. Not relying on the sterilization department allows the ICU to be resilient and to increase devices availability.The use of a novel reprocessing technique, UVC radiations, is proposed. Compared to current reprocessing techniques, it consumes less water, electricity, and space. In addition, UVC reprocessing allows a high level of automation of the process, increasing its safety and reducing the hassle for ICU workers.
Outcomes
A better understanding of the healthcare complexity and impact has been achieved. An action plan towards a pilot system is proposed, with which CO2 emissions, amount of waste and costs for the hospital would be reduced compared to the current single-use system. Future scale-up of the reuse system to other devices is envisioned, as well as replicating it into other Erasmus MC departments. Next to this pilot focusing on reuse, a set of complementary opportunities areas to introduce circularity to the ICU are summarized in a booklet.","Sustainability; Circular Design; Healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:cbcb37bb-a484-4169-9ec7-9226665fe2d7","http://resolver.tudelft.nl/uuid:cbcb37bb-a484-4169-9ec7-9226665fe2d7","The Future Patient Journey: A tool to improve the experience of patients who undergo a transcatheter aortic valve implantation (TAVI) by reducing their pre-operative anxiety","Bedaux, Juanita (TU Delft Industrial Design Engineering)","Goossens, R.H.M. (mentor); Dehli, S.R. (graduation committee); de Ronde, Marjo (graduation committee); van Mieghem, Nicolas (graduation committee); Delft University of Technology (degree granting institution)","2022","br/>The healthcare sector has reached a turning point in which the patient stands central during the continuum of care. Erasmus MC is a leading hospital in health care innovation and thrives on pioneering this shift towards value-based care. Value-based care is a philosophy of delivering optimal care for the patient while reducing costs.
To reach this, Erasmus MC has implemented a five-year strategy focused on dedication and technology. Dedication emphasizes the importance of providing a patient with the right treatments and supporting them in the process. Technology is seen as an enabler in both the procedures as well as improving patient experience. The question now is how to create the perfect balance between dedication and technology to optimize the patient experience while streamlining the journey for Erasmus MC staff. This project focuses on the specific case of the Transcatheter aortic valve implantation (TAVI) procedure. This procedure involves the implantation of valve prostheses in the native aortic valve of the patient’s heart by percutaneous puncture via their transfemoral artery. It is a minimally invasive procedure under local anesthesia, meaning they are vividly awake during the procedure. TAVI patients are, on average, 80 years old.
This project evolved from a problem identified by an interventional cardiologist at the Erasmus MC. He noticed that technological advancements were improving the procedure; however, the patient experience was not progressing.
The majority of the patients were anxious and uninformed prior to the procedure. This is a problem because pre-operative anxiety affects the interaction between cardiologist and patient, it hinders the person from processing information (Cammen, 2021), affects the post-operative recovery process (Yuzkat et al., 2020), and decreases overall patient satisfaction (Herrera et al.,2009). Therefore, the challenge was: Design a tool to improve the patient experience by reducing pre-operative anxiety of patients who undergo a TAVI.
To tackle this, extensive user research was conducted on the journey of TAVI patients. This led to a reliable patient experience curve identifying the pain and success points as well as the reasons for these peaks. Concurrently, the enablers of positive patient experience are defined through a literature review. This led to the concept proposal, an improved TAVI patient journey. The new patient journey consists of (1) several new touchpoints throughout the continuum of care that ensures the patient feels recognized and improves the continuity, (2) a physical care package (Zorgpakket) delivered to the patient's doorstep, supporting the patient by providing them with the right tools to prepare themselves for the procedure, and (3) a 3D animation of the TAVI procedure, creating an accessible manner for elderly patients to use technology which has an added value for the patient journey.
An extensive validation study has proven that the new patient journey, specifically the Zorgpakket, helps the patient feel at ease by providing the tools to form the right expectations and increase trust through empathy and professionalism. The aimed long-term effect is to eliminate the pain points in the experience curve.
The proposal is a desirable solution that fits the patient's needs while streamlining the workflow of the healthcare professionals. The different aspects of the project are applicable in other areas within the healthcare sector and will serve as inspiration within Erasmus MC to reach the goal of value-based care.
The healthcare sector is one of the most polluting sectors in the Netherlands. To limit the environmental impact of the medical sector, Erasmus MC collaborated with Metabolic to conduct a Material Flow Analysis (MFA) and Impact Assessment for the Intensive Care Unit (ICU). The research revealed the hotspots of the ICU, contributing to this polluting sector. Based on the hotspots The Convergence, a cooperation between the Erasmus University, Erasmus MC, and TU Delft have set up the first three design projects.
Project aim
This graduation project aimed to make a start towards greener ICUs. In the ICU care is delivered to critically ill patients. The number of gloves used is high because of the intensity of care and high standards. Due to its resource-intensive production and frequency of use, the use of nitrile disposable gloves was found as a hotspot. The question to be answered was; How could the environmental impact of gloves in the ICU be reduced, while remaining quality of care? Research
Extensive research is done with different focuses; product-centred, human-centred and material centred. Furthermore, the waste from the PICU was analysed for one week. The research revealed the importance of the procurement department and the Unit Infection Prevention.
Design direction
Together with the nursing staff, it was decided to go for the design direction of reducing the number of unused gloves. The scope was set to the current situation in the ICU and the idea should be implementable in the short term. The research resulted in five building blocks for the design that need to be incorporated; (1) infection prevention, (2) zero-risk, (3) ease of use, (4) efficiency and (5) technology.
Ideation
Ideation was done by involving people in creative sessions. Restrictions were excluded in the creative sessions, to come up with a wide range of ideas. Three ideas were chosen based on their short-term implementation possibility and incorporation of the building blocks. The ideas were presented to the Green Team of the ICU and it was decided to go on with an addition of the current box and applying a different way of dispensing gloves.
Prototyping and testing
Prototypes were made to quickly verify the functioning of the ideas. While testing the prototypes, iterations were applied. A user evaluation was performed and resulted in a preference for the vertical dispensing design.
Final design
The final design is GloVe, a vertical dispense system. By incorporating the five building blocks, the design can provide benefits for multiple stakeholders. It reduces the environmental impact of gloves in the ICU by dispensing one glove at a time. Furthermore, the gloves are dispensed at the cuff, which comes in little contact with the patient. The vertical movement is pleasant to the user. The use of colour for different sizes makes it clear to the care assistant which box should go in which holder. Also, nurses will see at a glance, which size gloves they are dispensing. The small V-shaped opening makes the undesirable behaviour, of placing gloves back, almost impossible.
Transformation towards greener ICUs The design thinking approach has yielded a design, insights, and recommendations for subsequent projects. Furthermore, the project has drawn a lot of attention to making healthcare more sustainable. The project has been a necessary start towards more sustainable ICUs.","Personal Protection equipment; Gloves; Sustainability; Healthcare; Medisign","en","master thesis","","","","","","","","","","","","Integrated Product Design | Medisign","",""
"uuid:6256cb61-eab8-4c4c-bd3a-07ff8e709219","http://resolver.tudelft.nl/uuid:6256cb61-eab8-4c4c-bd3a-07ff8e709219","An investigation into the carbon and material footprint of the Dutch consumption of pharmaceuticals","Hagenaars, Rosalie (TU Delft Technology, Policy and Management)","De Koning, Arjan (mentor); Kweekel, Dinemarie (mentor); Steenmeijer, Michelle (mentor); Delft University of Technology (degree granting institution); Universiteit Leiden (degree granting institution)","2022","This thesis explores the relatively large contribution of the product category ‘chemicals n.e.c.’ (chemicals not elsewhere classified) to the Dutch healthcare sector’s carbon and material footprint observed in previous studies. For this, an input-output study using SNAC-EXIOBASE data was performed. SNAC-EXIOBASE uses national statistics for the Dutch part of the multi-regional input-output table. It also distinguishes a separate chemical and pharmaceutical industry in the Dutch part. This can help identify possible aggregation problems in the EXIOBASE category ‘chemicals n.e.c.’ which is an aggregate of the chemical and pharmaceutical industry sectors. Comparing the carbon and material footprint of pharmaceuticals used in the Dutch health care sector as calculated with (default) EXIOBASE and SNAC-EXIOBASE shows that there is an aggregation problem in the ‘chemicals n.e.c.’ category. This means that grouping the pharmaceutical industry with the chemical industry greatly influences the carbon and material footprint of pharmaceuticals. The carbon footprint decreases by 11% and the material footprint by 61% when using SNAC-EXIOBASE compared to EXIOBASE data. The multiplier analysis showed that in all cases the Dutch pharmaceutical industry has a lower carbon, mineral and metal intensity (footprint per euro) compared to the Dutch chemical industry or ‘chemicals n.e.c.’ confirming the aggregation problem. The LCA literature review showed that the range of carbon intensities of individual pharmaceuticals matches the carbon intensity of the ‘pharmaceutical industry’ in SNAC-EXIOBASE. This study also showed that the material footprint of the Dutch healthcare sector is uncertain and should be used with care. Future research should focus on using MRIOs that better depict the pharmaceutical industry like the ICIO which is based on the ISIC Rev. 4 classification and, therefore, includes a separate pharmaceutical industry. Before performing analyses with the ICIO is possible, higher sectoral resolution and environmental extensions are needed.","Carbon footprint; Material footprint; pharmaceutical industry; Healthcare; input-output analysis","en","master thesis","","","","","","This thesis was written in combination with an internship at RIVM.","","","","","","Industrial Ecology","",""
"uuid:cd28c4d6-7d93-42fd-817f-d2e113d2255a","http://resolver.tudelft.nl/uuid:cd28c4d6-7d93-42fd-817f-d2e113d2255a","Optimizing Healthcare Accessibility through Flood Resiliency Improvements of Roads in a Network: A case study for Timor-Leste","van Veggel, Britt (TU Delft Electrical Engineering, Mathematics and Computer Science)","Den Hertog, Dick (mentor); Aardal, K.I. (graduation committee); Delft University of Technology (degree granting institution)","2022","Access to healthcare is a requirement for human well-being that is partly dependent upon safe infrastructure. One of the UN Sustainable Development Goals regarding healthcare is to achieve universal healthcare coverage, which includes access to qual- ity essential health-care services. In many developing nations, roads are often vulner- able to floods. Floods can cause roads (especially roads with a dirt or gravel surface type) to become inaccessible for a long period of time. This inaccessibility can cause many inhabitants to lose access to a healthcare facility within a crucial traveling time span. Upgrading flood prone roads on which many households are dependent in or- der to access a healthcare facility, could reduce this threat to healthcare accessibility for many inhabitants. This research aims to use optimization techniques to reduce the impact floods can have on healthcare accessibility, and apply a case study to the country Timor-Leste. We formulate an optimization model that maximises the num- ber of households that can access a healthcare facility within a 5 kilometer traveling distance via a flood resilient route, given a specific budget. Alongside this formula- tion, we provide a (simple) flood and costs model for the road as well as di↵erent heuristics to find (near-)optimal solutions. Our research includes multiple tests to de- termine which heuristic works best and which parameters and other settings increase the computational performance of these heuristics for Timor-Leste. The heuristic that performs the best is a dynamic greedy heuristic. This algorithm is able to generate an optimal solution for all possible budgets within 4 hours.","Optimization; Healthcare; floods; healthcare accessibility; road; network; road network; timor-leste; east-timor","en","master thesis","","","","","","","","","","","","Applied Mathematics","Analytics for a Better World","-8.874200, 125.727500"
"uuid:6aac0cd7-7bbf-4077-af56-9dfe3f55eadf","http://resolver.tudelft.nl/uuid:6aac0cd7-7bbf-4077-af56-9dfe3f55eadf","A self-portrait: Design opportunities for a tool that supports children's involvement in brain-related health care","Meulendijks, Paul (Student TU Delft); van Haren, Neeltje E.M. (Erasmus MC); Gielen, M.A. (TU Delft Design Conceptualization and Communication); van Veelen-Vincent, Marie Lise C. (Erasmus MC)","","2022","Introduction: Paediatric patients with disorders that involve brain functioning are particularly vulnerable with respect to including them in shared decision-making. Current tools are mostly paper or digital patient information. We lay the groundwork for improving engagement with a concept that we coined ‘the Self-Portrait’. The main goals were to identify (1) obstacles and (2) design parameters that enable patient participation. Methods: A research-through-design approach was utilized in nine patients with brain-related disorders (4–12 years), 15 parents and 15 medical professionals, involving contextual research (interviews and observations) within the paediatric hospital and patients' homes and codesign. Sensitizing materials and early instances of design solutions were deployed as catalysts for communication. Five rounds of enriched interviews and design reviews were thematically analysed to answer the research questions. Results: Obstacles to child involvement were related to children's level of understanding, the time and energy necessary for information processing and lack of perceived relevance of the information. Patients' engagement is supported by design features that extend the time frame of interaction beyond the consultation, transfer information interactively and give control and influence during the consultation. Conclusion: Obstacles were detected that complicate child engagement, which differ between stakeholders. Promising design features were identified that have the potential to play an important role in enabling active child involvement. These findings show that applying principles of human-centred design research and codesign can bring together patients, parents and medical professionals around a tool that provides a shared language and focus, which are prerequisites to increase child engagement. Patient or Public Contribution: Patients, parents and clinicians contributed as design informants during contextual research and design reviews. Clinicians provided feedback on the initial outcomes of thematic analysis. Two researchers assisted in consensus sessions during the thematic analysis.","brain disorders; codesign; paediatric patients; patient participation; research through design; value‐based healthcare; OA-Fund TU Delft","en","journal article","","","","","","","","","","","Design Conceptualization and Communication","","",""
"uuid:248b2da3-cea9-4fb1-8266-4e987c6a5140","http://resolver.tudelft.nl/uuid:248b2da3-cea9-4fb1-8266-4e987c6a5140","Doplor Sleep: Monitoring Hospital Soundscapes for Better Sleep Hygiene","Ozcan Vieira, E. (TU Delft Design Aesthetics); Liu, Y. (Student TU Delft); Vroon, Jered (TU Delft Internet of Things); Kamphuis, Daan (Reinier de Graaf Gasthuis); Spagnol, S. (TU Delft Design Aesthetics)","","2022","Good sleep is conducive to the recovery process of hospital patients - and yet, in many wards, sleep duration and quality can often be suboptimal, in part due to modifiable hospital-related sounds and noises. At the neurological ward of the Reinier de Graaf hospital in Delft, the Netherlands, we developed and evaluated a prototype information exchange system to raise awareness of specific sounds as disturbing patients' sleep. The system both classifies different relevant sound events and tracks sleep quality (using a Fitbit device). This information is then visualized for patients and staff to present the influence of the soundscape on patients' sleep hygiene in a friendly and comprehensive way. We discuss the design process, including a context study and various evaluations of the technology, interface, and created affordances. Our initial findings indicate that visualizing hospital soundscapes may, indeed, support both patients and staff in their efforts towards better sleep hygiene.","data visualization; design for healthcare; Sound-driven design","en","conference paper","Association for Computing Machinery (ACM)","","","","","","","","","","Design Aesthetics","","",""
"uuid:4080618e-9985-445b-9e4e-82bc84d138f6","http://resolver.tudelft.nl/uuid:4080618e-9985-445b-9e4e-82bc84d138f6","Navigating multiple contexts to integrate system transformation programs","Bos-de Vos, M. (TU Delft Methodologie en Organisatie van Design); Deken, Fleur (Vrije Universiteit Amsterdam); Kleinsmann, M.S. (TU Delft Methodologie en Organisatie van Design)","","2022","This paper unpacks how actors navigate the multiple organizational, interorganizational and industry contexts that are associated with system transformation programs for addressing wicked, societal problems. Because system transformation programs can only succeed when changes are implemented by multiple organizations, an increased understanding of integrating programs in multiple contexts is needed. We draw on a qualitative field study of an interorganizational program designed to help transform the Dutch healthcare system. We identified three practices of context navigation that actors used to integrate the program into multiple parent organizations and address emerging incongruencies among contexts. These are aligning contexts, prioritizing contexts, and adding contexts. Over time, these navigating practices promoted progress towards program objectives via multiple parallel collaborative paths. Our findings shed new light on the role of breakdowns and decoupled collaborative paths in programs oriented at contributing to system transformation.","Healthcare transformation; Interorganizational collaboration; Program embeddedness; Program–parent integration; Transformation programs","en","journal article","","","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:6a1f4d8d-5b03-40d4-843d-0e6c42551d8c","http://resolver.tudelft.nl/uuid:6a1f4d8d-5b03-40d4-843d-0e6c42551d8c","Design Framework for Audible Alarms: A Multidisciplinary and Integrated Approach","Sanz Segura, R. (University of Zaragoza); Manchado-Pérez, Eduardo (University of Zaragoza); Özcan, Elif (Erasmus MC; University of Zaragoza)","","2022","Designing alarms to address the increasing complexity of dynamic and interconnected systems in current socio-technological environments presents multi-faceted design problems that require systematic thinking and a collaborative and holistic approach. To understand the alarm design challenges better, we map out the design space for audible alarms in an applied domain, covering the alarm issues from the designers’ perspective, departing from the functional integrity of alarms, and bringing together the contribution of three major fields of expertise related to audible alarms (systems engineering, information design, and human factors). Three studies based on literature review, field observations, expert interviews, and focus groups are conducted by authors at different European Intensive Care Units. Our findings from these studies result in the definition of the components of audible alarm design, the key considerations for designing audible alarms, and a design framework for audible alarms that systematically integrates input from inter-connected disciplines that all aim for the success of a complex system that heavily relies on alarms.","Alarm Design; Design for Complexity; Design Tools; Healthcare; Multidisciplinary Design; Socio-technological Context","en","journal article","","","","","","","","","","","","","",""
"uuid:ae92649f-b102-4414-a537-a1e7bcf2256c","http://resolver.tudelft.nl/uuid:ae92649f-b102-4414-a537-a1e7bcf2256c","Impact of sink design on bacterial transmission from hospital sink drains to the surrounding sink environment tested using a fluorescent marker","Pirzadian, J. (Erasmus MC); Souhoka, T. (TU Delft Applied Ergonomics and Design; Productzaken, Den Haag); Herweijer, M. (Wiegerinck, Arnhem); van Heel, M.E. (Erasmus MC); van Wamel, W. J.B. (Erasmus MC); Goossens, R.H.M. (TU Delft Human-Centered Design; TU Delft Applied Ergonomics and Design); Severin, J. A. (Erasmus MC); Vos, M. C. (Erasmus MC)","","2022","In hospitals, sinks act as reservoirs for bacterial pathogens. To assess the extent of splashing, fluorescein dye was added to four hospital sinks previously involved in pathogen dispersal to the environment and/or transmission to patients, and one sink that was not. Applying dye to the p-trap or tailpiece did not result in any fluorescent droplets outside of the drain. When applied to the drain, droplets were found in all but one wash basin, and this was more common in the absence of a drain plug. Sink design considerations to install drain plugs, reduce dripping and offset the tap may help to prevent transmission from drains.","Biofilm; Health facility environment; Healthcare-associated infections; Infection control; Pathogen transmission; Pseudomonas aeruginosa","en","journal article","","","","","","","","","","Human-Centered Design","Applied Ergonomics and Design","","",""
"uuid:32257460-42c8-4f3b-8874-9de931e7351b","http://resolver.tudelft.nl/uuid:32257460-42c8-4f3b-8874-9de931e7351b","Resource Allocation Equity in the China’s Rural Three-Tier Healthcare System","Ao, Yibin (Chengdu University of Technology); Feng, Qiqi (Chengdu University of Technology); Zhou, Zhongli (Chengdu University of Technology); Chen, Yunfeng (Purdue University); Wang, T. (TU Delft Design & Construction Management)","","2022","The rural three-tier healthcare system is an essential part of the Chinese healthcare service system. To ensure rural residents’ equal access to such healthcare services, it is necessary to examine the current status of the healthcare system in rural China and formulate corresponding improvement suggestions. This study therefore collects the data from the China Health Statistics Yearbook, the China Health Yearbook and the China Statistical Yearbook between the years 2004 and 2021 to calculate the Gini coefficient (G), health resource density index (HRDI) and Theil index (T) first, and then perform the Mann–Kendall test afterwards to evaluate the equity of healthcare resource allocation comprehensively. This series of analysis helps in drawing the following conclusions: (1) county and county-level city medical and health institutions (CMHIs) show a higher development trend in comparison with township hospitals (THs) and village clinics (VCs); (2) VCs have higher institutional fairness, while for beds and personnel, CMHIs and THs are more fairly positioned; (3) more specifically for CMHIs and THs, personnel allocation is more fair than beds and institution allocations; (4) the density of healthcare resources in the eastern and central regions is higher than that in the western part, while the intra-regional distribution of beds and personnel in the west and central regions is better than that in the eastern region; (5) intra-regional differences are more significant than inter-regional differences and the fairness according to population distribution is higher than that of geographical area allocation. The results of this study provide theoretical basis for further optimizing the allocation of healthcare resources and improving the fairness of healthcare resources allocation from a macro perspective.","equity; resource allocation; rural China; three-tier healthcare system","en","journal article","","","","","","","","","","","Design & Construction Management","","",""
"uuid:afcae6a2-44ec-4d8f-b80f-d8fb8a35e871","http://resolver.tudelft.nl/uuid:afcae6a2-44ec-4d8f-b80f-d8fb8a35e871","Assessing Trustworthy AI in Times of COVID-19: Deep Learning for Predicting a Multiregional Score Conveying the Degree of Lung Compromise in COVID-19 Patients","Allahabadi, H. (EY Netherlands); Amann, J. (ETH Zürich); Balot, I. (Center for Diplomatic & Strategic Studies); Beretta, A. (CNR); Binkley, C. (Hackensack Meridian Health); Bozenhard, J. (University of Oxford); Bruneault, F. (Cégep André-Laurendeau; Université du Québec); Brusseau, J. (Pace University); Umbrello, S. (TU Delft Ethics & Philosophy of Technology)","","2022","This article’s main contributions are twofold: 1) to demonstrate how to apply the general European Union’s High-Level Expert Group’s (EU HLEG) guidelines for trustworthy AI in practice for the domain of healthcare and 2) to investigate the research question of what does “trustworthy AI” mean at the time of the COVID-19 pandemic. To this end, we present the results of a post-hoc self-assessment to evaluate the trustworthiness of an AI system for predicting a multiregional score conveying the degree of lung compromise in COVID-19 patients, developed and verified by an interdisciplinary team with members from academia, public hospitals, and industry in time of pandemic. The AI system aims to help radiologists to estimate and communicate the severity of damage in a patient’s lung from Chest X-rays. It has been experimentally deployed in the radiology department of the ASST Spedali Civili clinic in Brescia, Italy, since December 2020 during pandemic time. The methodology we have applied for our post-hoc assessment, called Z-Inspection®, uses sociotechnical scenarios to identify ethical, technical, and domain-specific issues in the use of the AI system in the context of the pandemic.","Artificial intelligence; COVID-19; Pandemics; Medical services; Ethics; Radiology; Lung; Deep learning; case study; ethical tradeoff; ethics; explainable AI; healthcare; pandemic; radiology; trust; trustworthy AI; Z-Inspection®","en","journal article","","","","","","","","","","","Ethics & Philosophy of Technology","","",""
"uuid:a93d43c6-2a13-4a64-b018-156faadcab27","http://resolver.tudelft.nl/uuid:a93d43c6-2a13-4a64-b018-156faadcab27","Home and Healthcare: The prospect of home adaptation through a computational design decision-support system","Romagnoli, Federica (Sapienza University of Rome); Nourian, Pirouz (TU Delft Design Informatics); Ferrante, Tizana (Sapienza University of Rome); Villani, Teresa (Sapienza University of Rome)","","2022","This paper presents ongoing research to define the framework of a computational design approach based on the ideas of spatial analysis and spatial synthesis to implement multi-criteria evaluations and provide evidence of the performance of the design alternatives in the specific case of home adaptation for healthcare at home. The European health systems place among their priority objectives the strengthening of the provision of healthcare at home to guarantee the well-being of elderly people and to limit, at the same time, the unnecessary use of resources. Therefore, existing homes must provide adequate safety, comfort, and accessibility features to ensure a high quality of life for the care receivers and facilitate the carer' tasks. To address the complexity of the requirements to be met, we propose a spatial decision support system (SDSS) to implement multi-criteria assessments to ergonomic design problems at a spatial scale of apartment homes. The system is intended to streamline and assist designers and homeowners in planning interventions for home adaptations for healthcare. Such design problems can be formulated as decision problems with costs and benefits modelled within the constraints of validity and quality criteria. Concerning the specific field of study, the system evaluates the degree of compliance with the accessibility and visibility quality criteria of each design alternative. The reiteration of the evaluation mechanism allows for the classification and supports the selection of satisfactory technical solutions identified with an informed and well-balanced trade-off between the relevant quality criteria.","healthcare at home; home adaptation; human-centred design; evidence-based design; multi-criteria decision-making","en","journal article","","","","","","","","","","","Design Informatics","","",""
"uuid:753e0d96-d4f9-454c-82e3-2e3d0e4acdf2","http://resolver.tudelft.nl/uuid:753e0d96-d4f9-454c-82e3-2e3d0e4acdf2","Accountable AI for Healthcare IoT Systems","Bagave, P. (TU Delft Information and Communication Technology); Westberg, M. (TU Delft Information and Communication Technology); Dobbe, R.I.J. (TU Delft Information and Communication Technology); Janssen, M.F.W.H.A. (TU Delft Engineering, Systems and Services); Ding, Aaron Yi (TU Delft Information and Communication Technology)","","2022","Various AI systems have taken a unique space in our daily lives, helping us in decision-making in critical as well as non-critical scenarios. Although these systems are widely adopted across different sectors, they have not been used to their full potential in critical domains such as the healthcare sector enabled by the Internet of Things (IoT). One of the important hindering factors for adoption is the implication for accountability of decisions and outcomes affected by an AI system, where the term accountability is understood as a means to ensure the performance of a system. However, this term is often interpreted differently in various sectors. Since the EU GDPR regulations and the US congress have emphasised the importance of enabling accountability in AI systems, there is a strong demand to understand and conceptualise this term. It is crucial to address various aspects integrated with accountability and understand how it affects the adoption of AI systems. In this paper, we conceptualise these factors affecting accountability and how it contributes to a trustworthy healthcare AI system. By focusing on healthcare IoT systems, our conceptual mapping will help the readers understand what system aspects those factors are contributing to and how they affect the system trustworthiness. Besides illustrating accountability in detail, we also share our vision towards causal interpretability as a means to enhance accountability for healthcare AI systems. The insights of this paper shall contribute to the knowledge of academic research on accountability, and benefit AI developers and practitioners in the healthcare sector.","Accountability; Healthcare AI; Internet of Things (IoT); Trustworthiness","en","conference paper","Institute of Electrical and Electronics Engineers (IEEE)","","","","","Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2023-09-15","","Engineering, Systems and Services","Information and Communication Technology","","",""
"uuid:07f58c61-4271-4faf-a83d-93f63cafc213","http://resolver.tudelft.nl/uuid:07f58c61-4271-4faf-a83d-93f63cafc213","A Survey on Blockchain for Healthcare: Challenges, Benefits, and Future Directions","Arbabi, Mohammad Salar (Universitetet i Oslo); Lal, C. (TU Delft Cyber Security); Veeraragavan, Narasimha Raghavan (Universitetet i Oslo); Marijan, Dusica (Simula Research Laboratory); Nygard, Jan F. (Cancer Registry of Norway); Vitenberg, Roman (Universitetet i Oslo)","","2022","Continuously generated volumes of health data make healthcare a data-intensive domain. This data needs to be collected, stored, and shared among different healthcare actors for various purposes, such as reporting, analysis, collaborative research, and personalized healthcare services. However, the existing data storage and exchange solutions in the healthcare domain exhibit several challenges related to e.g., data security, patient privacy, and interoperability. Recently, the industry and research community turned its focus to the possible use of blockchain technology to solve some of these challenges in the healthcare domain. The blockchain technology along with the support from smart contracts is considered a salient facilitator for secure and efficient health data sharing. This is due to its unique features, such as decentralization, trustlessness, immutability, traceability, and transparency. In this paper, we provide a comprehensive survey of the state-of-the-art efforts that envision the use of blockchain-based solutions in the healthcare domain. To this end, we introduce a systematic framework for classifying and analyzing such systems. The framework consists of classification in several dimensions: interactions between healthcare entities, functional components of healthcare storage systems, challenges in the healthcare domain that can be overcome by using the blockchain technology, and benefits for healthcare storage systems derived from the fundamental features of the technology. When analyzing over 40 systems and solutions proposed in the state-of-the-art, we perform their rigorous placement by identifying the exact scope of each solution and mapping it to the above taxonomies of interactions, functional components, challenges, and benefits. We additionally provide an extensive discussion of compliance with privacy-related regulations of General Data Protection Regulation (GDPR) in EU, and Health Insurance Portability and Accountability Act (HIPAA). Following the results of the analysis, we have outlined a number of important research gaps and future directions yet to be addressed.","Blockchain and Smart Contracts; Health Data; Health Data Collection; Health Data Protection Regulations; Health Data Sharing; Health data Storage; Healthcare Interoperability; Security and Privacy","en","journal article","","","","","","Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2023-07-01","","","Cyber Security","","",""
"uuid:404fca92-094b-4e5f-8334-e0e20df9d1a4","http://resolver.tudelft.nl/uuid:404fca92-094b-4e5f-8334-e0e20df9d1a4","The Online Support Platform for Facilitating Effective Communications between Facioscapulohumeral Muscular Dystrophy (FSHD) Patients and the Healthcare Network","FAN, QIYU (TU Delft Industrial Design Engineering)","Kuipers, H. (mentor); Dehli, S.R. (graduation committee); Fahlskog, Nikolas (graduation committee); Delft University of Technology (degree granting institution)","2021","Facioscapulohumeral muscular dystrophy (FSHD) is one typical type of chronic Neuromuscular Dystrophy. This type of disease necessitates network care because it is complex and necessitates a network of diverse healthcare expertise to reduce the negative effects of the disease and rehabilitate the patient to live a more normal life. As a result, effective communication and collaboration among various healthcare members become an important part of the overall patient experience.
Based on the user research, it can be found that patients often encounter problems during their treatment, but they often cannot get proper help quickly due to the slow reply time of the healthcare professionals. Also, because of the difference in the know-how of the disease, the communication towards the patient is not summarized as one diagnosis and support session and in the end, they cannot get a complete answer from the healthcare team. Therefore, I want to design an online support platform to help FSHD patients get the right help in time during the treatment of their disease.
The final design is an online support platform that aims to help patients solve their problems during the treatment and facilitate effective communications between patients and the healthcare network. The core of this service platform is to introduce a personalized coach to bridge the gap between the two sides. The platform has two main functions, treatment, and chat, which can meet most of the needs of a patient during the treatment process. In the treatment session, patients can follow the exercise videos based on their treatment plan made by the healthcare professionals. After they complete one exercise, the platform enables users to make a self-evaluation of their performance. When patients feel negative about the training, they can quickly inform this situation to the coach and the healthcare team by using the share function. Then they will receive comments on their recordings from the healthcare professionals so that they know how to adjust their actions. The chat function allows the patient to quickly ask questions and express their need when they encounter problems with their personalized coach. The coach will help to filter the question and inform the related healthcare professionals to discuss it in a chat group when needed. When the discussion ends, patients can get a summarized answer from the coach.
Based on the usability test, it can be validated that the design can bring benefits to people. The two main features of the online platform (chat and treatment) were useful to the test subjects, and they expressed a willingness to use the platform if it will be developed in the future. However, there is still room for improvement. In the future, we can further think about enlarging the user group, such as involving more patients of other neuromuscular diseases and expanding the service, such as helping the customer to build their healthcare team to add more value to more people.","Healthcare; Communication; Neuromuscular diseases; Online Platform","en","master thesis","","","","","","https://www.figma.com/proto/GjTXSk1ghTiSVojhGt5oeS/patient-4?page-id=0%3A1&node-id=47%3A2910&viewport=241%2C48%2C0.07&scaling=scale-down&starting-point-node-id=33%3A1822&show-proto-sidebar=1 Interactive prototype","","","","","","","",""
"uuid:23917652-ed54-4cda-8e3f-4620b4d10ab1","http://resolver.tudelft.nl/uuid:23917652-ed54-4cda-8e3f-4620b4d10ab1","Face it; a visual fore-glimpse in AR for facial skin cancer patients' surgery?","Heeres, Pleun (TU Delft Industrial Design Engineering)","Visch, V.T. (mentor); Albayrak, A. (graduation committee); Corten, E. M.L. (graduation committee); Delft University of Technology (degree granting institution)","2021","Skin cancer is the most common form of cancer in the Netherlands, often caused by having too much exposure to UV radiation from the sun. An effect of this is that the part of the body that is exposed the most to the sun is also the body part where skin cancer is seen more often; the head. When the skin cancer gets removed surgically, the defect is sometimes so big that reconstructive surgery has to take place. This treatment is impactful for patients, since their face can abruptly change, impacting their social interactions.
This project explores the patient experience that facial skin cancer patients have throughout their treatment and how augmented reality (AR) could contribute in this treatment, to ultimately bring about a better quality of life (QoL).
In the first phase of this project qualitative research was conducted. Interviews with healthcare professionals (HCPs) and observations in the hospital helped to understand the context for patients. Contextmapping interviews with patients gave insights on the patient journey they went through. It was found that this journey can best be explained as an emotional roller coaster with a long recovery phase.
In the second phase of this project the final concept “Face it” came about through experimentation with AR software and co-creation with HCPs using the patient journey as a basis. A final interactive mock-up was created and tested with ex patients to evaluate the concept as a whole.
The final concept Face it is a tool that helps patients to look at themselves in three different ways during the recovery phase of their treatment; the current selves, back in the past and the future selves. This is done by taking photos, keeping track with photos and looking to the future phases of the recovery in AR. The final concept was evaluated as a good example of digitalization to evoke patient engagement in their own care and with that patient empowerment.
This design research showed that there is a need and opportunity for more digitalization in healthcare. Furthermore, the project has shown that solutions in healthcare can benefit from taking a more holistic approach to a problem. Taking this a different perspective offers interesting opportunities for future projects on AR in healthcare, as does this project, offering a glimpse into the future.
Interviews were held with Dutch modular contractors to reveal the capabilities and specifics of building in a modular way and find proof for each cost factor. Experts in healthcare construction were interviewed to determine healthcare project priorities and find out whether these are catered for by modular construction. A live construction project of a hotfloor department was then studied. Several options competed in the tender project and were compared in the case study. By collecting the cost quotes and arguing for the monetary value of the identified cost factors, a life cycle cost calculation was done. Additionally, sustainability was considered by calculating the novel carbon tax. To expand the application of results to other projects, sensitivity studies were carried out for each life cycle cost parameter.
The study found that there is application for modular construction in healthcare in the Netherlands. Facilities, which do not host medical installations, do not differ to the construction used in residential modules. As for facilities such as the studied hotfloor department, larger modules and a lesser degree of finish offsite decreases the competitiveness of this construction approach. However, several evident cost factors were proposed to be considered within a life cycle costing. These were earlier income due to faster construction, a gain due to less interest and the residual value. It was found that these considerations allow for a 49,0% increase on the initial cost of a modular option in comparison to a conventional option. A hypothesis was further proposed, stating that the competitiveness of the modular option depends on three criteria. These include the initial modular option costs being up to 49,0% more expensive; the saving in construction time having a monetary value to the client; and life cycle costing results being used in total cost comparison.","Life Cycle Costing; Modular Construction; Healthcare; Sensitivity Study; Offsite Construction","en","master thesis","","","","","","","","","","","","Civil Engineering | Building Engineering - Structural Design","",""
"uuid:7bf3a10c-6844-4507-b293-752f113d625b","http://resolver.tudelft.nl/uuid:7bf3a10c-6844-4507-b293-752f113d625b","Reducing waiting times at out-of-hours general practitioner departments: A data-driven simulation modelling and optimization study","Post, Hanneke (TU Delft Technology, Policy and Management)","Hinrichs-Krapels, S. (graduation committee); Verbraeck, A. (mentor); Huang, Yilin (mentor); de Bruijn, Thijs (graduation committee); Delft University of Technology (degree granting institution)","2021","The pressure on healthcare systems is increasing all over the world. With an ageing world population, the costs for healthcare and the shortages in medical staff are continually increasing. In the Netherlands, out-of-hours general practitioner departments, or ‘huisartsenposten’, suffer from this increasing pressure in their telephone triage systems: the departments are crowded and the staff capacity is too low to adequately handle the amount of patients. This often leads to long waiting times on the phone for patients in need of potentially urgent medical care and to high pressure work environments for staff. There is no insight into when and why it is crowded, how high waiting times emerge from this, and how changes can be made in the departments internally and beyond to reduce this problem. In this thesis, research is presented that addresses the practical and scientific lack of knowledge of the factors that influence the out-of-hours departments and that identifies how waiting times can be reduced. The results of this thesis focus on the identification of the factors that influence the demand for healthcare and the service times of people at the out-of-hours departments, and they focus on the practical implications for reducing waiting times at these departments. Based on extensive data analysis of two out-of-hours departments in the Netherlands, it was found that temporal factors such as season, part of the week, day of the week and hour of the day, but also the weather conditions and the urgency of the problem of the patient have an impact on demand for healthcare and on service times at these departments. These factors determine how busy it will be and whether or not waiting times will emerge. With the knowledge of these factors, a discrete event simulation model was implemented to identify what system changes are necessary to reduce waiting times at these out-of-hours departments. It was found that there are several quick-win interventions that can help reduce waiting times: shifting of patients from peak demand, implementation of overlapping work shifts for staff and automatic retrieval of patient information when they are waiting in the queue on the phone. There are also some long term interventions, more focused on behavior change of people, that can be implemented: increased accessibility and understanding of the primary healthcare system, a small (dis)incentive for out-of-hours care, separate telephone lines for home care and implementation of working from home for staff.","healthcare; discrete event simulation; simulation model; out-of-hours care; data; python; modeling; healthcare system","en","master thesis","","","","","","","","","","","","Engineering and Policy Analysis","",""
"uuid:0bdb702d-01e6-49e2-b855-ab617a2535e7","http://resolver.tudelft.nl/uuid:0bdb702d-01e6-49e2-b855-ab617a2535e7","Towards a quieter neonatal intensive care unit: evaluating and visualizing soundscapes to raise awareness on sound-producing events","Viñas Vila, Núria (TU Delft Industrial Design Engineering)","Ozcan Vieira, E. (mentor); Spagnol, S. (graduation committee); Goos, T.G. (graduation committee); Akdag Salah, A.A. (graduation committee); Delft University of Technology (degree granting institution)","2021","A soundscape is the acoustic environment that is constantly surrounding us. Soundscapes in the neonatal intensive care unit (NICU) might adversely affect neonates, their families, and healthcare providers. In this unit, the number of alarms and nuisance is very high, and studies show that it negatively affects both the well-being of patients and the performance of healthcare professionals (Bliefnick, Ryherd, Jackson, & 2019). Additionally, elevated sound levels in the NICU may contribute to undesirable physiologic and behavioral effects in infants. Hearing impairment, heart rate, blood pressure, oxygen saturation, respiratory rate, and sleep were all deteriously affected (Zimmerman & Lahav, 2013).Sound studies within NICUs have only focused on short-term outcomes such as monitoring sound levels in decibels (dB) and reporting the results, with no further implication. Current market solutions give only feedback on high dB levels, limiting medical professionals’ complete understanding of the cacophonous environment. Additionally, they rely on counting sound in dB, discarding the effect of tone and frequency. Therefore, the problem with the dB measure is that it represents only one part of the complex sound taxonomy. Still, interpreting sound beyond dB is challenging to understand for people who are unfamiliar with the physics of sound.SOUNDscapes is a digital platform that maps and localizes sound events occurring at the NICU. It displays sound trends in real time and assesses the quality of the environment by having two main visualization pages: sound level trends and constellation map.The goal of providing real-time feedback is to make nurses aware of specific (sound) behaviours and their consequences. Additionally, they can assess and observe their collective impact on the unit. This dashboard motivates them to change their attitudes towards harmful sound events by ultimately triggering a behaviour change. The dashboard is a tool that will help nurses understand, assess and change their sound behaviour and patterns of harmful sound sources, ultimately having valuable feedback for reducing high sound levels at the unit.First, the proposed solution provides the first step for permanent sound monitoring, mapping, and visualising real-time sound-producing events. Additionally, supporting nurses and giving them the confidence to act upon harmful sound sources occurring at the NICU. Secondly, the suggested design, apart from advocating for a nurse’s sound quality, is also a tool that can go beyond their caring role. For the Neonatology department at ErasmusMC, this platform means a new source of data streams that healthcare developers can use for measuring and evaluating the care quality they are delivering. The new system provided opens new research possibilities in the future that will allow researchers to link the quality of the physical sound environment to physiological and psychological effects on listeners.","design for healthcare; future of healthcare; Neonatology; Neonatal intensive care unit; UX Design; Critical Alarms Lab; Soundscape","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:675caee2-4ae8-4d20-a9da-8070bc6124f9","http://resolver.tudelft.nl/uuid:675caee2-4ae8-4d20-a9da-8070bc6124f9","Arhealth: Enabling wellness as a road to health with service design","Flores Garcia, Rodrigo (TU Delft Industrial Design Engineering)","Lloyd, P.A. (mentor); Simonse, LWL (graduation committee); Weichselbraun, A.M. (graduation committee); Delft University of Technology (degree granting institution)","2021","The COVID-19 health crisis at the beginning of 2020 saw a dramatic number of adaptations to health systems around the world. One of these adaptations was the accelerated shift towards e-health solutions. This rise happened because of the inability of the medical system to serve patients of non-respiratory related illnesses during the pandemic. This was experienced as a rise from 1% to 70% of remote general practitioners consultations in the early months of 2020(Mueller, 2020).
Key to these consultations is the use of medical devices to gather information relating to the patient's state. New medical device categories now allow people with little or no training to collect accurate information (European Commission, 2017), including by using wearables first intended for tracking activity-related metrics that are currently being fitted with state-of-the-art sensors that allow them to become a realistic alternative to strict medical devices (Raja et al., 2019). Despite this, several key issues impede their use in standard medical practice and are more commonly used as informational tools only (Raja et al., 2019).
The use of wearables as informational tools has the potential to increase the awareness of people of the effect of the things they do on their wellbeing, an essential part of the concept of preventative medicine. A concept that aims to enhance wellbeing is wellness, with health being a state of being and a goal to achieve (Stoewen, 2015).
Wellness is also a concept that is well entrenched on the product lines of the brands of Arçelik, and is seen as an important opportunity to grow medical capabilities in the products they already dominate.
This thesis project presents a service design concept that aims to help people create their own wellness journey by passively tracking habits and receiving advice based on this information. The concept is based around the gathering of information through smart home appliances, focused around four modules: nutrition, activity, sleep and vitals.
The project concludes that the proposed service solution brings the possibility to integrate the capabilities that Arçelik needs to enter the larger healthcare market while staying in the product categories that it dominates.
The problem is modelled as a Markov decision process (MDP). As the state space is very large, the problem does not admit an exact solution. Therefore, least-squares policy iteration is used to find an approximate solution. We also formulate an (integer) linear program which is used to solve a deterministic variant of the MDP, and investigate some simple decision rules.
This thesis features a case study at the Sint Maartenskliniek, a hospital focusing on orthopaedic care in Nijmegen, the Netherlands. Data from the hospital is used to make a simulation with which solution methods can be tested and compared. We find that all methods improve on the static roster method used by the hospital, with the linear program leading to the best results. Furthermore, planning less far ahead allows for a better prediction of the state for which to plan, and so also leads to better performance. In the case of SMK, we recommend fixing 60\% of the timeslots using a static roster method 12 weeks in advance, and using the integer linear program to schedule the remaining 40\% of appointments 6 weeks in advance.","Optimization; Least squares policy iteration; Reinforcement learning; Healthcare planning; Linear programming; Markov Decision Process","en","master thesis","","","","","","","","","","","","Applied Mathematics","",""
"uuid:ba4e9e78-f589-43aa-82be-34e780b4dbc6","http://resolver.tudelft.nl/uuid:ba4e9e78-f589-43aa-82be-34e780b4dbc6","Supporting pregnant women with gestational hypertension when bringing about diet change","Khot, Rucha (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Kim, K. (graduation committee); Bais, Babette (graduation committee); Delft University of Technology (degree granting institution)","2021","Hypertensive disorders of pregnancy that include gestational hypertension are seen to complicate pregnancies worldwide. Even if hypertension resolves postpartum, these women are at an increased risk of developing cardiovascular issues in the future. So, they are recommended lifelong lifestyle changes that include making adjustments to their diet.
Although the hypertensive pregnancy offers an opportunity for positive change due to high motivation, various challenges get in the way of implementing change. Additionally, an individualistic and personalised approach is required to facilitate the adoption of healthy eating. However, the current setup to support women in the change-making process does not cater to this. A data-driven eHealth service has the potential to provide personalised support and therefore can prove to be useful for guiding women with gestational hypertension in making the required diet modifications.
This graduation thesis was set up with the aim to design the concept of a service that provides personalised support to women with gestational hypertension and helps them realise the prescribed diet changes. The design process was guided by the formative research on the challenges and enablers to diet change relating to pregnancy as reported in the literature followed by translating them into providing continuous care by applying behaviour change theories.
As a solution direction to providing personalised support, it is envisioned that women with gestational hypertension will be supported using a chatbot-driven service that assists them in effectively managing their diet by providing continuous training based on their lived experiences and with the help of relevant triggers. The chatbot was developed with the aim to (1) help the women cope with emotions, (2) provide knowledge and (3) effectively manage their diet.
The chatbot serves as a tool to gather data from the women, uncover it and deliver continuous support. In the process, it improves the current care pathway by providing (1) immediate response without increasing the load on the medical team, (2) ease of interaction through uninterrupted contact and increased reach and (3) personalisation of care utilizing tailored support. Thus, it has the potential to act as an effective means for guiding women when making diet changes while catering to specific needs within a diverse population. Further analysis through user testing is required to understand its acceptability and desirability in everyday use.","mHealth app; diet change; Pregnancy; chatbot; healthcare design","en","master thesis","","","","","","","","","","","","Integrated Product Design | Medisign","",""
"uuid:2a7e6372-d73c-4d09-bfc1-2009a54e10ec","http://resolver.tudelft.nl/uuid:2a7e6372-d73c-4d09-bfc1-2009a54e10ec","Ambulance drones in The Netherlands: a vision + concept design for 2035","Dielemans, Jasper (TU Delft Industrial Design Engineering)","Hoftijzer, J.W. (mentor); Brand, D.I. (mentor); Delft University of Technology (degree granting institution)","2021","In the previous decade, a new type of air travel has seen a surge of interest from established and start-up companies alike: Air Mobility, a type of short range air travel as an alternative to taking the train or the car. Part of air mobility are a new type of aircraft, called Electric Vertical Take-off and Landing vehicles (eVTOLs), which hold potential for many new use cases.
Design agency Modyn wants to profile themselves within the field of air mobility through a vision concept for an ambulance drone. This use case, they reckoned, would be a good starting point for Air Mobility and eVTOLs, as it attracts more public acceptance than commercial use cases, such as an air-taxi service.
Modyn’s vision project was turned into this graduation thesis: an ambulance drone concept for the scope of 2035. Far enough in the future to capture the imagination, but near enough for it to relate to our present day reality in 2021.
Keeping the project grounded was one of the main challenges. It required a good understanding of the current ambulance system in The Netherlands. Which was the first research subject. A visit to ambulance station Delft and interviews with people from the field were all valuable input.
After establishing the current status quo, a look into the future was taken. Here, plans towards Air Mobility were investigated, in order to see how much The Netherlands is interested in this idea. The influence of technological and societal developments that relate to Air Mobility were plotted on a timeline, creating a roadmap towards 2035. This roadmap would create an input for the technical architecture of the ambulance drone.
Having a good picture of the present and a potential future, the research was distilled into a vision and a mission. The focus now clearly went towards using ambulance drones to replace the current ambulance helicopters. Also, the design challenges were identified and a program of requirements was compiled.
The design phase started off with the ideation, in which Virtual Reality was used to generate interior layouts. The interior is the most fundamental part of the design, as it is responsible for 90% of the interactions that the users have with the ambulance drone. An inside-out design approach was therefore the most sensible.
From the VR based ideation, the most promising interior layouts were translated into concepts. The direction was still rather open at this point, so in order to converge towards the final concept, a lot of experts were consulted for feedback on the concepts and the direction of the project.
This led to the creation of the final design, which was loosely based on two of the concepts. Thanks to the feedback from experts, the final design underwent quite a metamorphosis compared to the concepts.
The result is an ambulance drone concept with novel features and interesting ideas regarding the interior layout. The final concept has a recognisable, yet unique identity from a visual standpoint, being professional and approachable at the same time.","Ambulance; Drone; eVTOL; Air Mobility; The Netherlands; Healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:787494c2-6a5d-416e-b262-1c6baa8ec958","http://resolver.tudelft.nl/uuid:787494c2-6a5d-416e-b262-1c6baa8ec958","A-eye: Implementation of AI in eye disease detection","de Leve, ward (TU Delft Industrial Design Engineering)","Cila, N. (mentor); Nas, D.N. (graduation committee); Delft University of Technology (degree granting institution)","2021","To prevent vision loss from eye diseases like glaucoma and retinopathy it is important to diagnose them on time. When you discover the diseases too late the vision will be irreversibly damaged. For this reason, diabetic people are screened preventively. In the past, this happened every year but now only every three years, all to save costs. Artificial intelligence is a promising technique in the field of eye disease detection, it is able to detect based on just a fundus picture if asymptomatic eye diseases like glaucoma or retinopathy are developing. It has the potential to make diagnosing these diseases easier and more affordable. But while AI systems often perform good in labs, the introduction in the real medical world often fails. This project focuses on designing an AI service around an AI eye detection algorithm using a human-centered approach. The goal is to create an AI service that fits and will be adapted in the clinical workflow of the different medical specialists.
The project is done for the company Ksyos, this is a digital healthcare institute in the Netherlands. The service is built on top of their current ophthalmology service. The new AI service uses besides ophthalmologists and optometrists also opticians. Opticians will in the new service do the pre-diagnosis of eye diseases, they do this by taking a fundus picture and run it through an AI system. This will filter out a lot of people who do not need the expertise of an optometrist. In the current ophthalmology service, 90% of the people screened have healthy eyes. The AI service will not be just a screening service but will be a disease detection service, which means that the GP needs to count on the validity of the results of the system. To guaranty the quality, the AI system will split the patients into three categories, green for people with clearly healthy eyes, red for people who have a severe case of an eye disease, and orange for people who probably have an eye disease. The orange and red patients will be sent based on the severity of the disease and the kind of disease to an optometrist or an ophthalmologist. Explaining the results of the AI screening will not be the responsibility of the optician. The optician does not have the knowledge and the capabilities to explain the results calmly and clearly to the patient, Ksyos will take over this task from him. Ksyos will send a letter with the results to the patient that explains calmly and clearly what the next step in the diagnosis will be. While the optician does not have to interact with the AI system the optometrists does, he needs to understand why the AI system makes certain decisions. They need to know what the AI system has found and where. This way they can interpret the decision of the AI system and decide if they agree with this or not.","service design; Artificial Intelligence; Healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:7732ddf5-da62-4150-b628-74624f129b4c","http://resolver.tudelft.nl/uuid:7732ddf5-da62-4150-b628-74624f129b4c","Towards Value-Based Healthcare: Research to the design for an IT architecture to enable value-based healthcare in the Netherlands","de Jonge, Floor (TU Delft Technology, Policy and Management)","Ding, Aaron Yi (mentor); Verbraeck, A. (graduation committee); Delft University of Technology (degree granting institution)","2021","The sustainability of the Dutch healthcare system is under severe pressure with increasing expenditure, more demand for care and a shortage of healthcare professionals. In the current healthcare system, providers are rewarded for increasing volume, but not for adding value, which only exacerbates the situation. Value-based healthcare (VBHC) is a candidate framework to reform the current healthcare system into an outcome-based system. Information systems are essential for the implementation of VBHC to execute outcome and cost measurements and collaborate across the care cycle. A literature review shows that there is a knowledge gap in the scientific literature to the architectures and components for such value-enabling information systems. This thesis aims to fill that gap by identifying and designing the essential components for a value-enabling IT architecture for the Dutch healthcare system.
The Information Systems (IS) research framework of Hevner et al. (2004) is adopted to guide the research. The environmental analysis shows several deficiencies in the as-is architecture for VBHC including a lack of patient-centredness, inaccessible or unavailable data, and complex to extract and integrate data. Preliminary semi-structured interviews reveal that, besides IT barriers, there is a deeply rooted trust issue among stakeholders which hampers successful implementation of VBHC. It is found that trust is often related to transparency and can be managed. Increasing transparency in the healthcare architecture would allow for (i) continuous quality improvements, (ii) improved decision-making, (iii) positive financial stimulus and (iv) patient empowerment. The design activities aim to facilitate VBHC through integrating components that reduce or eliminate the IT barriers and increase transparency. Another round of semi-structured interviews is carried out to find the principles, requirements and components for the design. The overall design developed uses three types of environment: a Healthcare Information System (HIS) used by caregivers, a Personal Healthcare Environment (PHE) used by patients and a Quality Registration System, available to all stakeholders. The design and components are evaluated with an expert panel. The most essential components are: PHE, HIS, Quality Registry system, Clinical building blocks (Zibs), terminology standards, a data integration centre, logging and monitoring services, measurements and evaluations, auditing IT and care processes and an intermediary that stimulates improvement and collaboration. The expert panel reached a consensus that transparency in healthcare would contribute to solving some of the problems, but it will not solve the core problems that lie within the healthcare structure. There are several areas recommended for future research. First, the components should be evaluated with a broader expert panel to increase the validity. Second, the PHE is an essential component, but still in its infancy. It is recommended to further evaluate the utility for VBHC. Third, blockchain technology might enhance the design due to its inherent characteristics that offer transparency. Fourth, further research on the privacy-utility trade-off in the context of VBHC is recommended. Finally, interoperable systems rely on a shared and uniform language. It is recommended to research which standards have the highest potential to facilitate the architecture components.
• Frequently a project leader lacks the competencies to lead a project properly. This has major influence on going through the project steps and the project outcome. A project leader should be a neutral actor who has no advising role towards the project team in terms of content. A competent project leader could increase buyer-supplier relationships which would decrease negative effects from disproportional social capital between physicians and manufacturers. It is suggested to consider full time project leaders with proper education to contribute to an effective purchasing process.
• In the procurement process the ability to save financial resources decreases as is proceeded through the steps. Assuming that the added steps of budgeting and initiation are executed well, the specification step is crucial for the outcome of the project. Participants indicate however that the means of specification does not serve the goal. Detailed programs of requirements are the status quo but lack the ability to differentiate between options because too many basic requirements have to be registered. It is suggested to change towards a best value approach where the desired outcome is described.
• A best value approach improves and demands buyer-supplier relationship. The specification and selection step melt together and the specification of solutions happens in cooperation with a manufacturer. Hospitals and the industry are dependent on each other for executing their purpose. Therefore cooperation between the two industries is already perceived as positive but legislation counteracts this. At this moment this is in this form not allowed for academic hospitals as they are subject to the tender law.
We can conclude that an improved systems approach is essential for an effective procurement process and a project leader should provide in this. Having proper project lead creates the opportunity to experiment with the best value approach and break loose from the strict program of requirements homogenizing the healthcare technology market. Future research could test the potential of this method to increase opportunity for innovation for manufacturers, as well as hospitals.","HTM; Healthcare decision-making; healthcare logistics","en","master thesis","","","","","","","","","","","","","",""
"uuid:5434c330-61df-4ad6-a044-f58cfcf9d5ea","http://resolver.tudelft.nl/uuid:5434c330-61df-4ad6-a044-f58cfcf9d5ea","Peri-operative care of major gastrointestinal surgeries through telemonitoring: A strategic design approach to the integration of telemonitoring services in peri-operative care","Leon Aguirre, Maria (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Snelders, H.M.J.J. (graduation committee); Pannunzio, V. (graduation committee); Raijmakers, J.H.M. (graduation committee); Delft University of Technology (degree granting institution)","2021","This project envisions the future of telemonitoring for peri-operative care. Through an extensive literature research and further expert and context exploration, a design strategy is created, as a starting point for the development of new services and technologies in healthcare around surgical environments. The design process with a strong focus on analysis guided the development of the project. This allowed the creation of a future vision that considers the findings from the literature, user and trend research and gives a direction to the current state. Within the creation of a future vision, different scenarios are detailed, to give a more detailed idea of how peri-operative care would be. In addition, some recommendations and future steps are presented, to facilitate the achievement of these future scenarios by providing the stakeholders involved with some tools to assess the viability of implementation and inclusion in planning. Finally, the project includes a call to action to develop technologies and services that enables the extension of care to the home context and the empowerment of patients to have a conscious and active role in maintaining and seeking their wellbeing.","Telemonitoring; Peri-operative care; Healthcare staff; Healthcare; Nurses; Workflow; Patients; Medisign","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","Philips",""
"uuid:8f933373-3a73-4ad5-9645-1b6ac75a0f4f","http://resolver.tudelft.nl/uuid:8f933373-3a73-4ad5-9645-1b6ac75a0f4f","From Prototype to Proposition: a Design Perspective on Scaling The Box: Framing Design Opportunities for Scaling while Supporting an Efficient Workflow that Reduces the Burden on Healthcare Professionals","Verschueren, Eveline (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Snelders, H.M.J.J. (graduation committee); Pannunzio, V. (graduation committee); Delft University of Technology (degree granting institution)","2021","The Box contains monitoring devices patients can use to perform monitoring activities in the comfort of their home. The success of the service relies on active patient participation. With The Box, the treating medical team now has insights in the patient’s health condition from a distance. It doesn’t require the patient to be physically present in the hospital, and there’s now even more reliable data available to adjust the treatment to. It makes the carepath insightful and approachable by both parties, resulting in accessible digital consultations. Since The Box has proven to be a success in patient care, several departments started adopting this service as well. However not much attention has been given to how the healthcare staff at LUMC is experiencing the implementation of The Box. As the idea of patient home monitoring looks very promising, the reality however is quite discrepant. Not having the physical presence of patients in the hospital, would appear to reduce the burden on healthcare staff, as instead these “empty” hospital bed will simply be taken up by other, even more severe cases, causing a larger amount of patients to both monitor digitally and take care for physically. It leaves us with the question of “Who will do it?”. Who will take on the so to speak additional workload? The healthcare staff at LUMC is experiencing more workload with the implementation of The Box as its intended use is mostly focussed on remote and safe patient monitoring, while missing out on an opportunity for assisting the care-team. It occasionally happens that additional staff is hired to cope with the excessive workload, or that LUMC is also investing in an intelligent system that prioritizes patient data. But momentarily, healthcare staff’s solution is simply to not check up on every patient that sends in data. The Box may appear as an implemented innovation in the care practice of LUMC, but in reality it is still a prototype. Therefore it requires scaling to towards an improved standard healthcare practice. The goal is to turn The Box into a mature proposition that can be implemented hospital-wide, but also that has the ability to change the current healthcare system. The burden on the care-team must be suppressed or else the future will include an immense scarcity of healthcare professionals of which the majority will be burnt out. A roadmap is created to show opportunities for continuous prototyping and what value it brings, scaling strategies, patient monitoring and what level of staff involvement it demands, required developments and finally stakeholder collaboration. What it actually proposes are the changes to be made to create an integrated healthcare solution that is focussed on “unburdening” the staff. LUMC is not capable of changing this alone: they are specialized in research, education and healthcare, yet they lack expertise on data management, financial resources, digital developments, etc. It therefore needs support of multiple organisations. The deliverable aims to show a designer’s perspective on scaling The Box from a prototype level towards a mature healthcare proposition.","eHealth; Remote Patient Monitoring; Workload; The Box; Roadmap; Quadruple Aim; LUMC; Philips; Workflow Efficiency; Care-team well-being; Future Vision; Healthcare; CardioLab","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:2ccb83be-c2b6-4c96-9b94-aa3ab95dce58","http://resolver.tudelft.nl/uuid:2ccb83be-c2b6-4c96-9b94-aa3ab95dce58","ExPEERience: Designing for Patient Empowerment for Head and Neck Cancer Patients in the Follow-up Phase","Peters, Tess (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Snelders, H.M.J.J. (graduation committee); Jung, J. (graduation committee); Offerman, Marinella (graduation committee); Delft University of Technology (degree granting institution)","2021","In this graduation thesis I investigate how to design for patient empowerment in the context of head and neck cancer (HNC) patients in their follow-up phase (the first 5 years after treatment). This project is set up with the Erasmus MC and was initiated to elaborate on their current service called the Healthcare Monitor (HM). The HM is a structure of electronic patient-reported outcome measures filled in by patients before every follow-up consultation. The answers are shown in a dashboard to the treating physician and used during patient consultations (Dronkers et al., 2020). What the current HM lacks however, is insight for the patients themselves into their health and addressing their concerns in between the consultations. Therefore this project aims to develop an additional service to the HM that empowers patients in between consults whilst also providing the doctor with a more frequent and realistic insight into their wellbeing. Patient empowerment can ultimately lead to a better quality of life. In this project it is viewed as a process that can be influenced through design. Therefore an inspirational model is created in this thesis that designers can use when designing for patient empowerment. HNC patients in their follow-up need to deal with a lot of different physical and psychosocial side effects (Aguilar et al., 2017). I investigate their concerns using the double loop method of Jung (2021). I analyze the community context through a computational analysis of online cancer community platforms. The patient context is investigated through a focus group with 6 care professionals and interviews with 9 ex-patients. 4 main concerns are found. Patients want to: •Be prepared for what they can expect and do •Have the overview of how they are doing •Be supported when they have a doubt •Have a relevant service for them The model for patient empowerment and patient concerns are combined to create a design vision. The vision is to provide patients with an overview that enables them to gain more control in dealing with issues that concern them. This overview was designed in a prototype application through 3 main elements; a logbook with previous experiences, a possibility to track current experiences and an overview of expected experiences based on peer experiences. This prototype was tested by 6 ex-patients who found value in the low threshold way to contact others, find trustworthy information and track their wellbeing. They valued peer experience exchange and better insight into themselves as this can ultimately lead to more reassurance in between consults. Based on this test further improvements, suggestions for the next steps and possibilities to scale the concept are presented. When developing an app for patient empowerment the Erasmus MC should; •Include peer patient experiences •Provide the patient with insight into their wellbeing over time •Integrate tools and databases in one complete overview For designing in the field of value based healthcare, this project stresses the importance of incorporating experiences of the community and using a multidisciplinary approach.","Patient Empowerment; eHealth Intervention; Healthcare Design; Head and Neck Cancer; Peer support; Value based health care","en","master thesis","","","","","","","","","","","","Design for Interaction | Medisign","",""
"uuid:cf920428-6515-4ac8-a809-67dc6b67b969","http://resolver.tudelft.nl/uuid:cf920428-6515-4ac8-a809-67dc6b67b969","Supporting a healthy dyadic lifestyle following a myocardial infarction using eHealth technology: Experiencing a Myocardial Infarction together","Houwen, Julian (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Link, O.V. (mentor); Atsma, Douwe (graduation committee); Delft University of Technology (degree granting institution)","2021","Problem In the current care pathway for patients suffering from a Myocardial Infarction (MI), a paradox has been identified in long-term chronic care: modification of cardiovascular risk factors reduce mortality and prevent recurrent cardiac events. However, MI survivors rarely change their lifestyle and relapse often in old habits. The identified cause within the system is a gap created by a lack of professional and social adherence support in relation to cardiovascular risk management. Research has shown how social support from a partner can improve lifestyle change adherence. To fill the gap, this study looks at how the patient's partner can be supported and empowered by the healthcare system to positively fulfill this role. Therefore, this strategic design thesis aims to develop a tangible strategy for the Hart Long Centrum of the LUMC by answering the following research question: ""How can partners of chronically ill patients, that suffered from a MI, provide effective and positive support for the patient to maintain long-term preventive lifestyle changes by means of an eHealth innovation linked to The Box?” Dyadic Opportunity The partner of the patient is able to influence the patient’s health behaviour and motivation through the dyadic nature of their relationship. Therefore, a new perspective has been identified for 'The Box' to stimulate long-term preventive lifestyle change; using positive dyadic communication and support to influence the illness perception of patients and partners. This offers the opportunity to create a parallel track to bridge the chronic care gap. The track will be next to the current care pathway, in the form of an eHealth intervention that complements the existing 'The Box' innovation. Dyadic Experience Each individual in a couple, who have experienced a MI, goes through their own grieving process after a life changing event such as transition from a ‘normal life’ to a chronic illness. Within this process it has been shown that the needs of the partner and patient change over time. This dyadic adaptation process has been examined and the dynamic key needs of the partner have been identified: •How can the partner support the right way at the right time? •How can the partner themselves be supported? •How to strive for a relationship where the right balance between ‘patient’ and ‘loved one’ is achieved during the adaptation process? Solution Direction A future solution is envisioned in which the patient's partner is actively given a central role in participating in long-term lifestyle change: Partners will be empowered and guided by the healthcare system, by means of an eHealth intervention driven by hybrid intelligence and P4 mechanisms (prevention, prediction, personalization, participation), to positively support the patient in the right way at the right moment in changing their lifestyle in the long term. WeCAIR - Partner Perspective of the Hybrid Intelligence Portal (HIP) To make the strategy of influencing patient adherence by empowering and guiding the partner tangible, WeCAIR is designed. WeCAIR is part of a Hybrid Intelligence Portal (HIP) which monitors and guards the balance of human dynamic interactions and needs between partner, patient and care professional. WeCAIR is a user-friendly interface developed from the perspective of the patient's partner. As discussed in the chapter before, the interface has three different main features: (1) Personalized Dyadic Route, (2) Behavioural Support and (3) Lifestyle Education. These characteristics are aimed at empowering and guiding the partner to take on a balanced role in relation to their life partner (the patient) in the adjustment process to chronic illness, in order to positively support the patient in the right way at the right moment in changing their lifestyle in the long term. Conclusion The proposed strategic Product Service System (PSS) improves the current care pathway by involving, supporting and empowering the partner in the care process, resulting in long-term adherence to lifestyle changes. Ultimately, this leads to secondary prevention for the patient and primary prevention for the patient's partner. For the LUMC Hart Long Centrum, this means that by implementing the PSS they will be one step closer to their goal of providing the best clinical and innovative care to patients.","eHealth Intervention; Long-term Lifestyle Change; Myocardial Infarction; Dyadic Relationship; Partner Box; Healthcare Design","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:1ef2a74d-978c-409b-a621-2c6b8ac58e28","http://resolver.tudelft.nl/uuid:1ef2a74d-978c-409b-a621-2c6b8ac58e28","Transformative Reconstruction: The application of a new approach towards dilapidated or unfinished buildings in Beirut","Grosveld, Marcus (TU Delft Architecture and the Built Environment)","Milani, S. (mentor); Schoonderbeek, M.G.H. (mentor); Jennen, P.H.M. (mentor); Delft University of Technology (degree granting institution)","2021","The conflictual past of Beirut is being erased by the company of Solidere, which has a strong will to modernise, through a highly destructive reconstruction, in an effort to heal the city. With this project, a new approach is taken on, in which an old concrete structure, riddled with bullet holes, part of the great variety of dilapidated and unfinished buildings that have characterized Beirut’s urban landscape for decades, is to be transformed and provided continuity. The structure in question dates back to the Lebanese Civil War, and was most likely built for its strategic position, just south of the city center, and it has been occupied ever since by the Lebanese military. In this project the structure will be transformed and completely redefined by the method of ‘creating by removing’. The rough edges, resulting from the cutting process and the existing scars marking the structure’s history, are proliferated in the transformation process as traces to preserve. The new intervention, housed in autonomous structures, will inhabit the existing concrete skeleton, and will absorb the program of a military first aid clinic, responding to the state of urgency Lebanon is currently in. A great contrast arises between the rough edges and exposed aggregate, with the sterile and seamless surfaces of the new intervention. The collision of both, grants an entirely new meaning to the neglected structure and its traumatic past, as it becomes the carrier of something prospective. Subsequently, in order to have the project further reflect on the status quo of Beirut’s built environment, it aims, through the transformation process, to attain a state of latency, in between demolition and construction, and in between a ruin and a building. The final result proposes a scenario which is neither stable, nor unstable, it simply exists in the inbetween.","Beirut; Post-war architecture; Transformation; Commemoration; Healthcare architecture; Decay; Ruins; Reverse engineering; Memorial; Intervention","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Borders and Territories","Thakanat Al Bashoura First Aid Clinic Beirut","33.892772, 35.502657"
"uuid:4225ff65-1860-49e7-b832-85990261a605","http://resolver.tudelft.nl/uuid:4225ff65-1860-49e7-b832-85990261a605","The Circular Redesign Focus Point tool: A novel method to determine focus points for redesigning surgical devices for circularity","Ligtelijn, Sharina (TU Delft Mechanical, Maritime and Materials Engineering; TU Delft Biomechanical Engineering)","Horeman, T. (mentor); Dankelman, J. (mentor); van Straten, Bart (mentor); Flipsen, Bas (graduation committee); Delft University of Technology (degree granting institution)","2021","For healthcare, an industry that is currently responsible for up to 10% of the global carbon footprint, the transition to carbon neutrality and circularity will be an enormous challenge. As 20-30% of the total hospital waste originates from operating rooms, optimising recovery from these waste streams has the potential to make a significant improvement on the environmental footprint of the healthcare sector. However, the recovery of components from current surgical devices is difficult and laborious and thus redesigns are necessary. A gap in the literature is identified regarding design methods specifically targeting circular redesign of surgical devices. Therefore, this thesis aimed to develop a method that helps designers in redesigning surgical devices for circularity.
As a result, the Circular Redesign Focus Point (CRFP) tool is developed. The tool guides designers in making substantiated decisions on which components to improve the recoverability of, by redesigning the surgical device. Through the assessment of the device on a component level, a set of outputs is generated which are split in the categories disassembly effort and potential gain. Utilising this division the new Circular Redesign Necessity metric is developed, which is used to score the focus points for redesign.
The validation results indicate that the thesis aim is achieved by the development of the tool. With this, the novel tool addresses the identified gap in the literature. The tool forms the first design tool for circular surgical device design and provides a starting point for future studies in this field.
As a result of the worldwide aging population, Vertebral Compression Fractures (VCF) are commonly detected in osteoporotic patients; these can originate from traumatic events or occur spontaneously. The existing VCF devices and their corresponding surgical instruments have their limitations in terms of short- and long-term performance, efficiency, safety, and complications. Amber Implants has developed an innovative new Titanium Implantable Vertebral Augmentation Device (TIVAD) that overcomes the shortcomings of the available state-of-the-art VCF devices. However, the specific surgical instruments required for the insertion and deployment of the TIVAD are yet to be developed.
Methods
A knowledge-driven iterative design process that includes extensive theoretical and empirical research together with spine surgeons, concept development, and experimental verification phases has been executed.
Results
The outcomes of the experiments have shown that the final TIVAD inserter and expander met the predefined requirements regarding efficiency, mechanical properties, and usability. These results lead to a significant contribution to the overall TIVAD procedure.
Conclusions
To summarize, it can be stated that the essential surgical instruments, the TIVAD inserter, and expander, enable the surgeon to insert and deploy the TIVAD to relieve the patient from its pain sensation and to restore the adequate spine curve while reducing the number of surgical steps, the overall surgery time, and thus costs. Additionally, the risk of infection and pulmonary embolisms is decreased significantly due to the TIVAD’s non-PMMA minimally invasive surgical procedure.
The distance between many seniors and others in the elderly´s living environment, including myself, is too large. This distance should be reduced because it could lead to social isolation and/or loneliness among the vulnerable elderly. Thereby, as a result of the baby boom generation, a large part of the Dutch population will be older than 65 years old in the upcoming years. That is why the question of a pleasant and personal living environment for this generation is even more urgent. According to my empirical and literature studies this segregation between the elderly and their surroundings is caused by several things:
•Firstly, the growth of this segregation is through the (physical and mental) barriers which make it increasingly difficult to meet others in their direct surrounding (due to age-related disabilities and illness)
•Secondly, most of the housing types for the elderly is now arranged so that they mainly live together with their age group and they continue living in their bubble.
•Thirdly, their “own” social network is getting smaller and the elderly becoming more dependent on help in the immediate vicinity.
These causes can be seen as a chain reaction that keeps getting bigger and therefore the distance gets bigger as well. The issue of this report is to what extent architectural design can contribute to reducing the growing gap between the elderly and their living environment and thus make a positive contribution to breaking through social isolation. Therefore, my research question for this thesis is:
''To what extent does the architectural design play a role in reducing the distance between the elderly and their neighbourhood to encourage the social inclusiveness of them in their living environment?''
The design of the Social Courtyards is the translation of the results of the research question. My graduation project aimed to ensure that the elderly continue to interact passively and actively with their environment in a pleasant way. This is to increase a sense of belonging in the neighbourhood, despite the mental and physical limitations associated with their old age. Reducing the distance of the elderly towards their living environment improves the elderly’s mental and physical health. The design is located in Driebergen and the design is named Social Courtyards.
This research, first defines the security and privacy requirements for healthcare systems. Then, we look deeper into the privacy requirements that have to be met in blockchain systems and the threats that can arise when systems do not meet them. Next, we present several privacy protection techniques that can be used in a blockchain-based healthcare system and present a design which is a combination of techniques that fulfill the privacy requirements. Lastly, this design is evaluated to see how each component of the design fulfills the requirements necessary.","blockchain; healthcare; Privacy-preserving","en","bachelor thesis","","","","","","","","","","","","Computer Science and Engineering","CSE3000 Research Project",""
"uuid:5b53f4e8-cbe2-456e-8872-e045f80e2cb6","http://resolver.tudelft.nl/uuid:5b53f4e8-cbe2-456e-8872-e045f80e2cb6","Exploring privacy challenges of blockchain-based supplychains in the pharmaceutical industry","GAL, Jean (TU Delft Electrical Engineering, Mathematics and Computer Science; TU Delft Intelligent Systems; TU Delft Cyber Security)","Li, T. (mentor); Erkin, Z. (graduation committee); Delft University of Technology (degree granting institution)","2021","Blockchain is an expanding technologythat offers benefits when applied to supplychain management. This distributed ledgertechnology is combined with supply chainsfor its intrinsic characteristics. For instance,traceability, immutability, and more arediscussed. In this paper, we first presentprivacy-related challenges encountered whenapplying blockchain technology to this work.These include dealing with immutable data,providing the anonymity of end-users, as wellas their accountability. The risks associatedwith the leakage of medical data show thenecessity of protecting patient privacy. Forthis sake, we delve into blood donation,clinical trial, PPE tracking supply chainsand highlight their privacy requirements.We introduce anonymous signatures, mixingservices, and other cryptographic techniques,which satisfy these requirements throughlocal anonymity, unlikability, but alsoaccountability in specific contexts.","Blockchain; Supply Chain; Healthcare; Pharmaceutical","en","bachelor thesis","","","","","","","","","","","","Computer Science and Engineering","CSE3000 Research Project",""
"uuid:e2e43934-c3ac-462b-a94b-25c1b32aa044","http://resolver.tudelft.nl/uuid:e2e43934-c3ac-462b-a94b-25c1b32aa044","A Roadmap towards Touchless Interaction during Image-guided Therapy: Enhancing workflow in complex medical procedures through strategic technology implementation","Wijn, Victor (TU Delft Industrial Design Engineering)","Goossens, R.H.M. (mentor); Li, M. (mentor); Buil, V. (graduation committee); Delft University of Technology (degree granting institution)","2021","Philips is the global leader in Image-Guided Therapy (IGT). This medical specialization provides integrated solutions that allow for minimally invasive medical procedures. A specialized medical team consisting of multiple stakeholders works closely with Philips's newest technological devices and systems during these interventions. These complex procedures are followed and guided via real-time, on-screen imaging modalities. This way, technology-enabled, optimal care can be provided for many different interventions. Clinical demands, challenges and complexities can be very specific and patient-dependent. Often bottlenecks in IGT procedures come down to limitations like sterility and hands-busy situations. However, touchless interaction technologies provide solutions in many ways. Technologies like eye-gaze, voice control and gesture sensing are expected to minimize the number of mistakes made and time lost because of inefficiencies. The future context of IGT is explored by doing creative trend research to get an idea of the technologies, trends, and developments in the future healthcare landscape. A future vision of IGT is established to give an expression of a desired future. It provides a strategic reference point for actionable innovations. Through qualitative research, ideation and conceptualization, several design implications are provided. Synthesizing these concepts into an implementation strategy that aligns with the future vision is essential. Since the result of this thesis will be a roadmap, a division is made into three separate horizons leading towards the future vision. These horizons address a particular aim, alignment with the developing healthcare landscape and related implementation of the concepts into the roadmap. Through validation and assessment, the roadmap is optimized and aligned with the business. An estimated improvement target is established as a reference point. Additionally, the expected value of the clinical and operational performance of the concept propositions are estimated and substantiated. This results in a strategic roadmap that can deliver concrete insights and provide guidance in the implementation possibilities of these touchless UI innovations in this healthcare domain.","Image-guided Therapy; Touchless Interaction; Roadmap; Workflow; Strategic Design; Interaction technologies; Sterility; Cath lab; Minimally-invasive Surgery; hands-busy; Experience; UX Design; UI Design; Future of healthcare","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:b6b016f5-d80c-44f4-95d3-2eb87b4fd8cb","http://resolver.tudelft.nl/uuid:b6b016f5-d80c-44f4-95d3-2eb87b4fd8cb","Accelerating the development of UCP-LF CAA strip readers for schistosomiasis diagnosis","de Goeje, Ludo (TU Delft Industrial Design Engineering)","Diehl, J.C. (mentor); Albayrak, A. (mentor); Delft University of Technology (degree granting institution)","2021","This document reports the exploration of the development of a context-specific strip reader for an innovative lateral flow test detecting schistosomiasis. Schistosomiasis is a common poverty-related parasitic disease in many Sub-Saharan African countries. Transmission happens in infested water, putting especially children at risk. Schistosomiasis can be effectively treated. In order to do that, accurate diagnostics are needed at the point of care to target communities at risk. Leiden University Medical Center is developing a lateral flow test that detects the antigen CAA with high accuracy, using upconverting particles. The test has great potential in terms of accuracy, but a dedicated reader is needed to interpret the test result. A reader typically limits the accessibility of a test in low-resource settings, because of its size, high costs, and limited user-friendliness and robustness. On the other hand, one could benefit from the opportunities that come with such a device, such as reducing human error, quantifying results, and real-time data collection. The starting point was to explore the possibilities of developing a context-specific strip reader dedicated to the new test. The approach of this project was based on systemic design methodologies. It deals with complexity by creating interventions that move the system to a more desired state in incremental steps. Transitions towards desired states were described on four different levels of abstraction. On a global level, we aim towards leaving no one behind, making healthcare accessible for everyone. Big forces, like climate change and COVID-19, and smaller forces, like stigmas and technological challenges, are risk factors that could steer change away from the desired direction Meanwhile, opportunities arise, such as the rapid digitization of Sub-Saharan Africa. From a systemic viewpoint, it became clear that new frames are needed to create a strong and attractive narrative for the role of strip readers in diagnostics. Based on the insights, an intervention strategy was proposed to accelerate the development of a context-specific strip reader by early involvement of stakeholders. The strategy consists of two elements. 1) Three new narratives are proposed as an alternative to the current, negative frame of the use of readers in low-resource settings. These narratives were used to formulate multiple development paths of different technical concepts. 2) The Block Reader was developed to support the narrative with evidence and as a means for collaborative prototyping. It enables to gain and share insights, and to communicate with stakeholders. The device is fully modular, allowing the user (developers) to iterate on the technology and user-interaction quickly. Lastly, an outline of the next steps is discussed.","schistosomiasis; global health; smart diagnostics; healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:22b88828-2851-49e2-8b44-74b598522e08","http://resolver.tudelft.nl/uuid:22b88828-2851-49e2-8b44-74b598522e08","Towards a resilient hospital design: Emerging design considerations for future healthcare facilities after the pandemic COVID-19","Pretelt Duque, Manuela (TU Delft Architecture and the Built Environment)","van Oel, C.J. (mentor); Herweijer, Milee (mentor); van Heel, Liesbeth (graduation committee); Delft University of Technology (degree granting institution)","2021","COVID-19 has highlighted the importance of the healthcare systems in society. The pandemic overwhelmed hospitals and forced rapid and radical changes in healthcare organizations' working practices and management structures (MASS Design Group, 2020; Ramboll, 2021; Capolongo et al., 2020). The virus led to unfamiliar environments, new spatial configurations of hospitals were necessary to cope with the surge capacity, new protocols and strategies were fundamental to respond to the crisis. Past pandemics have occurred, and other infectious diseases and viruses might come. COVID-19 is not going to be the last challenging situation for the health sector. Thus healthcare systems could become more resilient. Hospitals need to be resistant to future outbreaks, maintaining and adapting critical functions during crises (Ramboll, 2021). It is essential to learn from the experience of the COVID-19 pandemic to be more prepared for future events.
This practice-based research aims to gain insight into the pandemic experience to provide recommendations to future-proof hospital design. A qualitative approach is proposed for this study. First, through a general questionnaire, information on building adaptations and working practices of hospitals in the Netherlands during the pandemic was assessed. Then follow-up in-depth interviews with chosen facility and real estate managers that answered the survey would be conducted to reflect on the crisis period and understand the decisions and choices taken regarding planning, design, and engineering during the different waves in the country's hospitals.
According to findings, the pandemic in the Netherlands increased cohesion and collaboration between healthcare organizations. The national government advised the coordination of the emergency response, and the decisions within each organization were driven by independent Crisis Management Teams (CMT). Clear guidance facilitated the decision-making process of the measures and services that needed to be implemented. In general, hospitals felt well prepared for the pandemic, although changes and improvements were made regarding building, technical and employee-focused modifications to respond to the surging demand of covid-care.
Additionally, an analysis considering three spatial characteristics of hospitals: type, building year, and urban density, was done to determine if there was a distinction in the measures taken. It was found that most hospitals implemented some top measures and that there is also some differentiation between groups of hospitals. Based on the findings and the lessons learned from the interviews, some suggestions for future renovations and developments were made. Recommendations could help build up towards future-proof facilities to a virus-like COVID-19 increasing spatial flexibility, robustness and adaptive capacity of healthcare buildings.","Future hospital design; COVID-19 pandemic response; Hospital characteristics; Building interventions; Technical interventions; Employee-focused measures; adaptability; flexibility; Robustness; Healthcare resilience","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","",""
"uuid:e7254108-3040-449f-a301-744dec324e94","http://resolver.tudelft.nl/uuid:e7254108-3040-449f-a301-744dec324e94","A Digital Platform for Information Systems in Dutch first-line healthcare: A study on Boundary Resources","Groeneveld, Sebas (TU Delft Technology, Policy and Management)","de Reuver, G.A. (mentor); van de Kaa, G. (graduation committee); Delft University of Technology (degree granting institution)","2021","This master thesis explores the boundary resources in Dutch first line healthcare that are required in order to increase the intent of Information Systems suppliers in to join a digital platform. This is researched, as information systems suppliers lack an ability to innovate. Innovation can be increased by an open digital platform for information system suppliers as boundary resources can affect the degree of openness in a platform, which in return affects the willingness to join the platform. When more IS suppliers join a platform, the platform becomes more innovative. This is important, as in Dutch healthcare, IS needs to innovate in order to deal with tomorrows challenges. Currently, unfortunately, this is not happing. The boundary resources are evaluated by industry experts by means of a Multi Criteria Decision Analysis, using the Best-Worst Method.","Digital Platform; Healthcare; Boundary Resources; MCDA; BWM","en","master thesis","","","","","","","","","","","","Complex Systems Engineering and Management (CoSEM)","",""
"uuid:0bb60b54-e7f8-4cb0-9e78-d7e223c1b31e","http://resolver.tudelft.nl/uuid:0bb60b54-e7f8-4cb0-9e78-d7e223c1b31e","Transparent Decision Support in ever-changing healthcare contexts: Designing an architecture of a transparent and dynamic Clinical Decision Support System grounded in Discrete Choice Modeling","Schrama, Verena (TU Delft Technology, Policy and Management)","de Reuver, G.A. (mentor); Kortmann, L.J. (graduation committee); Chorus, C.G. (graduation committee); Delft University of Technology (degree granting institution)","2021","Every day physicians make choices on clinical treatment that directly influence patients’ well-being. To deal with these critical decisions and avoid treatment errors and costs, physicians show a growing interest in Clinical Decision Support Systems (IDSS). Current CDSSs, however, suffer from limited transparency and flexibility, which gives rise to ethical concerns when applied in healthcare environments. A novel CDSS approach overcomes these limitations: Behavioral Artificial Intelligence (BAIT). However, a BAIT-based CDSS is not yet capable of incorporating new clinical developments to keep its recommendations accurate over time. Because healthcare decision-making is highly dynamic, the static BAIT-based CDSS needs a transformation into a dynamic BAIT-based CDSS that retains its accuracy and, therefore, clinical relevance over time. However, the preferences regarding a dynamic BAIT-based CDSS vary among healthcare decision-making contexts. Therefore, CDSS developers need an architecture that illustrates how to create and customize a dynamic BAIT-based CDSS that matches physicians' preferences in a particular healthcare context. Because designing these architectures is challenging, this research aims to formulate design principles that guide the design of dynamic BAIT-based CDSS architectures. By following the Action Design Research (ADR) framework, this research identified and tested a set of architecture requirements by building an architecture in a situated problem context. The generalization of the requirements that worked in a situated context resulted in ten design principles guiding the design of a dynamic BAIT-based CDSS architecture. The greater part of the design principles is specific to the design of a dynamic BAIT-based CDSS architecture. By providing these novel insights, the design principles contribute to the CDSS architecture design knowledge base. The research also contributes to CDSS architecture design knowledge because it tackles the challenges of designing a dynamic BAIT-based CDSS architecture. By doing so, the research outcomes eliminate the barriers to design such an architecture and lay a foundation to continue the work on transparent and dynamic CDSSs. The findings highlight new design challenges for further research, like designing a dynamic BAIT-based CDSS architecture with the ten design principles in another sector to investigate how to modify the design principles, so the principles are useful outside the healthcare sector.","Clinical Decision Support Systems; Discrete Choice Modeling; System Architecture; Design Science Research; Action Design Research; Healthcare decision-making; Behavioral Artificial Intelligence Technology","en","master thesis","","","","","","","","","","","","Complex Systems Engineering and Management (CoSEM)","",""
"uuid:aa6cf728-6b30-4a0d-9d86-138cb10b26ce","http://resolver.tudelft.nl/uuid:aa6cf728-6b30-4a0d-9d86-138cb10b26ce","The LVATE brace as a tool to delay total knee replacement surgery for patients with knee arthritis","Van Steen, Elien (TU Delft Industrial Design Engineering; TU Delft Sustainable Design Engineering)","Jansen, A.J. (mentor); Albayrak, A. (mentor); Ruiter, I.A. (mentor); Delft University of Technology (degree granting institution)","2021","During the course of this thesis, the design of a knee brace that improves the quality of life for people with arthritis in the knee, is being researched. The knee joint is covered with articular cartilage which protects the bones from being damaged. Arthritis of the knee is a pathology where this cartilage is damaged potentially even to the extent that direct bone-to-bone contact occurs. The most common symptoms for the patient are pain and inflammation, affecting their mobility and quality of life. Firstly, research is conducted on the arthritis knee disorder, the patients and their interests, and the technical aspect of a knee brace in relation with the knee kinematics. The following main insights are revealed by the analyses: -Arthritis in the knee is wear and tear of the articular cartilage caused by loading. This can be the result of extensive sports, overweight, incorrect alignment of the joint or aging. -There are no treatments available that cure the damaged cartilage tissue. It is in the patient’s interest to slow down the deterioration process. When the disorder impacts the quality of life too much, replacement surgery can be opted for. -Replacement surgery is the last resort option due to its invasiveness, possible complications and high rate of dissatisfied patients. It is therefore preferred to delay the need for a surgery if possible. -The deterioration process can be slowed down by exposing the knee joint to less load. Partially unloading the joint can be beneficial during demanding activities or even daily activities, depending on the stage of arthritis. -A customized fit of the knee brace is preferred for increased comfort and effectiveness. Secondly, during the development phase, two main challenges are explored, being the custom fit of the brace and the unloading mechanism. To make a perfectly fitting brace design, many mock-ups are created and evaluated on their comfort and secure fit. The insights are translated into a standard model that can be shaped around the patient’s 3D scan of the leg. This experimental approach is also applied to find an unloading mechanism that can be integrated in the brace. The concepts are tested by attaching them to the brace mock-ups that were created when exploring the perfect fit. Thirdly, a design proposal is created, resulting in the LVATE brace that can be integrated in Orthobroker’s product-service platform. During the patient’s appointment with an orthotist, a 3D scan of the leg is made and uploaded to a digital platform. The platform morphs the LVATE brace around the 3D scan in such a way that it distributes pressure among tolerant zones of the leg. The brace can then be ordered right away. The unloading mechanism is activated by rotating a knob that is positioned on the lateral side of the brace. Finally, the brace is evaluated on its feasibility, desirability and viability. A conclusion is derived from the evaluation feedback and recommendations are prepared for a further development of the design proposal.","3D Printing; Additive Manufacturing; osteoarthritis; Healthcare; orthoses; Orthopaedic; Product Design","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:b68ff161-2f62-4858-9dec-45cafbc46d98","http://resolver.tudelft.nl/uuid:b68ff161-2f62-4858-9dec-45cafbc46d98","3D printing for Frugal Innovation in Kenya: the design of a hand grip tool","Kelly, Jordan (TU Delft Industrial Design Engineering)","Huysmans, T. (mentor); Persaud, S.M. (graduation committee); Delft University of Technology (degree granting institution)","2021","This thesis is concerned with exploring just how to develop products in line with this frugal methodology through the case study of a hand exerciser. This main research question for this design project asks to what extent can FDM 3D printing be applied to assist Kenyan occupational therapists in the provision of therapy to individuals with hand dexterity and strength challenges. This self-initiated graduation project is being completed in collaboration with Kijenzi (www.kijenzi.com) - a design and manufacturing company based in Kenya. Kijenzi is using additive manufacturing technology to produce products locally using low-cost FDM 3D printers. Research into the context of occupational therapy, additive manufacturing, and the context of Kenya revealed the following key insights: Professionals in Kenya do not have access to suitable tools because of their high associated cost and the challenges involved in importing the products and distributing them into rural locations. Traditional hand exercisers can have drawbacks that hinder patient recoveries. 3D printing is a laborious process and partially digitizing the process could lower production costs. Occupational therapists require products in a large range of sizes and strengths to suit the individual needs of their patients. This could be achieved in a product customising system. The synthesis of the insights gained in the research activity created an envisioned scenario which involved a product/service/system scope. In this scenario, patients can exercise their hands safely in a purposeful way with a meaningful outcome. Healthcare professionals would be empowered to order customised products from the manufacturing company by means of an online product customiser. The manufacturer would then be able to produce these customised goods in a way that minimises the cost of doing so. A list of requirements, design drivers, and design challenges were prepared as support to design activity. The HandBand product, service, system (PSS) concept is a holistic structure which affords the provision of patient-specific hand therapy. Through the use of the 3D-printed therapy device, an online configurator, and a production system, the concept’s full design articulation is achieved in a low-cost and feasible manner. The three-part proposition aims to provide impact for key stakeholders in both the Kenyan healthcare picture and the Kijenzi context. Six levels of the European Space Agency’s Technology Readiness Level were followed to embody these design proposals. The ultimate validation in this involved a test of the 3D-printed product in a clinical setting in Kenya. The outcome of this evaluation for the product was clear and decisive: the occupational therapist confirmed that the HandBand had made a significant contribution to the recoveries of multiple patients. The hand exerciser was a marked improvement to the current equipment and tools available in the hospital. Conclusions were derived from the feedback in the final chapter. Finally, recommendations were prepared for the development of the design proposal in future.","3D Printing; Product Design; therapy; Frugal innovation; additive manufacturing; healthcare; LMI","en","master thesis","","","","","","","","","","","","Integrated Product Design","","-0.091702, 34.767956"
"uuid:d30d81d5-79b4-4893-8fd6-623c38a9aee0","http://resolver.tudelft.nl/uuid:d30d81d5-79b4-4893-8fd6-623c38a9aee0","Developments of assisted living facilities for mentally disabled people from the interbellum period until present day: Towards the transition of assisted living facilities for mentally disabled people from healthcare institutions to a real home","van der Pijl, Bing (TU Delft Architecture and the Built Environment; TU Delft History & Complexity)","Teunissen, M.M. (mentor); Delft University of Technology (degree granting institution)","2021","Over the course of the 20th century, healthcare in general has seen many beneficial developments (e.g. medicine, procedures, hygiene etc.) However, when looking at assisted living facilities for mentally disabled people, a development towards an environment that largely resembles hospitals can be observed (den Duik 2015). Since the main purpose of these institutions is not to heal but to accommodate, the question arises how these institutes can strive to provide a real home for its inhabitants. This thesis presents several design considerations that may serve useful within the design process to aid into reaching this goal. These considerations are based on studying the Thomashuizen concept which was initiated by Hans van Putten with the same goal in mind. This concept is compared to the Rudolf Steiner clinic as a historical precedent from the interbellum period which is known to deviate from other historical conventional examples. After a thorough analysis, the concepts of scale, context, image and pragmatism were identified as aspects that could be considered when designing an institute that provides assisted living for mentally disabled people. A small scale may be adapted to provide a family community and more attention per inhabitant, the typologies of the farmhouse and the mansion complement this scale and fit into either the urban or rural context, while at the same time they carry the image of a home. Furthermore a pragmatic approach can be used to design space syntax in order to avoid complex interventions and thereby harming the overall image of a building.","AR2A011; Healthcare architecture; Assisted living; Mentally disabled people","en","student report","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","AR2A011",""
"uuid:8bd19597-09eb-4166-87bd-f428b625b929","http://resolver.tudelft.nl/uuid:8bd19597-09eb-4166-87bd-f428b625b929","Healing Oncology: The impact of the physical medical environment on the wellbeing of cancer patients and their relatives","van Benten, Ties (TU Delft Architecture and the Built Environment)","Stuhlmacher, M.E. (mentor); van de Voort, J.A. (graduation committee); Sioli, A. (graduation committee); Delft University of Technology (degree granting institution)","2021","Our hospitals will start to get larger and larger as the number of people on this earth will rise. Due to medical solutions our stays in these hospitals will get shorter as we can cure ourselves from diseases. But as we are getting older, we will spend more time in the hospital. The paradox of healing from diseases and becoming more and more dependent on the medical environment in order to heal causes the need of the hospital as a welcoming and comforting place to becomes more and more meaningful. Experiences of patients and their relatives showed that dealing with disease can be all consuming, while at the same time ‘normal’ life goes on. “I am in the hospital even when I’m not in the hospital” said Clara (Mukherjee. The Emperor of All Maladies, 398). Living in these two worlds at the same time can be hard to bear and I think we can have an influence on that as an architect. It is up to the architect to bring these worlds together. Daily life should not stop the moment you end up in the medical environment. As I just stated, the medical environment will increasingly become part of our lives. It is therefore essential that we design the medical environment to our wishes of “normal” life and not to create a second world in which medical knowledge is placed first and us as humans second.","Healthcare architecture; Healing Environments; Architectural design","en","master thesis","","","","","","https://tiesvanbenten.com/Oostbroek-Healthcare-Centre","","","","","","Architecture, Urbanism and Building Sciences | Explorelab","","52.091338, 5.185693"
"uuid:9e58a6b2-8a18-4c27-b677-ce4b448e3d6f","http://resolver.tudelft.nl/uuid:9e58a6b2-8a18-4c27-b677-ce4b448e3d6f","A typological analysis of temporary medical structures before and during the Covid-19 pandemic: How can design help us to deal with situations of crisis and emergency?","Grünewald, David (TU Delft Architecture and the Built Environment)","Teunissen, M.M. (mentor); Delft University of Technology (degree granting institution)","2021","In situations of crisis, regular hospitals often do not longer suffice the high demand for medical care. In this case, temporary medical structures become indispensable. The Covid 19 pandemic brought to the fore architectural challenges such as the spatial reorganization of healthcare facilities for high occupancy levels, the issue of infection control, the integration of new technologies, and the flexible and sustainable use of space. As a result, planners were urged to think about flexible and adaptable structures that were efficient in terms of materials, time, effort, and cost. This resulted in innovative solutions from which we can learn for future crisis and emergency situations.
The goal of this thesis is to create a ""catalogue"" of design strategies within the typology of temporary medical structures that can be applied to future projects during the Covid 19 pandemic but can also be applied to other scenarios where requirements overlap. Therefore, temporary medical structures before and during the Covid 19 pandemic will be embedded in their broader context and examined according to specific parameters. These parameters revolve around hygiene, psychological aspects, program, technology, and the architectural context. The analysis of the case studies is based on publications, articles, statements, and interviews with healthcare professionals. In this way, the reader is provided with an in-depth overview of strategies that can be implemented in temporary medical structures to solve challenges posed by crisis and emergency situations.","AR2A011; Covid-19 pandemic; Temporary medical structures; Medical architecture; Healthcare architecture; temporary architecture","en","student report","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","AR2A011",""
"uuid:71de5371-4610-465b-bba5-6af0b31521c8","http://resolver.tudelft.nl/uuid:71de5371-4610-465b-bba5-6af0b31521c8","The Digital Entrance for Primary Care: Translating patients’ and caregivers’ needs into a new way to interact and connect","Schut, Lennart (TU Delft Industrial Design Engineering)","Simonse, LWL (mentor); van Heur, R.J.H.G. (graduation committee); Kattenberg, Kit (graduation committee); Delft University of Technology (degree granting institution)","2021","The current pandemic has drastically changed the primary care field. Suddenly, GP practices had to implement more digital or ‘care at a distance’ methods to keep interacting with patients. This was reflected by the strong increase in telephone consults and practices that used video calling for the first time. However, the sudden digital experience is not welcomed with open arms by patients and caregivers. 47% of the patient express that they are not positive about ‘care at a distance’ modalities (Meurs, 2020b), and approximately only a quarter of caregivers want to intensify e-consultation methods after the pandemic (Keuper, 2020). It is quite likely that after this pandemic, both groups return to the previous status quo, regardless of the benefits that eHealth and e-consultation can provide. The goal of this graduation project was to increase the adoption of e-consultation in primary care together with IZER. The graduation project followed the roadmapping process, starting with an analysis consisting of a literature study, qualitative interviews, and observations. During the research, caregivers and patients were thoroughly analysed to search for trends and wishes about (digital) primary care. The major discovered trends were the need for higher efficiency in the process due to the high effort of digitalisation, the demanded shift in control to the patient, the need for accessibility for the patient, the wish for digital to support the process, and the need for good communication. The result is DagKo: the Data-driven complaint support for patients in primary care (Data-gedreven Klacht Ondersteuning). DagKo is a software service that supports patients to do their triage independently and guides them towards the best next step concerning their complaint and medical history. The service uses data from previous patients with similar situations to analyse the most efficient and effective methods in a specific situation. Additionally, new consultation options are added to enhance the right care in the right situation. These additions consist of a data-driven virtual doctor, a monitoring program and a quickly accessible doctor service. The needs and wishes of the patients and caregivers were translated into DagKo. The software provides increased accessibility and control for the patients. It is an app that listens carefully to the user and gives options for the best suitable care. Because of the smart use of data, caregivers will be supported with suitable advice during their triage. Caregivers just have to confirm the suggested modality. This will result in an increase in efficiency for the caregivers, letting them give more attention to patients that need it by spending less time on simple situations. During the user-testing, patients experienced the two characteristics of the concept, the option to choose and data-driven advice based on effectiveness and efficiency, as positive. The additional modalities were ranked relatively positively, but due to the futuristic aspects were also harder to grasp. Caregivers also expressed support for the concept of DagKo. The caregiver acknowledged the potential of the gain in efficiency and it was recognized that the service is especially useful for filtering easier complaints.","Primary care; General practitioner; Medical decision support system; Patient; Patient-centred; Healthcare Design; Patient journey; Caregiver","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:478f2651-c351-4460-a817-f06468ecfdfd","http://resolver.tudelft.nl/uuid:478f2651-c351-4460-a817-f06468ecfdfd","SLOWLY: A digital reflection tool to help Dutch nurses tell their story.","Sabée, Merijn (TU Delft Industrial Design Engineering; TU Delft Design Aesthetics)","Ozcan Vieira, E. (mentor); Vegt, N.J.H. (mentor); Delft University of Technology (degree granting institution)","2021","The extraordinary working conditions caused by the first wave of COVID-19 patients caused stress, anxiety and lack of sleep in frontline nurses. This negatively impacted their psychological well being which is important for providing optimal care and maintaining long-term employability (Schoonhoven & Trappenburg, 2020). There is a lack of accessible and low-threshold support tools such as online peer support platforms for nurses. While storytelling driven online peer support is a promising tool, it is unclear how it should be designed. This project aimed to design a storytelling tool, specific to the psychological needs of the Dutch nurses, that best facilitates online peer support. This report describes the research, design and evaluation activities as part of the design process of SLOWLY - A tool that helps nurses reflect on their experiences, preparing them to write a story to be shared as part of online peer support. A context and target group analysis lead to the assessment of the thirteen fundamental needs (Desmet & Fokkinga, 2020). Fulfilment of autonomy, competence and relatedness, as part of self determination theory (Deci & Ryan, 2000), was found to be critically low. This was the primary source for the design requirements of SLOWLY. After using the design requirements to access a wide variety of design interventions, SLOWLY proved to be the most promising concept due to its potential to provide understanding about an experience in an accessible, low-threshold and safe manner. A detailed digital prototype was created, which used five storytelling prompts (character, setting, plot, conflict and theme) to guide nurses in a five day reflection process. Their responses were shown to them during the writing process to help them write stories with more details relevant to their experience. SLOWLY was found to provide increased understanding of the experience based on user testing with seven participants. It showed potential to fulfil all three critically affected fundamental needs. An additional expert review with one nurse yielded a positive response to the likeability, ease of use, clarity and benefit of SLOWLY. The results of this project provided insight into the potential role of storytelling in facilitating online peer support for nurses. Further research is recommended to evaluate longitudinal effects and possible interactions as a result of story sharing.","Nurses; Healthcare; Reflection; Well-being; Peer support","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:0fa88eaa-ef57-43d7-9312-ed82876da5fe","http://resolver.tudelft.nl/uuid:0fa88eaa-ef57-43d7-9312-ed82876da5fe","Towards Digital Twins in Healthcare: How would a meaningful Digital Twin for the user look like?","Strasser, Carla (TU Delft Industrial Design Engineering)","Bos-de Vos, M. (mentor); Mulder, S.S. (graduation committee); de Boer, Bas (graduation committee); Delft University of Technology (degree granting institution)","2021","Healthcare is starting to change fundamentally. One of the disruptive technologies that can be seen as an enabler for this change is the technology of a Digital Twin (DT). A DT is widely adopted in the field of engineering for predictive maintenance and testing of parameters of physical objectives such as engines to increase the effectiveness and optimize processes. A DT consists of three major factors: a physical object, its virtual representation and a continuous data stream between the two. In the healthcare sector this could mean to represent not an engine but a whole human with the potential goal for predicting a disease, taking necessary actions for prevention or identifying optimal treatments. This could shift the current underlying paradigm in medicine of curing a disease towards preventing a disease. The extent of representing a whole human body with this technology is still only a vision, but first steps towards this concept have been taken. This development may come with a lot of responsibility so that a user-centered perspective needs greater attention. This thesis aimed at unraveling users’ values for a meaningful DT as innovative technology. By using the concept of Responsible Research in Innovation (RRI), I addressed the importance of grasping, anticipating, and evaluating the potential impact of a DT on the individual interview partners. In a first step, I identified the field of diagnosis as a central research topic with high importance for the user. The semi-structured interviews were conducted with a focus on the context of diagnosis and followed a practice-based approach of Interpretative Phenomenological Analysis (IPA). This allowed me to explore underlying values from the past into the future of diagnosis with and without DTs. A six-step analysis approach proposed by IPA led to the discovery of values embedded in the (anticipated) experience of diagnosis of the interviewees. Finally, the findings led to the development of different forms or concepts a DT could take. These are meant to start a reflection. The findings showed that the meaningfulness of a DT may change significantly by age, life situation, preferences or also individual personality. In contrast to current company visions which visualize a DT as dashboard overview of the human, I assumed that this may lead to an objectification of the body and might rather support the development of an alienate feeling. Furthermore, it might be that the possibility of constant confrontation of one’s own objective status of the body might rather have negative effects on the individual. Additionally, time, place and frequency an individual interacts with a DT seemed to play an important role and should be reflected upon. In order to complement the development of a more user-centered and meaningful DT, I concluded this work with nine guidelines that can be a starting point for further reflection on responsible innovation of a DT. Taken together, I showed that meaningfulness of a DT is highly variable and would need a dynamic, personalized approach to create and implement a meaningful and responsible innovation for the user.","Digital Twin; Healthcare; Responsible Research and Innovation","en","master thesis","","","","","","","","","","","","Strategic Product Design","Pride and Prejudice",""
"uuid:79b71f4a-034c-42cd-92a8-bf44a084eb7c","http://resolver.tudelft.nl/uuid:79b71f4a-034c-42cd-92a8-bf44a084eb7c","The role of cybersecurity in hospital procurement processes","van Baren, Rutger (TU Delft Technology, Policy and Management; TU Delft Organisation and Governance)","van Eeten, M.J.G. (mentor); Labunets, K. (graduation committee); van de Poel, I.R. (graduation committee); Delft University of Technology (degree granting institution)","2021","Cybersecurity is important to hospitals and patients alike and is becoming more important as healthcare is experiencing more cybercrime over time. It is the result of complex interactions between actors and their environment during procurement, but research has not yet studied the combination of cybersecurity, healthcare and procurement together. The main research question is: What is the role of cybersecurity in hospital procurement processes and how can that role be analysed across the sector? Nine semi-structured interviews were conducted with hospital cybersecurity experts. Using a combination of a purchase process model and complex decision-making framework and using semi-grounded theory techniques for analysis, five key factors and their interrelations were identified: supplier-hospital relationship, knowledge exchange and retention, alternative purchase processes, cloud transition and conflicting priorities. These factors influence the decision power of hospitals and their internal departments before and after signing off on a purchase. Based on the results, a complementary survey was developed to scale this research across Dutch hospitals. This survey serves as a stepping stonet for future research efforts.","cybersecurity; procurement; healthcare","en","master thesis","","","","","","","","2022-01-26","","","","Complex Systems Engineering and Management (CoSEM)","",""
"uuid:0e21ebae-057d-49c7-9000-f14244c8c8c5","http://resolver.tudelft.nl/uuid:0e21ebae-057d-49c7-9000-f14244c8c8c5","Robust needle channel planning for patient-tailored applicator design in cervical cancer brachytherapy","Straathof, Robin (TU Delft Mechanical, Maritime and Materials Engineering)","van de Berg, N.J. (mentor); Dankelman, J. (mentor); Kolkman-Deurloo, I.K.K. (graduation committee); Alonso Mora, J. (graduation committee); Wang, C.C. (graduation committee); Delft University of Technology (degree granting institution)","2021","Brachytherapy (BT) is an essential component in the treatment of cervical cancer as it allows for locally delivering a high dose to the tumour with minimal trauma to surrounding tissues and organs at risk (OARs). However, in advanced cervical cancer patients commercially available BT applicators are particularly ill-adapted and therefore result in suboptimal local control and frequent occurrence of substantial tissue morbidity. Additionally, cervical cancer BT is associated with large dosimetric uncertainty which has been shown to significantly impact the delivered dose and the occurrence of normal tissue complications. The clinical outcomes of treatment may be improved through combined efforts in sophisticated applicator design and robust treatment optimisation. Patient-tailored BT applicators have been introduced to improve dose conformity, but currently rely on manual indication of needle channels. Automated needle channel planning software exists, but does not account for OAR dose constraints or uncertainty in planning. Robust treatment optimisation potentially improves the dose conformity of plans in the presence of uncertainty, but relies on the questionable presumption that optimisation of dwell times can fully correct for suboptimal dwell positions. In this thesis, the freedom of source placement that 3D-printed applicators allow and the principle of robust treatment optimisation are leveraged to develop robust needle channel planning software for personalised applicators. This thesis was accordingly divided into three parts. In the first part, literature was reviewed to establish the dosimetric uncertainty budget and evaluate geometric uncertainty of OARs. Inter and intra-fraction uncertainty are likely the greatest contributors to the uncertainty budget, possibly increasing the delivered dose to OARs with up to 4.0±20% (k = 1). Using dose-response models it was established that this may realistically increase the occurrence of moderate to severe morbidity of the bladder or rectum by 1.5 and 3.7% respectively. The BT needle channel planning problem under uncertainty was accordingly defined as the problem of computing multiple feasible, non-intersecting curvature- constrained channels under probabilistic or bounded spatial uncertainty of OARs. In the second part, a tool termed motion-planning quality function deployment (MP-QFD) was developed to select a suitable motion planning class. Using the results from a pilot study among nine medical specialists, this tool substantiated the preferred choice for an incremental sampling-based motion planning algorithm. In the last part, robust variants of sampling-based planners were introduced that are capable of computing trajectories for non-holonomic agents in environments under uncertainty. In a two-dimensional simulated patient case, it was shown that these planners were able to generate near-optimal trajectories that (probabilistically) guaranteed not exceeding OAR dose constraints. Subsequent dose-based optimisation showed that (robust) trajectory planning could theoretically yield treatment plans with improved dose conformity over those generated for conventional applicators. Due to modelling assumptions, robust motion planning did not result in improved dose conformity over a nominal motion planning approach in a worst-case scenario. Future work should therefore focus on improving our understanding of OAR movement in and during BT treatment and validating this theoretical work in a patient case series.","Brachytherapy; Cervical cancer; Personalised healthcare; Robust optimization; Uncertainty quantification; QFD","en","master thesis","","","","","","","","2023-01-26","","","","Mechanical Engineering | BioMechanical Design","",""
"uuid:bf72d02c-014f-4e07-aa23-69edd29a696c","http://resolver.tudelft.nl/uuid:bf72d02c-014f-4e07-aa23-69edd29a696c","Minimally Invasive Sentinel Lymph Node Biopsy: Finding a less invasive alternative to an existing procedure","Joosen, Max (TU Delft Mechanical, Maritime and Materials Engineering)","van den Dobbelsteen, J.J. (mentor); Mulder, E.E.A.P (mentor); de Vries, M. (graduation committee); Plettenburg, D.H. (graduation committee); Grünhagen, D.J. (graduation committee); Delft University of Technology (degree granting institution)","2021","Sentinel lymph node biopsy (SLNB) is a procedure that is used to determine the stage of disease of melanoma patients and determine further treatment. However, the morbidities accompanied with this procedure are not negligible (e.g., wound infection, lymphoedema and seroma). With the goal reduce the incidence of morbidities, this thesis investigated the possibility of minimally invasive sentinel lymph node biopsy (MISLNB). Preceding this thesis, a literature study was written by the writer of this thesis to examine whether there was already a possible solution for this problem. This literature study showed that there are no off the shelf available solutions for MISLNB. Therefore, three solution with the reduction of comorbidities and the importance of \textit{en bloc} excision at their core were proposed. These solutions were found through literature, patents, and some ingenuity. The solution with the highest probability was selected to develop further. This concept was then subjected to different experiments to determine whether it was viable option for MISLNB. This study also aimed to fill some of the missing data on the material behaviour of lymph nodes (LN), specifically stress-strain behaviour under compression. By using a set of requirements one solution was selected to be the most viable given the available information. This solution was called the Pull-and-Harvest method. This concept uses a vacuum to grip the sentinel lymph node (SLN) and stash it in a tube, hereafter a snare would cut the lymph ducts and blood vessels. This concept scored well mainly due to the low risk of damaging SLN and its simplicity. The next step was to determine whether this concept was a feasible solution to MISLNB. The problem was divided into three subproblems to estimate this feasibility. The first being the force required to separate the SLN from its surrounding tissue. Since no data on this subject was available a simplified model was created to estimate this value based on the stretch of lymph ducts. The second part of this problem was, determining the force required to stash the SLN inside the tubular volume. Finally, the maximal force of two silicon suction cups was determined. From these experiments several conclusions could be drawn: the conical silicon suction cups used in this study are very inefficient (10%) efficiency) for gripping LNs, these suction cups will stash the LNs but probably not with the additional estimated adherence force and the risk of damaging the LN using a vacuum seems to be low. Based on these observations during these experiments possible ways of were suggested and could make the Pull-and-Harvest a viable procedure. Lastly stress-strain behaviour of LNs could be described using an exponential relationship. This thesis outlines the problem of MISLNB and highlights the areas of interest for further research. However, there is more research and development needed to find a definitive solution for MISLNB.","sentinel lymph node; minimally invasive surgery; minimally invasive; vacuum; Medical instrument; biopsy; suction cup; lymph node; Design for healthcare; gripper","en","master thesis","","","","","","","","2023-01-21","","","","","",""
"uuid:d223fe3c-21f2-4c89-b762-30fbe6ba214f","http://resolver.tudelft.nl/uuid:d223fe3c-21f2-4c89-b762-30fbe6ba214f","Designing Depression Screening Chatbots","Giunti, Guido (TU Delft Applied Ergonomics and Design; Oulu University); Isomursu, M. (Oulu University); Gabarron, E. (Norwegian Centre for E-health Research); Solad, Y. (Yale New Haven Health, New Haven)","Honey, Michelle (editor); Ronquillo, Charlene (editor); Lee, Ting-Ting (editor); Westbrooke, Lucy (editor)","2021","Advances in voice recognition, natural language processing, and artificial intelligence have led to the increasing availability and use of conversational agents (chatbots) in different settings. Chatbots are systems that mimic human dialogue interaction through text or voice. This paper describes a series of design considerations for integrating chatbots interfaces with health services. The present paper is part of ongoing work that explores the overall implementation of chatbots in the healthcare context. The findings have been created using a research through design process, combining (1) literature survey of existing body of knowledge on designing chatbots, (2) analysis on state-of-the-practice in using chatbots as service interfaces, and (3) generative process of designing a chatbot interface for depression screening. In this paper we describe considerations that would be useful for the design of a chatbot for a healthcare context.","artificial intelligence; chatbots; conversational agents; depression; healthcare; machine learning; mHealth; natural language processing","en","conference paper","IOS Press","","","","","","","","","","Applied Ergonomics and Design","","",""
"uuid:df61c4fc-36bb-4a3b-ab0f-9e0176327c45","http://resolver.tudelft.nl/uuid:df61c4fc-36bb-4a3b-ab0f-9e0176327c45","On intimate relationships between healthcare professionals and patients: a nationwide cohort analysis of medical tribunal decisions in the Netherlands","Rietdijk, Wim (Erasmus MC); Renes, Sander (TU Delft Economics of Technology and Innovation; Erasmus Universiteit Rotterdam)","","2021","Background: We examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions. Methods: We conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017. Results: We found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an alleged intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups. Conclusions: We found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients.","Inappropriate sexual conduct; Medical disciplinary actions; Medical doctors & healthcare professionals; Professional behavior","en","journal article","","","","","","","","","","","Economics of Technology and Innovation","","",""
"uuid:2ac2f8cb-52fb-451c-84c1-3ad8e4988b86","http://resolver.tudelft.nl/uuid:2ac2f8cb-52fb-451c-84c1-3ad8e4988b86","Constructing a mutually supportive interface between ethics and regulation","Delacroix, Sylvie (The Alan Turing Institute); Wagner, Ben (TU Delft Organisation & Governance)","","2021","When the word 'ethical' becomes synonymous with specious, you know that something is amiss. With each data governance scandal, with each creation of a corporate 'ethics board', 'ethical standards' seemingly lose a few more feathers, to the point of generating instant suspicion when invoked in any official report. We argue that a key challenge in this regard is to more precisely define the ethics-regulation interface. In order to do this, we first provide an overview of recent endeavours to develop ethical frameworks around technology. We then look at a successful process of refinement of the ethics-regulation interface: the case of healthcare ethics in the UK. The third section develops an account of what a more robust ethics-regulation interface could look like, which would support a process of cross-fertilisation between the political, ethical and legal approaches. Finally, the fourth and last section critically examines a ‘live’ implementation of such ethics-regulation interface, as put forward in Quebec's ‘Bill 29′.","Healthcare ethics; Regulation and governance; Technology ethics","en","journal article","","","","","","","","","","","Organisation & Governance","","",""
"uuid:f00f8aa8-6fd5-4b61-9505-318cfb8df0f3","http://resolver.tudelft.nl/uuid:f00f8aa8-6fd5-4b61-9505-318cfb8df0f3","Systems approaches to healthcare systems design and care delivery: An overview of the literature","Komashie, Alexander (University of Cambridge); Hinrichs-Krapels, S. (TU Delft Multi Actor Systems; TU Delft Policy Analysis); Clarkson, P.J. (TU Delft Applied Ergonomics and Design; University of Cambridge)","","2021","The healthcare sector is facing significant challenges that require a systems approach, resulting in a rapid growth in the application of systems approaches in healthcare since the beginning of the 21st century. Consequently, healthcare practitioners and policymakers now desire to understand the evidence-base for the approach, but little evidence of the kind desired exists. This paper is a first step in conducting a narrative review of the application of systems approaches in healthcare based on a systematic review of the academic and grey literature. First, the emergence of the approach in healthcare is explored. Second, specific examples of applications of systems approaches in healthcare are examined to identify any missing elements in current practice. Third, fourteen reviews of the approach in healthcare published in the last ten years are analysed. The results suggest that the use of the approach in healthcare will most likely continue to increase, however, significant work remains for the design and systems community to demonstrate the effectiveness of systems approaches, specifically in providing convincing measures of impact on patient and service outcomes.","Design engineering; Healthcare design; Healthcare quality improvement; Service design; Systems Engineering (SE)","en","journal article","","","","","","","","","","Multi Actor Systems","Policy Analysis","","",""
"uuid:e489cb7e-8ef0-4b73-a423-37f846f2840c","http://resolver.tudelft.nl/uuid:e489cb7e-8ef0-4b73-a423-37f846f2840c","A healthy debate: Exploring the views of medical doctors on the ethics of artificial intelligence","Martins Martinho Bessa, A.C. (TU Delft Transport and Logistics); Kroesen, M. (TU Delft Transport and Logistics); Chorus, C.G. (TU Delft Transport and Logistics)","","2021","Artificial Intelligence (AI) is moving towards the health space. It is generally acknowledged that, while there is great promise in the implementation of AI technologies in healthcare, it also raises important ethical issues. In this study we surveyed medical doctors based in The Netherlands, Portugal, and the U.S. from a diverse mix of medical specializations about the ethics surrounding Health AI. Four main perspectives have emerged from the data representing different views about this matter. The first perspective (AI is a helpful tool: Let physicians do what they were trained for) highlights the efficiency associated with automation, which will allow doctors to have the time to focus on expanding their medical knowledge and skills. The second perspective (Rules & Regulations are crucial: Private companies only think about money) shows strong distrust in private tech companies and emphasizes the need for regulatory oversight. The third perspective (Ethics is enough: Private companies can be trusted) puts more trust in private tech companies and maintains that ethics is sufficient to ground these corporations. And finally the fourth perspective (Explainable AI tools: Learning is necessary and inevitable) emphasizes the importance of explainability of AI tools in order to ensure that doctors are engaged in the technological progress. Each perspective provides valuable and often contrasting insights about ethical issues that should be operationalized and accounted for in the design and development of AI Health.","Artificial intelligence; Ethics; Healthcare; Medicine; Q-methodology","en","journal article","","","","","","","","","","","Transport and Logistics","","",""
"uuid:19accd03-26f8-4f94-81a6-ed9cc698b34b","http://resolver.tudelft.nl/uuid:19accd03-26f8-4f94-81a6-ed9cc698b34b","Criteria for recommendations after perioperative sentinel events","Bos, Kelly (Universiteit van Amsterdam); Dongelmans, Dave A. (Universiteit van Amsterdam); Groeneweg, J. (TU Delft Safety and Security Science; Universiteit Leiden); Legemate, Dink A. (Universiteit van Amsterdam); Leistikow, Ian P. (Erasmus Universiteit Rotterdam); Van Der Laan, Maarten J. (University Medical Center Groningen)","","2021","Background The recurrence of sentinel events (SEs) is a persistent problem worldwide, despite repeated analyses and recommendations formulated to prevent recurrence. Research suggests this is partly attributable to the quality of the recommendations, and determining if a recommendation will be effective is not yet covered by an adequate guideline. Our objectives were to (1) develop and validate criteria for high-quality recommendations, and (2) evaluate recommendations using the criteria developed. Methods (1) Criteria were developed by experts using the bowtie method. Medical doctors then determined if the recommendations of Dutch in-hospital SE analysis reports met the criteria, after which interobserver variability was tested. (2) Researchers determined which recommendations of Dutch perioperative SE analysis reports produced from 2017 to 2018 met the criteria. Results The criteria were: (1) a recommendation needs to be well defined and clear, (2) it needs to specifically describe the intended changes, and (3) it needs to describe how it will reduce the risk or limit the consequences of a similar SE. Validation of criteria showed substantial interobserver agreement. The SE analysis reports (n=115) contained 442 recommendations, of which 64% failed to meet all criteria, and 28% of reports did not contain a single recommendation that met the criteria. Conclusion We developed and validated criteria for high-quality recommendations. The majority of recommendations did not meet our criteria. It was disconcerting to find that over a quarter of the investigations did not produce a single recommendation that met the criteria, not even in SEs with a fatal outcome. Healthcare providers have an obligation to prevent SEs, and certainly their recurrence. We anticipate that using these criteria to determine the potential of recommendations will aid in this endeavour.","healthcare quality improvement; incident reporting; never events; patient safety; root cause analysis","en","journal article","","","","","","","","","","","Safety and Security Science","","",""
"uuid:638c7d78-d4f5-4c2b-a4d2-a327a2ecc452","http://resolver.tudelft.nl/uuid:638c7d78-d4f5-4c2b-a4d2-a327a2ecc452","Midwives’ experiences with and perspectives on online (Nutritional) counselling and mhealth applications for pregnant women; an explorative qualitative study","Wit, Renate F. (Wageningen University & Research); Lucassen, Desiree A. (Wageningen University & Research); Beulen, Yvette H. (Wageningen University & Research); Faessen, Janine P. M. (Wageningen University & Research); Bos-de Vos, M. (TU Delft Methodologie en Organisatie van Design); van Dongen, Johanna M. (Vrije Universiteit Amsterdam); Feskens, Edith J. M. (Wageningen University & Research); Wagemakers, Annemarie (Wageningen University & Research); Brouwer-Brolsma, Elske M. (Wageningen University & Research)","","2021","Prenatal nutrition is a key predictor of early-life development. However, despite mass campaigns to stimulate healthy nutrition during pregnancy, the diet of Dutch pregnant women is often suboptimal. Innovative technologies offer an opportunity to develop tailored tools, which resulted in the release of various apps on healthy nutrition during pregnancy. As midwives act as primary contact for Dutch pregnant women, the goal was to explore the experiences and perspectives of midwives on (1) nutritional counselling during pregnancy, and (2) nutritional mHealth apps to support midwifery care. Analyses of eleven in-depth interviews indicated that nutritional counselling involved the referral to websites, a brochure, and an app developed by the Dutch Nutrition Centre. Midwives were aware of the existence of other nutritional mHealth apps but felt uncertain about their trustworthiness. Nevertheless, midwives were open towards the implementation of new tools providing that these are trustworthy, accessible, user-friendly, personalised, scientifically sound, and contain easy-digestible information. Midwives stressed the need for guidelines for professionals on the implementation of new tools. Involving midwives early-on in the development of future nutritional mHealth apps may facilitate better alignment with the needs and preferences of end-users and professionals, and thus increase the likelihood of successful implementation in midwifery practice.","Apps; Health; Healthcare professionals; Maternal; MHealth gestation; Midwives; Nutrition","en","journal article","","","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:e0bd4350-3817-4b7e-8fd4-20ebdafbedee","http://resolver.tudelft.nl/uuid:e0bd4350-3817-4b7e-8fd4-20ebdafbedee","A Computational Network Model for Shared Mental Models in Hospital Operation Rooms","van Ments, Laila (AutoLeadStar, Jerusalem); Treur, J. (Vrije Universiteit Amsterdam); Klein, L.J. (TU Delft Information management); Roelofsma, P.H.M.P. (TU Delft Safety and Security Science)","Mahmud, Mufti (editor); Kaiser, M Shamim (editor); Vassanelli, Stefano (editor); Dai, Qionghai (editor); Zhong, Ning (editor)","2021","This paper describes a network model for mental processes making use of shared mental models (SMM) of team performance. The paper illustrates the value of adequate SMM’s for safe and efficient team performance. The addressed application context is that of a medical team performing a tracheal intubation executed by a nurse and a medical specialist. Simulations of successful and unsuccessful team performance have been performed, some of which are presented. The paper discusses potential further elaborations for future research as well as implications for other domains of team performance.","Healthcare safety; Hospital; Network model; Shared mental model; Team performance","en","conference paper","Springer","","","","","","","","","","Information management","","",""
"uuid:32c91c7d-11c9-4aec-8c39-fd534f649032","http://resolver.tudelft.nl/uuid:32c91c7d-11c9-4aec-8c39-fd534f649032","Medical Device Development in Living Labs, a case study","Schouten, Anneke (TU Delft Mechanical, Maritime and Materials Engineering; TU Delft Applied Sciences)","Flipse, S.M. (mentor); van den Dobbelsteen, J.J. (mentor); Delft University of Technology (degree granting institution)","2020","When in 2008 the financial crisis set it in Europe, consequences for the healthcare systems were inevitable (Parmar, Stavropoulou, & Ioannidis, 2016). Health budgets were reduced, and since the beginning of the crisis, 1.5 million additional people in Europe have had an unmet need for healthcare (A. Reeves, McKee, & Stuckler, 2015). A key challenge is both to achieve and to maintain the quality of healthcare, including new technologies within constrained budgets (Godman et al., 2016). This puts facilities such as hospitals in a difficult position. They are required to balance the contradictory and competing demands of efficiency and specialization, low operating costs and high-end amenities, minimized capital costs and optimum clinical quality (Clough et al., 2011). Innovation is a key concept in healthcare, because innovation engineering and management allow for more efficient development of better concepts of medical devices (Lamé, Yannou, & Cluzel, 2018). This is essential for sustainable healthcare systems in the future (Ellner et al., 2015). In this light, there has been an increased interest in the Living Lab concept (Bergvall-Kåreborn, Eriksson, Ståhlbröst, & Svensson, 2009). In a Living Lab, multiple relevant stakeholders work together in a real life setting. Despite the growing recognition and use of Living Labs throughout society, literature on this phenomenon remains scarce (Dell’Era & Landoni, 2014). The Living Lab method is relatively new, and Living Lab participants are rarely entrepreneurs. The result tends to be an unclear Living Lab structure with little focus on management. A consequence is that the overall structure, activities and vision are not always clear. Due to these unclarities, management might take more time than necessary. Creating structure in Living Lab collaborations can save participants lots of time and frustration. It is crucial however, to maintain the free and open way of collaborating, which is characteristic for Living Labs. The key in finding the sweet spot between working like a community and a bureaucracy might be systematically tracking of involved Living Lab stakeholders. Much of the Living Lab structure and organization will be dependent on local circumstances. And that is both the strength and the curse of the Living Lab. But, being able to systematically track your stakeholders, their responsibilities and contributions by the means of a protocol could save many Living Labs a lot of time and unpleasant surprises.","Living Labs; Medical device design; Collaboration in healthcare","en","master thesis","","","","","","","","","","","","Biomedical Engineering","",""
"uuid:5f94a350-8311-4ed8-a505-5113220b077e","http://resolver.tudelft.nl/uuid:5f94a350-8311-4ed8-a505-5113220b077e","Privacy-Preserving Electronic Healthcare with Self-Monitoring Devices using Trusted Execution Environments","To, Seu Man (TU Delft Electrical Engineering, Mathematics and Computer Science)","Erkin, Z. (mentor); Lagendijk, R.L. (graduation committee); Roos, S. (graduation committee); Delft University of Technology (degree granting institution)","2020","The adoption of smart wearable devices has been on the rise over the past few years. These wearables are able to track the user's vital signs, making them valuable for use in the healthcare industry. Sharing this information with the user's healthcare provider has the potential to improve medical care by reducing medical misinformation. Currently, patients in the Netherlands are able to inspect their medical file at each healthcare provider they are attending, but they are unable to inspect all their medical files at one place. Moreover, they are not able to contribute to their own medical files. In this thesis, we propose the use of Trusted Execution Environments (TEEs) as an extension to the Polymorphic Encryption and Pseudonymisation (PEP) framework. PEP facilitates the exchange of medical data between multiple parties in a privacy-preserving manner. However, PEP suffers from collusion and scalability issues. The Distributed Polymorphic Encryption and Pseudonymisation (Dist-PEP) protocol is an improvement to PEP, and mitigates these issues. To make further improvements, the Distributed Polymorphic Access Management (Dist-PACMAN) protocol has been introduced to handle the access management more securely. By introducing TEEs, we make further improvements to the efficiency en scalability of the protocol. The result is a privacy-preserving framework that can be used to share the information gathered by the wearables with the user's healthcare provider securely and more efficiently. Additionally, the user can keep and inspect their own medical file at a cloud provider.","cryptography; security and privacy; e-healthcare","en","master thesis","","","","","","","","","","","","","",""
"uuid:7bfcf41b-68fe-4aa8-90f2-7894b3fcaf82","http://resolver.tudelft.nl/uuid:7bfcf41b-68fe-4aa8-90f2-7894b3fcaf82","Let's walk! Design the gait test station for children","Xu, Chenye (TU Delft Industrial Design Engineering)","Gielen, M.A. (mentor); Weerdesteijn, J.M.W. (mentor); Roebroeck, M.E. (mentor); Delft University of Technology (degree granting institution)","2020","This project aims at designing a gait test station for children. The gait test station tests children’s walking in Child Brain Lab at Sophia Children’s hospital. The children in this project are at the age of 4-10 with different capacities.
There are two scopes in this project, the service scope of the gait test and the experience scope of children. The service scope is to define the current procedure of the gait test. The procedure includes the gait test device, the gait test process, and the test conductor’s working experience. A service blueprint specifies the entire procedure. Another research with physical therapists, child experts, and parents by questionnaire is conducted in the service scope. With those experts’ experiences, I understand children’s related capacities to follow and finish a gait test; some design opportunities also are found. Regarding the scope of children’s experience, as the gait test station has not been set up at the hospital, the research with children is conducted at home, based on the defined service blueprint. In the Covid-19 situation, the children are researched remotely or at the family home with permission. With the research results, children’s current situations are defined and depicted in the experience maps. The current situations are four different typical situations at the gait test station. After the series of research activities, children’s current problems at the gait test station are defined. I formulate my design goal as Design an experience journey for children’s (aged 4-10) gait test to induce their natural walking, make them motivated and fun, or learn about the walking. A shortlist of design requirements is also concluded in the service scope. Before the design phase, there is a project phase of design sprints. I test and iterate different interventions in this phase for several rounds. With the intervention iterations, I can emphasize more on children to better design for them. With the iteration results, the design patterns are concluded on children’s experience maps. A list of design elements is also concluded from the iteration interventions. In the design phase, concepts have been generated with the combination of all the design patterns. As these are the combined concepts, I first evaluate if the concept includes all the design elements in different design patterns. The concepts are also evaluated with the hospital in the service scope. With these two evaluations, one concept has been selected. This concept contains three different tasks for different types of children. The three tasks are exploring walking knowledge, imitating animal walking, and sending animals to the jungle. Children can have one task during the gait test to achieve the envisioned experience. In the final concept, the technology tool is changed from the previous concept to enhance the walking experience. With the final concept, a new service blueprint and a technology roadmap are made as final deliverables. Considering a long-term implementation, I also implemented the concept into the interactive videos for short term use. The interactive videos can directly work at the gait test station, also as a final deliverable.","Value-based healthcare; Experience design; Design for children","en","master thesis","","","","","","","","","","","","","",""
"uuid:1e4403f0-842b-48a0-ae27-3eec3272a096","http://resolver.tudelft.nl/uuid:1e4403f0-842b-48a0-ae27-3eec3272a096","End-user involvement in hospital building design: A Case Study On Information Management And Design Process: Erasmus MC Rotterdam new building project","Yalniz, Burcak (TU Delft Architecture and the Built Environment)","van Oel, C.J. (mentor); Koolwijk, J.S.J. (mentor); Delft University of Technology (degree granting institution)","2020","Design in healthcare projects is complex because of the high number of stakeholders and the involvement of end-users in the design process. This causes collaboration issues and information asymmetry which are barriers in communication and information exchange. The purpose of this research is to gain insight into the design process in healthcare building projects, more particularly into the way the end-users groups like the medical caregivers and the design team exchanged information and participate in developing the design. The focus of this research is the end-user design team interactions in the hospital design process.
The main research question is: In hospital building projects, how does the project organization translate the end-user information into design? By performing a single case study, data was collected through context analysis, document analysis, and in-depth interviews about end-user involvement, information flow, and decision-making process in Erasmus MC Rotterdam new building project. Ten interviews were conducted with different members of the project organization including project managers and leaders, design experts, and also external advisors. The research analysis illustrates a participative design and decision-making process and the three main findings of this research:(1)End-users from different groups were involved in the design and decision-making process and the level of involvement was different in each stage. There is mainly a consultative form of user involvement that evolved into a co-design form in the technical phase of design. User representatives and designers were members of technical design teams: TOTs in this phase looking for design solutions together. (2) Two groups had key roles during the process: User Coordinators and the Building Expertise group. User Coordinators ensure the gathering of user information and engagement of end-users during the design, and they are the information exchange link between the end-users and the design team. The Building Expertise group in this project had an intermediator role acting in different boundaries of the organization. (3) Design decisions are based on continuous consultation with end-user representatives which are linked to the project organization at all levels. There was a transparent and informed decision-making process. Review matrices were decision-making support tools used by different groups including different end- end-user groups and help different groups exchange information in different boundaries. Research findings and the analysis gives a better understanding of information management, end-user, and stakeholder management in healthcare building design and planning and give insights on project management and how to organize the information exchange and the team interactions and use different methods and tools during the briefing and design process in complex building design projects like hospitals.","User involvement; End-user behaviour; Healthcare design; Design process","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","","51.911026, 4.467844"
"uuid:5b543e5a-59ab-4824-9fa6-e89b208ea739","http://resolver.tudelft.nl/uuid:5b543e5a-59ab-4824-9fa6-e89b208ea739","Sounds of Surgeries: Design for health behavior change in the soundscape of orthopedic operating theaters","Luck, Zoe (TU Delft Industrial Design Engineering)","Ozcan Vieira, E. (mentor); Kraal, J.J. (graduation committee); Delft University of Technology (degree granting institution)","2020","class=""MsoNormal"">Noise in orthopedic operating theaters The medical staff working in orthopedic operating theaters are often exposed to significant noise generated by many simultaneous sound events (e.g. powered tools, alarms) that pose a risk to their health and well-being. This thesis focuses on their health behaviors associated with the sound situation. Existing literature provides evidence that noise in some orthopedic surgeries can cause health issues ranging from increased stress levels to noise-induced hearing loss. Nevertheless, literature research also shows that the field of sound and health assessment has not been widely explored. Consequently, this thesis has two aims: Firstly, understanding the soundscape, its entailing health risks and the motivations of current health behaviors of the medical staff in relation to the soundscape. Secondly, contributing to an improved sound situation and reduced health risks for medical staff applying design. Sound perception and health behavior Applying the user research method “context mapping” (design method making people reflect on personal experiences) current health behaviors of the medical staff (e.g.surgeons, anesthesiologists) were investigated. In particular psychological consequences of noise are often underestimated. Sound levels in seven orthopedic surgeries (with varying surgical approaches) were assessed. Although the evaluation showed differences in sound levels, average sound levels did not exceed current legislation. Further investigations on sound characteristics(through psycho acoustic analysis) show that sound perceptions (e.g. pleasant or unpleasant sound experiences), causing psychological health impacts, are not sufficiently explained by loudness (i.e. especially average decibel levels). Based on the research findings, that some sound situations in operating theaters are in parts hazardous and that the behavior of the medical staff is often non-precautionary, a theoretical framework (based on Social-Ecological Model (SEM)) was developed. It showcases the stakeholders directly or indirectly involved in potential behavior change processes towards an improved sound and health situation in operating theaters.This framework formed the core guideline for the consecutive design process,aiming to explore how behavior concerning the soundscape can be improved. The key discovery: There is a lack of awareness and knowledge of health consequences posed by sound within medical staff, as well as on other social-ecological levels (e.g. hospital management). Design towards sound and health awareness The final design outcome, a website, targets a wide healthcare audience. The website initiates greater engagement concerning sound improvements through increasing awareness of the current sound situation in operating theaters. It caters to varying awareness levels: General information on sound and health in operating theaters (to increase knowledge and initiate awareness) and concrete action advice to transform awareness into action for sound improvement and risk reduction. Reflecting on the final outcome and future research This thesis showed that sound perception in operating theaters is still not sufficiently explored. The initial evaluation with medical and non-medical staff participants indicates that the website successfully improves knowledge, triggers reflection and thereby sparks awareness. By further extending the websites’ sphere of activities, it has the potential to contribute to the achievement of better sound quality in operating theaters. This thesis concludes with suggestions on future sound and health behavior research.
Hence, the thesis addresses the implementation opportunities to use the Visual Thinking and Storytelling design method to tackle this communication challenge, provide clarification and structure to help the patient voice their issues, and improve doctor-patient communication. Simultaneously, the method also allows patients to engage in Shared decision-making and receive better treatment (Slade, M., 2017). This thesis uses the mental health organization Geestelijke Gezondheidszorg (GGZ) Delfland’s ITB Support program as a context example, with the aim of proposing a new visual story communication strategy to help the GGZ Delfland improve the clarity and structure of communication between social workers and clients.
To provide better clarification and structure, a Visual toolkit was designed to help the health experts clarify the clients’ needs. In addition, a Visual strategy plan was designed to guide the GGZ Delfland on how to operate the toolkit in the ITB program. This thesis gives inspiration about how Visual Thinking the Storytelling can improve doctor-patient communication and how they can be used in practice.","Visual Thinking; Storytelling; Visual metaphor; Mental healthcare; doctor-patient communication","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:df1447e6-4d71-46aa-b931-a1f38aa7efdf","http://resolver.tudelft.nl/uuid:df1447e6-4d71-46aa-b931-a1f38aa7efdf","Innovate New Service Development in a product-oriented healthcare corporation","Sailer, Tim (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); Snelders, H.M.J.J. (mentor); Hultermans, Martijn (mentor); Delft University of Technology (degree granting institution)","2020","To satisfy the growing needs of customers for services many product-oriented companies in various industries have started switching their focus from products towards service offerings. To stay competitive, New Service Development became an important concern for many companies to achieve. Company Z, which is one of the largest product-oriented corporations around the globe, continuously improved its New Product Development processes to successfully launch technology-driven product innovations. Aware of the current importance of service offerings, Company Z has integrated New Service Development into their processes but still faces challenges while developing their service offerings. A key role in developing and launching services plays the recently established New Services Design team of the service development and delivery function.
The aim of this project was to identify the pitfalls of the current New Service Development process of the New Services Design team of company Z and identify opportunities for overcoming them to create an improved process framework that fits the flexibility required for services. The development and delivery stages of the New Service development process of company Z were reviewed and literature was researched about Services and New Service Development. It was found that New Service Development in order to be successful require, compared to NPD, a different mindset, high customer involvement and flexibility. However, product-oriented companies tend to keep their old New Product Development approaches for certainty reasons and the rather less researched field of modern New Service Development.
Comparably, internal company research revealed that Company Z develops and delivers its service offerings with a product-oriented stage-gate process that originates from the company‘s product mindset. Based on the literature and qualitative research it was identified that this product-logic causes a highly fragmented and overstretched process that causes excessive amounts of bureaucracy, a strong focus on documentation, low customer involvement, and uncollaborative teams. In order to address any of these issues in the long term, the product-logic, which is the start point of the Causal Chain, needs to be replaced by a service-logic. To find a solution, in this rather academically unexplored research area, a Delphi study with several experts was conducted. Based on the Delphi study and literature it was discovered that an incremental change towards a service-logic can be fostered by establishing a high level of customer-centricity within the current New Service Development process. A solution was created that enables customer involvement within the New Service Development process of Company Z via early service prototyping to foster a service-oriented way of working. Finally, a Roadmap describes the implementation of the service prototyping approach in three horizons.","Servitization; New service Development; new product development; healthcare; Process design; Process model; service prototyping; service design","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:fad805a9-136b-49a7-a2e8-228b37ba597f","http://resolver.tudelft.nl/uuid:fad805a9-136b-49a7-a2e8-228b37ba597f","Improving Search Relevance Feedback through Human Centered Design","GU, Shengfeng (TU Delft Industrial Design Engineering)","Bozzon, A. (mentor); Lomas, J.D. (mentor); Szlávik, Zoltán (mentor); Delft University of Technology (degree granting institution)","2020","br/>Artificial intelligence (AI) is expected to play a transformational role in health and wellbeing. Search (i.e. information retrieval) technologies already play a significant role in healthcare research and practice. Relevance feedback in Search is vital for system evaluation and improvements. However, in small user scale contexts, the exploitation of user behaviors may not infer valid relevance judgments. Therefore, engaging users to provide such feedback explicitly is essential for improving search performance (i.e. effectiveness). However, previous research has found that users are generally reluctant to provide explicit feedback in digital environments, and the willingness decreases overtime in some experiments. In collaboration with myTomorrows, an Amsterdam-based pharma-tech company, this Master thesis aims to find answers to the challenge mentioned above through a specific context of myTomororws AI-powered treatment Search which has the urgent need for engaging healthcare professionals (HCPs) in providing relevance feedback on search results (e.g. Clinical Trials and Expanded Access Programs) for system evaluation and improvements. Through Human Centered Design methods such as interviews, observations, and speed dates, the project yielded a future myTomorrows Search design enhanced with three relevance feedback collection concepts. As research materials, the concepts were tested and evaluated by nine HCPs from three countries (the Netherlands, China, and Brazil). The user study results indicate that embedding utility, as the motivator, in relevance feedback collection appeals to HCPs more than using motivators such as altruism or enjoyment. Moreover, the best point of user engagement is identified as the moment between users finishing the examination of information and starting the next ones. Additionally, this study generalized the project process and user study insights into a four-stage guide for designing explicit feedback collection in text-base Search. Although it remains unvalidated, this guide has the potential to apply to other small user scale contexts, guiding or inspiring user researchers and designers to design explicit user feedback collection in Search.
Therefore, the aim of this research is to redefine shelter design so to improve the mental well-being of homeless people. This, by learning lessons from psycho-supportive design approaches in the healthcare environment. Hence, the main question in this research is: ‘Which architectural elements in the care environment have a positive effect on the (mental) well-being of homeless (terminal) people with chronic mental health problems?’.
The above question is answered by means of literature studies, case study analysis and fieldwork. From the results, several spatial-design components have been extracted and categorized into problems and solutions concerning the theoretical themes of: stigma; security; sensorial stimulation and environmental experience.
The results showed that privacy, daylight entrance, access to nature and social integration are the four main elements that positively improve one’s (mental or physical) well-being. Additional spatial-design components have been summarized into four conclusive Evidence-Based-Design guidelines and crucial design factors which may be applied on both urban and building scale. When all four guidelines are considered in the architectural design of shelters, the best mental health outcomes are achieved.
As the issue of homelessness is not yet solved and the number of people with complex care needs increase, the Netherlands is in desperate need of more assisted and affordable housing. With this research architects, urban planners and developers are encouraged to enter the discourse of homelessness. Moreover, they are stimulated to use the Evidence-Based Toolkit into the design process of new homeless shelters.","Homelessness; Evidence Based Design; Dwelling; Shelter; Psycho-supportive design; Healthcare architecture; Palliative care; Mental health; Social care","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Explorelab","","51.882035,4.537928."
"uuid:a9c9107b-57be-40f8-84ad-e4b7b9a8918c","http://resolver.tudelft.nl/uuid:a9c9107b-57be-40f8-84ad-e4b7b9a8918c","Building a Social Community","van Vuuren, K. (TU Delft Architecture and the Built Environment)","Jurgenhake, B.M. (mentor); Tomesen, P.L. (graduation committee); Sedighi, S.M.A. (graduation committee); Delft University of Technology (degree granting institution)","2020","Loneliness is social pain. It occurs as a defence mechanism if a person does not
have enough social contact. This pain prevents people from being isolated which
in historical times would be fatal as people are stronger and safer in groups. Among elderly loneliness is more severe then in other age groups. This is due to
the loss of good friends and loved ones. Next to this elderly are less active in public places as they are housed in more closed off complexes where every facility is present so that they wont have to leave the complex. This means they are not likely to meet new people outside of their building or wing.
But loneliness is a pain that also leads to retraction and people isolating themselves from public life. It then becomes a vicious cycle where people can become increasingly lonely. It can only be contested by the individual that suffers from it. Loneliness can thus not be solved by architecture but it can be prevented by it.
But how to prevent loneliness with architecture? By addressing relations which
have the most impact on people their social life their social health can be restored. According to multiple sociologists weak ties such as colleagues and neighbours are of most important as they replace lost strong ties such as loved ones and friends. But social interactions with weak ties should happen naturally and not forced upon or organised. Organised social activities are a major threshold for people with social anxiety which excludes them from such activites.
The main question for this research is therefore as follows:
How can the build environment promote spontaneous social interaction to prevent loneliness among elderly?
The main conclusion of this research is that people need to leave their private domain and enter the public realm as this is where spontaneous interactions take place. To get elderly out of their private domain the environment should invite to do so. This means to create attractive environments with opportunities to engage in social activities as well as to live independent, to fulfil potential and to be seen by others.
Activity attracts activity so by activating public spaces elderly are more tempted to go outside. But as elderly are less active then other groups it is good to mix them with youth, students, and families, which also increases their visibility to the rest of the community they live in. But while they should live mixed between other types of demographic groups they still want to seek support among each other but in small manageable groups of approximately five elderly. Elderly should therefore be housed in small groups with a communal garden or space to meet and control.
Next to organising dwellings the public realm should also be organised so that it stimulates spontaneous social interaction. By creating third spaces, green spaces and transitional spaces this can be accomplished. This is because people transfer to or past these locations which creates opportunities to meet others on the way over and/or at the location itself. These spaces can be locations such as a restaurant, park and library and they should be visible from inside the dwellings as activity attracts activity.
But these location should also have certain qualities such as that they have to be comfortable, safe, visually stimulating and controllable. This latter describes the hierarchy and depiction of private and public spaces. As being social also means to have control over the amount of social interaction one has, and thus also being able to retreat in privacy. The difference between private and public should therefore be clearly marked so that it is recognisable for others. These interventions or design guidelines should all be implemented close to the housing as elderly do not have a broad range where they can go.","Healthcare; Elderly; Loneliness; Housing; Leiden; social interaction","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Dwelling","Designing for Care","52.153400, 4.482504"
"uuid:7f7cb98c-1f25-40bb-9e91-9ae31061aa01","http://resolver.tudelft.nl/uuid:7f7cb98c-1f25-40bb-9e91-9ae31061aa01","Selvplejecenter: A Healthy Mind in a Healthy Body","Meyer, F.M. (TU Delft Architecture and the Built Environment)","Bultstra, Henk (mentor); Fokkinga, Jelke (mentor); Schnater, Frank (graduation committee); Delft University of Technology (degree granting institution)","2020","Danish people have a relatively high death-rate, compared to other Nordic countries. This has not gone unnoticed. The government has been actively promoting a healthy lifestyle for quite some time now. This promotion is mainly focussed on physical health. With this public condenser project, an architectural interpretation of this healthy lifestyle is provided. Hereby, the focus is not just on physical health. Since mental health and physical health are always connected, the project addresses both subjects. On top of that, a healthcare component is also addressed within the intervention, in order to make sure that nothing is “broken”, and that the physical and mental health can be continuously developed. By taking a very contextual approach to the way that the design is created and structured, it is possible to strengthen the positive qualities of the site, whilst simultaneously tending to the aspects of the site that could be better. Therefore the project is not just conceptually integrated (by the overarching theme), but also contextually.","Public Condenser; Vesterbro; Public Building; Public Space; Healthcare; Mental Health; Physical Health","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","Public Condenser: Copenhagen","55.671111,12.553889"
"uuid:d1eb5e4c-c44f-404b-921a-cdccc304cf27","http://resolver.tudelft.nl/uuid:d1eb5e4c-c44f-404b-921a-cdccc304cf27","Ageing Safely: Designing a safe environment for elderly Asian migrants in the Netherlands","Hwang, Han-Sol (TU Delft Architecture and the Built Environment)","Mooij, H.A.F. (mentor); Jennen, P.H.M. (mentor); Cuperus, I.J.J. (graduation committee); Delft University of Technology (degree granting institution)","2020","The population of the Netherlands is aging. This well-known characteristic of the present-day’s society is caused by multiple factors like low birth rate and improvement of healthcare. Dementia is one of the most common diseases that occurs to aged people. Most people with severe dementia are usually situated in a nursing home where they are assisted by caregivers day and night. These are protected facilities, in both urban and suburban context, which are separated from the society and daily life. This leads to several issues such as isolation and loneliness within the nursing homes. Also, isolation simultaneously stigmatizes people with dementia. People who are still living in their homes and capable of functioning are being excluded from society. However, nursing homes are often not an option for elderly migrants who are suffering from dementia. There are not enough nursing homes where they can seek help at the moment due to lack of anticipation –the Dutch government is not yet prepared for the considerable amount of dementia patients with migrant backgrounds who has different needs and wishes. This large group of people are excluded from the society and are taken care of by their families who are often overloaded due to the fact that they usually don’t get help from professionals. Elderly who cannot get help are forced to return to their respective original countries and are afraid to age in the Netherlands. This project is a proposal towards a new form of living and ageing in a safe environment as an Asian migrant in the Netherlands, with the aim to social inclusion of the elderly.
The core problem of NIV is the excess of unintentional air leakage. Therefore the main focus lies on reducing air leakage by increasing the fit of the new developed NIV mask. The new masks need to fit patients up till the age of seven, because the available masks do often not fit well. There are no non-vented NIV masks available for patients below one year. An oronasal mask is developed, it is most effective and relatively non-intrusive compared to the other types of non-vented NIV mask. NIV at the PICU can be divided into acute NIV, for which an acute NIV mask will be developed, and extended NIV, for which an ideal NIV mask will be developed.
Four concept NIV masks are developed, of which two concepts are selected based on the results of the simulation and most important requirements. The NIV intervention is simulated by ventilating a reanimation mannequin with prototypes of the concepts to determine the effectiveness in terms of air leakage and contact pressure. The two selected concepts shows reduced air leakage compared to commercially available masks.
The final design proposal consists of two masks: the Modular Mask, and the Quick Curable Mask. The Quick Curable Mask is developed for patients who require acute NIV. The Modular Mask is developed for patients who need NIV for an extended time. Due to overcrowding at the PICU of Amsterdam UMC there was a shortage of NIV tubes and sensors, it was not responsible to test the masks. Therefore a protocol is written to test the air leakage and evaluate the wearing comfort of the two proposed masks with a test participant after the COVID-19 pandemic.
The final design proposal is suitable for NIV at the PICU. A roadmap describes how the two mask can be further developed by the hospital and implemented in the PICU. It consists of the following phases: the optimising phase, the clinical testing phase, the implementing phase, and the redesigning phase.
First, the project explored individual preferences for information and communication among patients. It was concluded that in addition to the profiles, an individual patient’s mind-set (e.g. insecurity or anxiety regarding the surgery), and their social support needs, in combination with their physical condition and medical history, should guide the provision of tailored information and communication services. Subsequently, several prototypes were developed and evaluated with patients and care providers: Storyboards, paper-based prototypes, and a fully functional web application that informs THA patients about their activity levels after surgery. The final study explored the use and evaluation of the web application by different profiles. It was concluded that the profiles are an adequate segmentation that, combined with customized features, can be used to designing tailored information tools in THA. However, to increase the relevance of the tailored information, it should align with the course of recovery (e.g. post-surgery complications). Resolving generic technical and usability issues is also essential.
The profile-specific design guidelines that resulted from this thesis can be used by creative industry and healthcare providers to tailor products and services for THA patients. They are also available online, at www.medisigntudelft.nl/research/patientprofiles.","E-Health; Research through Design (RtD); Tailoring; Patient experience; patient education; Personalisation; Personalised healthcare; Orthopaedic surgery","en","doctoral thesis","","978-94-028-2019-5","","","","","","","","","Applied Ergonomics and Design","","",""
"uuid:a473a5fe-0b78-4e1f-b4e3-f98d68dfef1c","http://resolver.tudelft.nl/uuid:a473a5fe-0b78-4e1f-b4e3-f98d68dfef1c","Designing the road to the implementation of Heart for Health's eHealth solution at general practitioners: formulating advice for future development","van Triet, Edda (TU Delft Industrial Design Engineering)","Simonse, LWL (mentor); Pannunzio, Valeria (graduation committee); Wolsak, Julie (graduation committee); Delft University of Technology (degree granting institution)","2020","The Dutch healthcare system is currently under a lot of stress. Contemporary social, technological, economic and political trends demonstrate an emerging pressure on both primary and secondary care. The trend with the most profound impact, is the growing amount of chronically ill patients, causing a high pressure on the workforce and on limited resources. Additionally, during the past number of years, healthcare costs have been growing substantially. Simultaneously, people expect more services and more involvement in their health. Partly caused by those trends, Heart for Health seeks for a solution to work towards a ""future where remote healthcare prevents unnecessary CVRM patient visits at general practices"". But, it has been found that there are currently many obstacles to be overcome for the implementation of such solutions. This thesis aims to create a complete overview of the complex environment where Heart for Health is currently working in. Even though all stakeholders strive to work towards a healthier population, many conflicts of interests were found. Besides, the concerned stakeholders have complex expectations and desires, that are not easily satisfied. Like others, Heart for Health has experienced that overcoming those obstacles is challenging. The aim of this thesis is to research and propose how Heart for Health can create new business within the general practitioner sector. Therefore, an extensive research has been done into the current care pathway of CVRM patients and the desires of the stakeholders. In order to create a comprehensive overview, many stakeholders were involved throughout this project. A product vision has been created to formulate what a product for monitoring CVRM patients at general practitioners should contain. Besides, multiple requirements were found to develop such products. This thesis discusses why Heart for Health is currently struggling with the development and implementation of their pilot. And explores how this struggle could be overcome by taking a more customer centered approach. To do so, an explorative session has been executed to find opportunities for creating new values. This exploration has led to a proposal for a more comprehensive product than Heart for Health is currently making. To realise the development of this product, a step-by-step approach has been proposed. It is argued that Heart for Health should first focus on creating a product for patients before including general practitioners. The proposed approach is translated into a roadmap, describing the different steps that Heart for Health can use to work towards the future that they envision. This thesis strives to give a realistic and strategic perspective on the proposed solution by repeatedly testing on desirability, feasibility and viability.","Healthcare; eHealth; Roadmap; Strategy; Strategic Design; general practitioners; CVRM; Heart for Health; patient app; health monitoring","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:5202bac0-ba37-4f69-9ef0-efe6aa0a11d6","http://resolver.tudelft.nl/uuid:5202bac0-ba37-4f69-9ef0-efe6aa0a11d6","Redesigning Psychiatry: A strategic repertoire to stimulate transition in the mental healthcare sector","Holierhoek, Sophie (TU Delft Industrial Design Engineering)","Price, Rebecca (graduation committee); van Dijk, Matthijs (mentor); van den Berg, David (graduation committee); Delft University of Technology (degree granting institution)","2020","The mental healthcare system in the Netherlands is in dire need of anupdate. With 90,000 people on the waiting list, an urgent shortage instaff, regular occurrence of ‘incorrect’ diagnoses, and a persistentstigma on mental health, this was exactly what was on RedesigningPsychiatry’s mind (Redesigning Psychiatry, 2020). Steering clear of theproblems of today and rather focusing on a desired future, they crafteda vision for mental healthcare in 2030. The purpose of this project is tosupport Redesigning Psychiatry in their efforts to move towards themental healthcare system they envisioned.By gaining understanding of how societies and their functional systemstransition, a theoretic framework depicting societal change will bedeveloped. This newfound knowledge is enriched by studying ways toinfluence transitions. In parallel, a context study will be performed,to understand how change happens in the mental healthcare sector,and how people working in the sector perceive change. The theoreticframework will be used to structure and understand the findings fromthis context study, providing insight into what is influencing the systemin moving towards its desired goal. The aspects influencing change(and transition) are boiled down to four primary themes, that describeenablers next to blockers:> The challenges of addressing system lock-ins;> The inertia of mental healthcare organisations and theirinexperience with innovation;> The balance between intuitive and scientifically funded change;> The effect of growing public interest on the system.Making use of the newly gained understanding of transitions andways to influence them, a strategic repertoire is created to addresseach of the challenges. Furthermore, the most relevant challenge forthis project—the challenge of organisational inertia—is addressedin a more specific strategy. The strategy outlines a way to structureinnovation in mental healthcare organisations as a means to increasethe organisation’s capability to address systemic problems, and thusits readiness for transitions. Redesigning Psychiatry’s role in this is asa facilitator of design processes and knowledge exchange. The resultsof this project have been evaluated with experts, which enabled afurther detailing of the proposed strategies.","transition; transition design; strategy; mental healthcare","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:1a2836e8-b457-4193-a293-8cc9d9d633db","http://resolver.tudelft.nl/uuid:1a2836e8-b457-4193-a293-8cc9d9d633db","Towards Optimal Communication of Patient Details in Tactical Combat Casualty Care","Licher, Yvonne (TU Delft Industrial Design Engineering)","van Erp, Jeroen (graduation committee); Sonneveld, Marieke (graduation committee); Pijl, Vera (mentor); Delft University of Technology (degree granting institution)","2020","Due to the increase of political friction and terrorist attacks, the Netherlands Ministry of Defence (MinDef) is preparing its armed forces for combat situations. If these occur, a large number of victims is expected in a short amount of time, which puts pressure on the military medical chain. As it is crucial to treat patients as early as possible, low resource medical treatment facilities (Role 1 MTFs) are placed near the battlefield. Heavily wounded soldiers are transported to this facility, where they are stabilised in order to survive transportation to a facility with more resources. Due to the Role 1 MTF’s critical function, it is of importance that the communication of patient details is optimal, as it improves the patient flow and survival rate. Currently, the communication of patient details causes a delay in the treatment process. This graduation project aimed for the improvement of patient detail communication by providing insight into the current communication process and formulating a vision for future innovation. By performing different research activities, such as observations and interviews, an understanding of the Role 1 MTF and the used communication methods was developed. This resulted in an overview of communication problems that affect the efficiency of care and are experienced as frustrating. The key influence of these frustrations was the lack of situational awareness (SA), which became the focus of this project. To summarise the research findings, a journey map was made. The journey map provides an overview of the events that take place within the Role 1 MTF, the communication activities, the workload, and the cognitive load as it is perceived by the general military physician (AMA). It was decided to focus on the AMA, as this person has the role of commander and has to makes the medical decisions. Design opportunities could be identified from the journey map and were used as a starting point for ideation. The ideation resulted in several design ideas, which were evaluated on their desirability and credibility. The insights obtained from this evaluation were used to formulate a future vision, which was visualised in a vision map (figure 1).
The future vision describes three innovation horizons to increase SA and improve the communication of patient details in the Role 1 MTF. The first horizon describes how process innovation could be achieved in the short term. The second horizon proposes the adaptation of available technology, which can be implemented within 15 years. The third horizon describes disruptive innovation for the far future, where the Role 1 MTF will become obsolete.
In the end, this graduation project provided a tool to evaluate the communication of patient details in the Role 1 MTF and a vision for future innovation. These tools are the outcome of user-centered research, which makes them of value for the MinDef and can support future innovation for the Role 1 MTF.","Military; Situational awareness; Communication; Healthcare; Journey mapping; Vision; Efficiency","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:b4d3cac4-c2ba-4b9d-8713-cb1619688a1f","http://resolver.tudelft.nl/uuid:b4d3cac4-c2ba-4b9d-8713-cb1619688a1f","Facilitating the transition towards desired behaviour in the ICU","Scipio, Nick (TU Delft Industrial Design Engineering; TU Delft Applied Ergonomics and Design)","Paus-Buzink, Sonja (mentor); Albayrak, Armagan (graduation committee); Delft University of Technology (degree granting institution)","2020","The Intensive Care Unit (ICU) of the Leids Universitair Medisch Centrum (LUMC) focuses on vitally threatened patients, who cannot survive without daily intensive treatment. As the patients in this department could easily deteriorate and (potentially) pass away, the staff members of LUMC’s ICU often need to act rapidly and make decisions within a short period of time, while they experience severe (time) pressure. This pressure causes stress and increases the chance of human errors by the staff members, which eventually could lead to adverse events (incidents that caused irreversible damage to patients). In order to minimise the human errors made by the staff members and thereby, the amount of adverse events, the ICU physicians and nurses of the LUMC currently need to participate with two training exercises, called Advanced Life Support+ (ALS+) and Crew Resource Management (CRM). Despite the fact that they are encouraged to reflect on- and expand their non-technical skill set, the (ALS+/CRM) trainers still notice that the non-technical skills of the staff members differ with their expectations. Initially, they believed that the difference in desired behaviour (by the trainers) and shown behaviour (by the staff members) is caused by the current set-up of the ALS+ and CRM training. However, it was found that this difference is mainly caused by two other factors. First, although they need to participate with the ALS+ and CRM training, the staff members still have little awareness about their behavioural impact on acute procedures, meaning that they do not precisely know how they can stimulate effective teamwork. Second, the staff members are barely triggered to reflect on their behaviour or to apply their learnings/action points (in practice) once they participated with the ALS+ and CRM training. As a result, (sustainable) behavioural change is not established and the staff members continue to show their old behavioural patterns. Based on these two factors, I developed the iCare-initiative. The iCare-initiative consists of four product solutions: an application, renewed (digital) patient boards, pocket cards and debriefing-flyers.
In the short term, the staff members can reflect more structuredly on their behaviour with the use of the debriefing-flyers. Next, they are reminded of their action points and other important behaviours (during acute procedures) via the pocket cards. In the long term, once the staff members feel more comfortable to think about- and reflect on their behaviour (in teams), the application and renewed patient boards will be launched. The application offers a platform to the staff members to individually develop/train their non-technical skill set and reflect more consciously on their behavioural impact. Furthermore, the patient boards aim to create continuous awareness amongst the staff members to reflect on their behaviour, but also to encourage them to share useful insights via a convenient (accessible) platform. Although the iCare-initiative consists of four separate product solutions, they all work together in one integrated system. This system mainly aims to prepare the staff members for acute procedures, to expose which non-technical skills they should improve, and to allow the staff members to individually develop their non-technical skills. Eventually, these new opportunities will accelerate the transition towards desired behaviour in LUMC’s ICU.","intensive care unit; behaviour; behavioural change; teamwork; healthcare; service design; concept design","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:8f3090a6-39c6-4ddf-9ee8-9afb73021605","http://resolver.tudelft.nl/uuid:8f3090a6-39c6-4ddf-9ee8-9afb73021605","Playscapes: Creating Space for Young Children's Physical Activity and Play","Boon, Boudewijn (TU Delft Human Information Communication Design; TU Delft Design Aesthetics)","Stappers, P.J. (promotor); Van den Heuvel-Eibrink, Marry M. (promotor); Rozendaal, M.C. (copromotor); Delft University of Technology (degree granting institution)","2020","Young children often lack opportunities to play in a physically active way. This is particularly the case for children with cancer and other chronic diseases, who regularly undergo periods of hospitalization. Promoting their physical activity and play can contribute to their health, wellbeing, and development. This thesis develops ‘Playscapes’ – a design perspective that emphasizes the unstructured and spontaneous nature of young children’s physical activity. Playscapes encourages designers to enable such physical activity through the design of open-ended and ambiguous playthings. By designing such playthings for children with cancer, this thesis contributes to turning hospital environments, such as patient rooms and waiting areas, into potential ‘landscapes for physical activity and play’.","Design for behavior change; physical activity; open-ended play; young children; pediatric healthcare; research through design","en","doctoral thesis","","978-94-6384-117-7","","","","","","","","","Human Information Communication Design","","",""
"uuid:713f976a-7b9a-47bc-baef-68b9cbee579b","http://resolver.tudelft.nl/uuid:713f976a-7b9a-47bc-baef-68b9cbee579b","DesigNurse: Active involvement of nurses in improving their own work environment","Tetteroo, Karin (TU Delft Industrial Design Engineering)","Stappers, P.J. (mentor); Brinkman, C. (graduation committee); de Vries, Rosa (graduation committee); Delft University of Technology (degree granting institution)","2020","The high workload of nurses could be decreased by solutions that improve the work environment. Solutions that are currently made are not implemented effectively on the units. This report will describe a design project leading to a way in which nurses can be involved in improving their own work environment which will lead to a decreased workload an more job satisfaction. The first part of the report shows that improvement opportunities nurses face do not reach the departments that could solve these opportunities. To involve nurses, in order to decrease their workload and increase their job satisfaction, it is not only important for them to be involved in projects that are started at the technical departments. Participatory design theory shows that by giving users a voice in what could be improved in their work, not only will the solutions fit the context better, having a say in what happens will by itself add to the job satisfaction.
The following chapter elaborates on different personas of nurses, what they currently do with improvement opportunities and what limits them in doing so.
Nurses currently improve the processes on their own units. This can be done by the nurses themselves. If an opportunity can not be improved on by nurses themselves, this opportunity will not be documented or improved upon.
Based on the insights of this research a design goal was formulated:
Design a participatory design process to improve the work environment of nurses, in which all relevant stakeholders are included and actively involved.
The ideation phase describes how the active role of nurses was chosen.
For a nurse to be actively involved, they need time and the ability to take responsibility. Though activating nurses without other relevant stakeholders also having time and responsibility, the workload and job satisfaction will not improve. Therefore the design of “De Ontwerkgroep” was made. “De Ontwerkgroep” is a multidisciplinary team that has the goal of improving the work environment of nurses. This team exists of three roles, the DesigNurse, the Design Engineer and the Design Facilitator. These three roles work together in an improvement process where the DesigNurses gather improvement opportunities from the units. The team shares the improvement opportunities and prioritizes them. The entire team even the DesigNurses are involved in generating solutions. After which the Design Engineers make or buy a prototype to test. This design shows the roll of all the stakeholders that need to be involved for a nurse to be able to be actively part of improving their own work environment. It takes away the beforementioned limitations and creates a clear process in which improvements can be made. It allows nurses to use the critical mindset some of them already have. This design is a communication tool, to show a board of a hospital what is needed in order for nurses to be actively involved in improving their work environment. Which is in line with the vision of continuous improvement and innovation.","participatory design; healthcare; Co-creation","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:1596d5ec-6ed5-4917-9bb4-38835a3be425","http://resolver.tudelft.nl/uuid:1596d5ec-6ed5-4917-9bb4-38835a3be425","Tailored Interactive 3D animation","Steenbergen, Selwyn (TU Delft Industrial Design Engineering)","Visch, Valentijn (mentor); Vegt, Niko (graduation committee); Delft University of Technology (degree granting institution)","2020","In 2020 the law ‘informed consent’ is renewed, with the aim to strengthen the patient’s position in the field of shared health decision making. Research showed that patients only recall 20% of the information provided by their medical specialist.Therefore other information materials are offered, to ensure the patient can comprehend the other 80% of health information. Nevertheless, these materials do not satisfy all patient’s needs concerning health information preferences. A qualitative research is conducted to gather knowledge of the health information preferences of non-muscle invasive bladder cancer patients. Based on these findings a tailored interactive animation is developed. The animation is used in a second qualitative research to learn if this material better meets the patient’s needs, compared to current resources as a traditional folder and 3D animation.","Tailored healthcare; interactive decision making; 3D animation","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:971f4ce0-7c8f-4d78-bddc-39cad9b71094","http://resolver.tudelft.nl/uuid:971f4ce0-7c8f-4d78-bddc-39cad9b71094","Service roadmapping of Smart Care solutions: Towards the orthopedic care journey of the future","Bernards, Lotte (TU Delft Industrial Design Engineering)","Simonse, LWL (mentor); Albayrak, Armagan (mentor); Delft University of Technology (degree granting institution)","2020","The implementation of digital innovations is becoming vital in the provision of healthcare. Only this way, issues concerning employee decline and increased demand for care can be tackled. Furthermore, it is seen as the key towards Person Centered Care, a concept where patients and health professionals act as partners. Many digital multi user innovations have already been developed to a conceptual level. However, the cohesion between these concepts and their future potential is yet under researched. This projects aims to investigate both, with a new service model and service roadmap as a result. A service roadmap can be seen as a future timeline for the service model and its supporting elements. The project tried to answer the following research question: ‘How can service roadmapping enable an integrated service delivery using digital healthcare innovations?’ Orthopedic care was used as a case study for this research, based on 41 concept demonstrators aimed at improving the orthopedic care journey. To answer the research question, a concept demonstrator analysis was performed, focusing on function, user and technology. This analysis showed that most concept demonstrators contained a service model focusing on achieving patient self-management, by obtaining insight, in the form of an app-wearable combination. The user analysis showed that the patient, General Practitioner, Orthopedic surgeon and the Physiotherapist should be the multi user group. And finally, the technology analysis showed a need for technological enhancements in the concept demonstrator setup. Next to the concept research, research on the Orthopedic care context was performed, with special interest in treating hip Osteoarthritis. The research was focused on stakeholder explorations; both desk research and performing interviews in the field. Next to that, a trend research in both the socio-cultural and technological area was performed. This research highlighted the need for a shared learning aspect; both for the service users and the service itself. Furthermore, a need for enhanced personalisation, information and communication was found, with the preservation of the ‘human’ aspect. Based on this research as a whole, a selection of 13 concept features from the concept demonstrators was done. These form the basis of the service model. It consists of an patient app, on body wearable and a plugin for health professionals, making it a multi user service. The service model will focus on providing information and feedback to all users in a personalised manner, about the patient status within the Osteoarthritis treatment. Furthermore, it allows for digital communication to occur. Future adjustments are primarily focused on improving the back end of the service, by adopting shared learning with help of Artificial Intelligence. Ultimately, patient and health professional become partners in the Osteoarthritis treatment. To summarize both the drivers for innovation, the service model setup and the back-end enablers in the context of time, a service roadmap was developed. This roadmap can be used by the Smart Care Lab of the TU Delft to start further dialogue with stakeholders in orthopedic care, as well as a starting point for new research projects.","Roadmapping; Service roadmapping; Healthcare; Service model; Research by design; Orthopedic care; osteoarthritis; Service design","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:fd895415-c353-41d5-8430-f0a67fd40ad4","http://resolver.tudelft.nl/uuid:fd895415-c353-41d5-8430-f0a67fd40ad4","Bo: An intelligent network agent to promote physical activity in children with Congenital Heart Defects","Morales Ornelas, Hosana (TU Delft Industrial Design Engineering)","Kortuem, G.W. (mentor); Jung, Jiwon (graduation committee); Van Deutekom, Arend (graduation committee); Delft University of Technology (degree granting institution)","2020","There are various organisations such as the European Society of Cardiology (2012) and American Heart Association (2013), which describe why physical activity is essential for the development in youth. Unfortunately, children who have a Congenital Heart Defect (CHD), may suffer from a lack of opportunity to perform physical activity, decreasing cognitive maturation, motor development and autonomy during childhood (Krol, 2003). This impediment arises due to a misunderstanding from parents, who do not know to what extent their child can exercise safely, and therefore adopt overprotective behaviours (Schwerzmann, Thomet, & Moons, 2016).In order to understand better overprotection during childhood, 305 online parental stories from various patient-association websites were analysed using Natural-Language-Processing techniques. The results exhibited the lifetime journey of these families, where an uncertain future evocated a constant search for symptoms. The findings of this phase were employed during generative interviews with seven families with a CHD paediatric patient to understand the continuous search for symptoms during exercise. The combination of the insights gathered from interviews and the lifetime journey was presented to five medical team members to inspire a co-creation session. The outcome of the meeting helped to define the problem and create a design vision which helped to ideate a potential Product-Service-System (PSS) solution to support parents to let their children safely perform physical activities. To encourage families to have a safe, ordinary sports-life, BO is introduced, a smart PSS aiming to support parents and their children with a CHD to understand better the safety boundaries of exercise during free-living conditions. With an activity tracker and his nine system modules, Bo aims to guide the child through different heart rate zones defined by doctors. Furthermore, Bo has a conversational agent function where parents can send concerns to the medical team and find relief when seeing their child’s heart rate zone.A functional prototype of the conversational agent was developed and implemented in the real context of four families to understand how could it influence overprotection. The implementation experience and overall concept of Bo were evaluated through in-depth interviews with paediatric CHD patients and their parents and three different specialities from the medical team. The results showed that Bo provides a supportive exploratory environment for the family, where the child can self-discover the safety boundaries and parents, instead of limiting the child, adopt an encouraging attitude towards physical activity.","Product-Service-System; Conversational Agent; Design for Children; Healthcare Design","en","master thesis","","","","","","","","","","","","Integrated Product Design | Medisign","",""
"uuid:3b3de62c-e726-4b4f-ae68-caad751858f3","http://resolver.tudelft.nl/uuid:3b3de62c-e726-4b4f-ae68-caad751858f3","Hospitable Hospital","Giudetti, Francesca (TU Delft Architecture and the Built Environment)","Frausto, Salomon (mentor); Riedijk, Michiel (mentor); Corbett, Hugo (mentor); Kaan, Kees (graduation committee); Delft University of Technology (degree granting institution)","2020","Healthcare has been often described as the most complex human organization ever devised.
The life of hospitals has been supplanted many times by an aseptic compliance with norms, regulations, procedures, protocols, and hyper technologies. Hence, there is no longer any trace of the old sacred enclosures, the Greek temples, the Roman valetudinaria, hospices, of the home of the sick, or cathedrals and abbeys equipped to host people in need. The hospital as an inflexible monument of civic pride was to remain until the second half of the twentieth century.
We often perceive the hospital as a place adorned with hard light, bare corridors, with no personal or interesting features. As Mukherjee wrote in The Emperor of All Maladies, “Science begins with counting. To understand a phenomenon, a scientist must first describe it; to describe it objectively, he must first measure it.” Hence, to describe the future of healthcare is necessary to understand the forces shaping it.
Aging and growing populations, greater prevalence of chronic diseases, and exponential advances in innovative—but costly—digital technologies are the developments that continue to increase demand and expenditure. The future of healthcare is also much less centered around institutions; it is rapidly becoming decentralized, dematerialized, demonetized, and, ultimately, democratized. As healthcare becomes more data-driven, it is also becoming more personalized.
This is the story of families moving to Gibraltar. This is the story of a new hospital—the ultimate housing for births, souls, hopes, and dignity. This project proposes Gibraltar as a healthcare destination. In the tradition of Swiss mountain open-air sanatoria, it has a strategic location, boasting effective local healthcare legislation, economic incentives, and continued infrastructural development between southern Europe and youthful north Africa. It is isolated from chaotic cities, with a positive climate (300 days of sunshine a year), green slopes, sea views, fresh air, and quieter streets.
Gibraltar is the perfect set because of the current and forecasted importance of healthcare in its economy. Based on Gibraltar's budget between 2017 and 2019, a forecast envisions a growing expenditure in the healthcare field. The forecast demographic increase suggests almost 30% of the new population will be composed of children under 18.
In the peaceful ambience of the mighty Rock, only a short walking distance from the Royal Naval Hospital, a block of sheltered housing with primary health facilities (emergency, occupational therapy, and imaging departments) aspires to renovate, making the transition from home to hospital imperceptible. By all measures, in fact, the home is the future of healthcare.
Specifically, the proposal focuses on the design of a long-term residential paediatric centre, targeting young patients and families who normally travel far from their homes to specialized hospitals. Hence, the design for Gibraltar's 2050 hospital envisions the city-state as a place for treatment, healing, and recovery, strengthening the economy by serving the population expansion and strengthening Gibraltar’s position as an attractive and pleasant place to live.
Architecturally, the bottom-up complex provides an experiential journey from medical processes and foyers, common spaces, and a public healing garden (the Rock itself), to rest, healing, and independence. The new social and architectural melting-pot attempts to combine the notions of domesticity and hospitality in a secluded area on the Rock.
In summation, this social-architectural project aims to reach a point of privacy and dignity, especially through its small, human scale. Families and residents of all ages and origins can enjoy much-needed breathing space, and carry on their normal and dignified lives.
It focuses on the not yet existing (July 2020) context of the Child Brain Lab, a clinical research project that is being set up at the Sophia Children’s Hospital. Here, child patients will undergo a wide variety of tests related to their brain that will take up several hours of their time. Their test results will then be discussed by the clinician and the child-patient family. Without the right supporting design, the Child Brain Lab (CBL) is subject to many of the issues that child patients generally face: Not being able to comprehend the conversations between parents and doctors, not getting the chance to voice their own needs and opinions and suffering anxiety about if, how and why clinical tests will be conducted. This project started with a broad context analysis. This included reviewing the literature, observing consultations, and interviewing a variety of healthcare professionals and child patients. This analysis revealed many possible reasons why child involvement is often limited. For example, it was found that by default, the child patients themselves typically take a rather passive role in discussing their care. These insights were then translated into design drivers that inspired several iterations of design ideas. Consequently, these ideas were used to learn from by discussing them with all main stakeholders of this project. This sparked a second iteration of design drivers that ultimately lead to the brain puzzle concept.
The brain puzzle concept is a collection of avatar-based, personalized puzzle pieces the child patient collects as it goes through the CBL. Each piece comes with a different function and serves a different phase of the CBL experience: The first type of pieces shows the sequence of tests that will be conducted while the second type shows which brain functions those tests investigate. Before the consultation, the child patients also receive an indication of their test results in the form of stickers, which can be placed on the corresponding puzzle piece. With these stickers, both the clinicians and the children can indicate which part they want to discuss. These pieces are then brought to the consultation as a discussion tool and to structure the conversation with more regard for the child’s perspective. To evaluate this concept, a prototype was made and evaluated with child-patients, their parents, and their clinicians in over 17 interviews. The results show that the participants were unanimously positive about the overall design and they would like to see it being implemented. Especially parents and clinicians indicated that the concept would playfully guide the children through the CBL and enable them to discuss what they want to discuss. This thesis concludes by listing areas for improvement of the concept and discusses those in the broader context of informing children about their test results.","Design for healthcare; Value based health care; Child involvement in healthcare; Playful Interactions; patient experience","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:72f4a301-c736-475c-aa88-98c5d7a75906","http://resolver.tudelft.nl/uuid:72f4a301-c736-475c-aa88-98c5d7a75906","An Ethical Framework for the Design, Development, Implementation, and Assessment of Drones Used in Public Healthcare","Cawthorne, C.D. (TU Delft Ethics & Philosophy of Technology; University of Southern Denmark); Robbins-van Wynsberghe, A.L. (TU Delft Ethics & Philosophy of Technology)","","2020","The use of drones in public healthcare is suggested as a means to improve efficiency under constrained resources and personnel. This paper begins by framing drones in healthcare as a social experiment where ethical guidelines are needed to protect those impacted while fully realizing the benefits the technology offers. Then we propose an ethical framework to facilitate the design, development, implementation, and assessment of drones used in public healthcare. Given the healthcare context, we structure the framework according to the four bioethics principles: beneficence, non-maleficence, autonomy, and justice, plus a fifth principle from artificial intelligence ethics: explicability. These principles are abstract which makes operationalization a challenge; therefore, we suggest an approach of translation according to a values hierarchy whereby the top-level ethical principles are translated into relevant human values within the domain. The resulting framework is an applied ethics tool that facilitates awareness of relevant ethical issues during the design, development, implementation, and assessment of drones in public healthcare.","Applied ethics; Drones; Public healthcare; Robot ethics; Value-sensitive design (VSD); Values hierarchy","en","journal article","","","","","","","","","","","Ethics & Philosophy of Technology","","",""
"uuid:216489d4-9ad4-4725-b99f-7d7157c86e41","http://resolver.tudelft.nl/uuid:216489d4-9ad4-4725-b99f-7d7157c86e41","Collaboration in open innovation health initiatives: Working towards a sustainable healthcare system","Morán Reséndiz, R. (Student TU Delft); Bos-de Vos, M. (TU Delft Methodologie en Organisatie van Design)","Christer, Kristy (editor); Craig, Claire (editor); Chamberlain, Paul (editor)","2020","Open innovation initiatives in the health sector are considered spaces that can fuel systemic change. However, it is not clear yet how these initiatives contribute to the transition to a sustainable healthcare system. This research explores how actors in open innovation health initiatives contribute to a sustainable transition in healthcare by implementing the Quadruple Aim. The Quadruple Aim is a practical framework that helps organizations to innovate in healthcare. It consists of four aims: improving the health of the population, improving the work-life of care providers, enhancing patients’ experience and reducing health cost. Sixteen interviews with professionals from different backgrounds working in health initiatives in the Netherlands, highlight that 1) improving the health of the population is the main aim, 2) not all initiatives are considering all four aims, 3) solutions to one aim can cause new problems, and 4) the Quadruple Aim is not assessed in a structured way. This indicates that the implementation of the Quadruple Aim is highly challenging. A suggestion for future research is to focus on how design can facilitate the implementation of the Quadruple Aim in open innovation health initiatives.","Quadruple Aim; open innovation; sustainable healthcare system; collaboration","en","conference paper","Sheffield Hallam University","","","","","Virtual/online event due to COVID-19","","","","","Methodologie en Organisatie van Design","","",""
"uuid:14c1cfe2-bae3-474f-8168-ea590cb6240d","http://resolver.tudelft.nl/uuid:14c1cfe2-bae3-474f-8168-ea590cb6240d","Improving access to diagnostics for schistosomiasis case management in oyo state, Nigeria: Barriers and opportunities","Van, G.Y. (TU Delft Design for Sustainability); Onasanya, A.A. (TU Delft Design for Sustainability); van Engelen, J.M.L. (TU Delft Design for Sustainability; Rijksuniversiteit Groningen); Oladepo, Oladimeji (University of Ibadan, Ibadan); Diehl, J.C. (TU Delft Design for Sustainability)","","2020","Schistosomiasis is one of the Neglected Tropical Diseases that affects over 200 million people worldwide, of which 29million people in Nigeria. The principal strategy for schistosomiasis in Nigeria is a control and elimination program which comprises a school-based Mass Drug Administration (MDA)with limitations of high re-infection rates and the exclusion of high-risk populations. TheWorld Health Organization (WHO) recommends guided case management of schistosomiasis (diagnostic tests or symptom-based detection plus treatment) at the Primary Health Care (PHC) level to ensure more comprehensive morbidity control. However, these require experienced personnel with sufficient knowledge of symptoms and functioning laboratory equipment. Little is known aboutwhere, bywhom and how diagnosis is performed at health facilities within the case management of schistosomiasis in Nigeria. Furthermore, there is a paucity of information on patients' health-seeking behaviour from the onset of disease symptoms until a cure is obtained. In this study, we describe both perspectives in Oyo state, Nigeria and address the barriers using adapted health-seeking stages and access framework. The opportunities for improving case management were identified, such as a prevalence study of high-risk groups, community education and screening, enhancing diagnostic capacity at the PHC through point-of-care diagnostics and strengthening the capability of health workers.","Access to healthcare; Barriers to diagnostics; Case management; End-user perspectives; Neglected tropical diseases; Nigeria; Schistosomiasis","en","journal article","","","","","","","","","","","Design for Sustainability","","",""
"uuid:bddfd806-cefe-4a6f-9133-546017eb4dc4","http://resolver.tudelft.nl/uuid:bddfd806-cefe-4a6f-9133-546017eb4dc4","The healthcare design dilemma: perils of a technology-driven design process for medical products","Wilke, H. (Anhalt University of Applied Sciences Dessau); Badke-Schaub, P.G. (TU Delft Methodologie en Organisatie van Design); Thoring, K.C. (TU Delft Design Aesthetics; Anhalt University of Applied Sciences Dessau)","","2020","This paper reports an embedded single case study from a globally operating manufacturer for digital healthcare products. Based on nine semi-structured interviews, document analysis, and a diary study among employees, we were able to gain insights on the daily business routines and interactions of the design team, the UX research team, and the product management department. The results revealed several unexpected insights that indicate a practical mismatch between user-centred design processes learned from the textbook and design practice in the healthcare sector that warrant further research.","design process; healthcare design; industrial design; user experience; user-centred design","en","journal article","","","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:4f9ce0a5-5bf5-4b0d-8f71-967a5898998c","http://resolver.tudelft.nl/uuid:4f9ce0a5-5bf5-4b0d-8f71-967a5898998c","Finding the land, planting first seeds: lead user research in early stage design for intelligent ecosystems","Pannunzio, V. (TU Delft Methodologie en Organisatie van Design); Kleinsmann, M.S. (TU Delft Methodologie en Organisatie van Design); Falcão Duarte, C. (TU Delft Methodologie en Organisatie van Design); Snelders, H.M.J.J. (TU Delft Methodologie en Organisatie van Design)","","2020","This contribution explores the potential of lead user research for early-stage designing for intelligent ecosystems through a literature review and a single case study concerning a lead user research initiative on blood pressure monitoring. The results suggest advantages of executing lead user research in early-stage designing for intelligent ecosystems from the points of view envisioning broad initial ecosystem boundaries, developing first intelligence components, and overcoming research challenges related to technical issues.","healthcare design; open innovation; systems engineering (SE)","en","conference paper","Cambridge University Press","","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:ce4fd12f-288a-431f-bc50-af88b6a3a67f","http://resolver.tudelft.nl/uuid:ce4fd12f-288a-431f-bc50-af88b6a3a67f","A New Hybrid Predictive Model to Predict the Early Mortality Risk in Intensive Care Units on a Highly Imbalanced Dataset","Ghorbani, R. (TU Delft Pattern Recognition and Bioinformatics); Ghousi, Rouzbeh (Iran University of Science and Technology); Makui, Ahmad (Iran University of Science and Technology); Atashi, Alireza (Tehran University of Medical Sciences; Motamed Cancer Institute)","","2020","Due to the development of biomedical equipment and healthcare level, especially in the Intensive Care Unit (ICU), a considerable amount of data has been collected for analysis. Mortality prediction in the ICUs is considered as one of the most important topics in the healthcare data analysis section. A precise prediction of the mortality risk for patients in ICU could provide us with valuable information about patients' lives and reduce costs at the earliest possible stage. This paper aims to introduce a new hybrid predictive model using the Genetic Algorithm as a feature selection method and a new ensemble classifier based on the combination of Stacking and Boosting ensemble methods to create an early mortality prediction model on a highly imbalanced dataset. The SVM-SMOTE method is used to solve the imbalanced data problem. This paper compares the new model with various machine learning models to validate the efficiency of the introduced model. The achieved results using the shuffle 5-fold cross-validation and random hold-out methods indicate that the new hybrid model has the best performance among other classifiers. Additionally, the Friedman test is applied as a statistical significance test to examine the differences between classifiers. The results of the statistical analysis prove that the proposed model is more effective than other classifiers. Furthermore, the proposed model is compared to APACHE and SAPS scoring systems and is benchmarked against state-of-the-art predictive models applied to the MIMIC dataset for experimental validation and achieved promising results as it outperformed the state-of-the-art models.","boosting ensemble method; Classification; Friedman test; hybrid predictive model; imbalanced data problem; intensive care unit (ICU); machine learning in healthcare; stacking ensemble method; SVM-SMOTE method","en","journal article","","","","","","","","","","","Pattern Recognition and Bioinformatics","","",""
"uuid:f3929bc3-7dd2-4d5e-b28a-bb49155545c4","http://resolver.tudelft.nl/uuid:f3929bc3-7dd2-4d5e-b28a-bb49155545c4","Human activity classification with radar signal processing and machine learning","Jia, Mu (University of Glasgow); Li, Shaoxuan (University of Glasgow); Le Kernec, Julien (University of Glasgow); Yang, Shufan (University of Glasgow); Fioranelli, F. (TU Delft Microwave Sensing, Signals & Systems); Romain, Olivier (University of Cergy-Pontoise)","","2020","As the number of older adults increases worldwide, new paradigms for indoor activity monitoring are required to keep people living at home independently longer. Radar-based human activity recognition has been identified as a sensing modality of choice because it is privacy-preserving and does not require end-users compliance or manipulation. In this paper, we explore the robustness of machine learning algorithms for human activity recognition using six different activities from the University of Glasgow dataset recorded with an FMCW radar. The raw radar data is pre-processed and represented using four different domains, namely, range-time, range-Doppler amplitude and phase diagrams, and Cadence Velocity Diagram. From those, salient features can be extracted and classified using Support Vector Machine, Stacked AutoEncoder, and Convolutional Neural Networks. The fusion of handcrafted features and features from CNN is applied to get the best scheme of classification with over 96% accuracy.","Radar; signal processing; Machine Learning; deep learning; classification; healthcare; assisted living","en","conference paper","IEEE","","","","","Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2021-03-29","","","Microwave Sensing, Signals & Systems","","",""
"uuid:b483d2b7-c83f-4c0c-9de3-1fc3425b82df","http://resolver.tudelft.nl/uuid:b483d2b7-c83f-4c0c-9de3-1fc3425b82df","Design Strategies for Promoting Young Children’s Physical Activity: A Playscapes Perspective","Boon, Boudewijn (TU Delft Design Aesthetics); Rozendaal, M.C. (TU Delft Human Information Communication Design); Van den Heuvel-Eibrink, Marry M. (Princess Máxima Center for Pediatric Oncology); van der Net, J.J. (Wilhelmina Children's Hospital); van Grotel, M. (Princess Máxima Center for Pediatric Oncology); Stappers, P.J. (TU Delft Design Conceptualization and Communication)","","2020","This paper develops a set of design strategies for promoting young children’s physical activity. These strategies are developed by taking the design perspective of Playscapes as a starting point. Playscapes suggests that three play qualities are key in promoting young children’s physical activity: free, bodily, and dispersed play. We present two field studies in a pediatric oncology center, in which we observed how these play qualities were reflected in children’s interactions with two Playscape designs: Stickz, a collection of branch-shaped objects, were placed in a semi-public waiting area; Fizzy, a self-propelled robotic ball, was introduced to patient rooms. Free play was analyzed according to the diversity of play activities, bodily play according to the diversity and exertion level of bodily movements, and dispersed play according to the floor area covered. Based on the findings, we discuss how Fizzy and Stickz contributed to each play quality, and derive a set of design strategies that can be applied in different contexts to stimulate young children’s physical activity. With these strategies, Playscapes offers a concrete alternative to existing approaches, supporting designers in directing interactions towards physical activity while leaving room for children’s unstructured and spontaneous play.","Childhood Cancer; Exergames; Intermediate-Level Knowledge; Open-Ended Play; Pediatric Healthcare; Research through design","en","journal article","","","","","","","","","","","Design Aesthetics","","",""
"uuid:90793fa6-9a8d-46d7-a26e-c8c000d44236","http://resolver.tudelft.nl/uuid:90793fa6-9a8d-46d7-a26e-c8c000d44236","The (New) roles of prototypes during the co-development of digital product service systems","Kleinsmann, M.S. (TU Delft Methodologie en Organisatie van Design); Bhömer, Martijn Ten (The University of Nottingham Ningbo China)","","2020","This paper investigates different roles that prototypes play during the development of digital Product Service Systems (PSSs). A literature review reveals that prototyping supports designers during the design process, as well as during knowledge sharing processes with stakeholders. To create a better understanding of these two co-existing roles of prototyping, we executed a research-through-design project in the healthcare domain. This design project was centred around the development of four different prototypes that the designer sequentially developed. A major input into the design process was co-reflection sessions between the designer and different stakeholders. We analysed the prototyping process and the co-reflection sessions. Moreover, we executed a conversational analysis to understand the actual knowledge sharing processes between the designer and the different stakeholders. The results present a detailed overview of the different (co-existing) roles of the prototypes. We distinguished two new types of prototypes which were both related to the development of the intangible aspects of the digital PSS: (1) service interface prototrial aimed at exploring several options for detailing the different intangible aspects of the digital PSS, and (2) service provotype to stimulate collaborative creation of the intangible aspects of the digital PSS in an early stage.","Collaborative Design Tools; Healthcare; Product Service Systems; Prototyping","en","journal article","","","","","","","","","","","Methodologie en Organisatie van Design","","",""
"uuid:8569ffea-2d7f-428a-843c-46fd9bd8aac6","http://resolver.tudelft.nl/uuid:8569ffea-2d7f-428a-843c-46fd9bd8aac6","Solutions for mitigating cybersecurity risks caused by legacy software in medical devices: A scoping review","Tervoort, Tom (Universiteit van Amsterdam); Tuler de Oliveira, M. (Universiteit van Amsterdam); Pieters, W. (TU Delft Organisation & Governance); van Gelder, P.H.A.J.M. (TU Delft Safety and Security Science); Olabarriaga, Silvia Delgado (Universiteit van Amsterdam); Marquering, Henk (Universiteit van Amsterdam)","","2020","Cyberattacks against healthcare institutions threaten patient care. The risk of being targeted by a damaging attack is increased when medical devices are used which rely on unmaintained legacy software that cannot be replaced and may have publicly known vulnerabilities. This review aims to provide insight into solutions presented in the literature that mitigate risks caused by legacy software on medical devices. We performed a scoping review by categorising and analysing the contributions of a selection of articles, taken from a literature set discovered through bidirectional citation searching. We found 18 solutions, each fitting at least one of the categories of intrusion detection and prevention, communication tunnelling or hardware protections. Approaches taken include proxying Bluetooth communication through smartphones, behaviour-specification based anomaly detection and authenticating signals based on physical characteristics. These solutions are applicable to various use-cases, ranging from securing pacemakers to medical sensor networks. Most of the solutions are based on intrusion detection and on tunnelling insecure wireless communications. These technologies have distinct application areas, and the decision which one is most appropriate will depend on the type of medical device.","Healthcare; legacy software; medical devices; security","en","journal article","","","","","","","","","","","Organisation & Governance","","",""
"uuid:15a92587-116d-4f0f-bc65-05b37048ad34","http://resolver.tudelft.nl/uuid:15a92587-116d-4f0f-bc65-05b37048ad34","Non-emergency Patient Transfer Scheduling and Assignment","Foster, Travis (Dalhousie University); Vanberkel, Peter (Dalhousie University); Venkatadri, Uday (Dalhousie University); van Essen, J.T. (TU Delft Discrete Mathematics and Optimization)","Belanger, Valerie (editor); Lahrichi, Nadia (editor); Lanzarone, Ettore (editor); Yalcindag, Semih (editor)","2020","Emergency Medical Services organizations are responsible for providing paramedic crews, vehicles and equipment to transfer patients from one location to another in emergency and non-emergency settings. They must solve difficult scheduling and assignment problems to ensure on-time arrival of patients and the efficient use of health care resources during non-emergency operations. Ambulances can serve both emergency and non-emergency requests but are rarely available to serve non-emergency requests. Therefore, non-emergency requests are the responsibility of Patient Transfer Units. The objective of this study is to develop a mathematical model that will assign Patient Transfer Units to non-emergency patient transfer requests, design a schedule that will minimize travel costs and balance workloads and apply it to a real-world case study. This paper also proposes a framework to utilize historical patient transfer data in the scheduling process. The mathematical model provides decision support for the non-emergency patient transfer scheduling process.","Emergency Medical Services; Healthcare; Vehicle Routing","en","conference paper","Springer","","","","","Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.","","2021-04-16","","","Discrete Mathematics and Optimization","","",""
"uuid:0f113c67-02ef-4d2d-a890-b0c45ff48a3c","http://resolver.tudelft.nl/uuid:0f113c67-02ef-4d2d-a890-b0c45ff48a3c","Improving radiation safety for hospital staff during interventional surgery","Gudde, Tom (TU Delft Industrial Design Engineering)","van Heur, Rudolf (mentor); Beets, Margreet (graduation committee); Bloemen, Bert (graduation committee); Delft University of Technology (degree granting institution)","2019","Radiation is increasingly used to treat otherwise dangerous operations such as valve replacements with minimal consequences for the patient using live X-ray and catheters. These minimal invasive interventions are beneficial for the patient but physicians are exposed to high doses of radiation as a result. Products in the market of radiation protection are focusing on physical barriers for the radiation such as lead aprons and acrylic lead shields. Although effective, these are often not properly used, which increases the risk for exposure. Next to this, new products will enter a highly saturated market with vast generic alternatives. A design opportunity was found in the range of product aiming for training of physicians to properly work with radiation. From interviews and observations, it was concluded that there is no commons census among cardiologists regarding where the dangerous scatter radiation is present surrounding the patient. It is therefore vital to train or even reprogram their instinctive mind to have a clear idea about the presence of scatter in the OR; radiation safety through behavior change. Philips is involved in a strategy that is called the Quadruple aim. Where the current focus is more directed to the patient experience, the quadruple aim also includes the staff experience as a large influence in better healthcare. A product concept is created where staff experience is key. With this direction Philips will fill a gap in the market for training products and create a common census for safe radiation behavior. Introduced to new generations of hybrid OR’s as the Exposure Prevention Package (EPP), the concept solution will provide a set of clear indicators for safe radiation conduct. Physicians and other staff can now identify when they are exposed to the harmful, but invisible, radiation and act upon it. Through further involvement in the hospital itself Philips will be engaged in an introduction phase of their systems. This includes a introductory course in which operators learn to work with the system and at the same time experience a “learning by doing” style radiation safety course.","Radiation; Interventional cardiology; Radiation shielding; Scatter radiation; Philips Healthcare; Staff safety","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:262e4dd5-7d57-4adc-bbf5-eb87aaeab86a","http://resolver.tudelft.nl/uuid:262e4dd5-7d57-4adc-bbf5-eb87aaeab86a","The redesign of CPAP supplies for the Circular Economy: A product service system as a modular solution","Beeftink, Floor (TU Delft Industrial Design Engineering)","Flipsen, Bas (mentor); Kroon, Caroline (graduation committee); Thornander, Sophie (graduation committee); Delft University of Technology (degree granting institution)","2019","The business wide objective of Philips regarding the transition to the circular economy is among others, that 15% of the total revenue should be from circular revenue from products and services by 2020.Patients with Obstructive Sleep Apnea Syndrome use a CPAP machine at home to keep their airways open during sleep. The Sleep & Respiratory Care business of Philips creates these products and needs to reach the same general sustainability targets related to circular revenue. The masks and headgear are medical consumables and are replaced on a regularly basis according to the insurance’s reimbursement cycle. The products are not always broken when they are replaced and the current headgear design can not be recycled. Next to this, the products are provided to the patient through multiple stakeholders whereby Philips has low control over the material flow. Therefore, in this project the products are redesigned to become ‘circular ready’ and a roadmap for the implementation of new circular propositions have been created. A Life Cycle Assessment tool is created to assess the life cycle of the current product system and compare this to new designs and scenarios in an iterative way. The propositions are based on the three different circular strategies: Slowing resource loops, Closing resource loops and material efficiency. The new design has been optimized for a longer lifetime and easier cleaning ritual, as a first short term circular strategy. The new headgear will be made with a knitting production technique and two arms that slide in this piece. This design is based on the just released headgear with arms design of Philips. This ensures comfort and more stability for the user. It is recyclable and is material efficiently produced. The business model is redesigned in combination with a new procurement scenario that can be included in the already existing DreamMapper app. This is done to link the replacement to the performance of the products and stimulate a longer product life. Furthermore, a recycling and future reverse logistic scenario has been created. The silicone of the mask can be taken back and sold for recycling. The user can sent the products through the normal mail with the help of information from the app. The headgear can be recycled through the municipal textile recycling stream that should be widely implemented in Europe by 2025. All the proposition parts are designed with the eye on the future and technology trends. The future in CPAP supplies are custom made products, supported by digital production techniques and the 3d face scan software. This can enable super local production. From the final life cycle assessment of the different proposition parts can be concluded that these lower the kg CO2 emissions. The project results are expected to be highly feasible as already existing resources and infrastructures are used for the new proposition. The holistic design approach and solution, including the clear steps and advantages for the 4 key ingredients have inspired the business. The next steps are already taken.","Circular Economy; Circular Design Strategies; design for healthcare; Eco Design; Life Cycle Assessment; Recycling; Roadmapping; design for disassembly","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:17c5457a-5fc7-420b-92a7-ad121d4b9fa9","http://resolver.tudelft.nl/uuid:17c5457a-5fc7-420b-92a7-ad121d4b9fa9","Efficient cryptographic building blocks for processing private measurements in e-healthcare","Nateghizad, M. (TU Delft Cyber Security)","Lagendijk, R.L. (promotor); Delft University of Technology (degree granting institution)","2019","In order to achieve practical e-healthcare systems, five requirements should be addressed, namely 1) availability, 2) integrity, 3) accuracy, 4) confidentiality, and 5) efficiency. Using remote computer storage and processing services satisfies availability, integrity, and efficiency. However, it introduces privacy concerns regarding the leakage of private medical data to unauthorized parties, which violates GDPR. Data encryption is one of the widely used techniques to address those privacy concerns in e-healthcare systems. Although data encryption provides data confidentiality, while the accuracy and integrity of the data are preserved, it introduces computation and communication overheads that downgrade the efficiency of the e-healthcare systems.
To precisely find the bottlenecks in achieving privacy-preserving e-healthcare systems, we design three real-life e-healthcare scenarios. The scenarios are different in terms of the number of parties used in the system, the way that data are stored (centralized or distributed), and encryption key setting (single-key or multiple-key). Then, we identify the challenges and required cryptographic protocols for each scenario. Afterward, we investigate the performance of several applications that are using the same identified cryptographic protocols. We show that the existing cryptographic protocols, which are required for our scenarios, are dominating the computation and communication costs of the applications.
To address the challenges in the single-key setting, we improve the existing core building blocks, comparison, and equality testing, and develop new protocols to mitigate the overall costs of e-healthcare systems. We show that data filtering and retrieval protocols are still highly resource demanding, even though efficient building blocks are used. Thus, we develop a new secure indexing protocol that reduces the data filtering cost significantly. Moreover, we develop a novel data packing technique to achieve an efficient data retrieval protocol by using our indexing protocol. For themultiple-key setting, we introduce a homomorphic proxy re-encryption scheme. Our encryption scheme
has several properties such as an unlimited number of re-encryption, supporting homomorphism after each re-encryption, one-direction re-encryption, and non-interactive re-encryption key generation. Afterward, we use our encryption scheme for data filtering in the multiple-key setting and evaluate its performance.
The results of the performance analysis of our protocols show that improving core building blocks can significantly decrease both computation and communication costs of the cryptographic applications. Moreover, we show that developing techniques such as data packing and indexing can limit the number of homomorphic operations considerably, and consequently, mitigate the overall computation and communication costs of the cryptographic applications.","e-healthcare; privacy; multi-party protocol; building block; efficiency","en","doctoral thesis","","978-94-6366-224-6","","","","","","","","","Cyber Security","","",""
"uuid:e7a3a35d-fd49-4d2e-9bf8-47da7787a2d7","http://resolver.tudelft.nl/uuid:e7a3a35d-fd49-4d2e-9bf8-47da7787a2d7","Infection prevention as a shared responsibility: Improving the patient experience during contact isolation","de Koning, Judith (TU Delft Industrial Design Engineering)","Melles, M. (mentor); Sonneveld, M.H. (graduation committee); Jongerden, Irene (graduation committee); Dekker, Mireille (graduation committee); Delft University of Technology (degree granting institution)","2019","Healthcare-Associated Infections (HAI) can occur when microorganisms spread between hospitalized patients. To prevent highly contagious or resistant microorganisms from spreading from one patient to the other, isolation precautions such as contact isolation are applied when patients carry such a microorganism. The first part of this theses describes how contact isolation has a negative impact on well-being on patients. The experience during contact isolation can improve by establishing an open healthcare environment and providing information during the full isolation process. Collective action theories appear to have potential to be applied to the context of infection prevention. The contribution of patients, healthcare providers and visitors to infection prevention can be stimulated by increasing community feeling, establishing connections between individuals and providing information about past actions of other individuals. Context research has been conducted in VUmc and results on the current patient experience are gathered in a patient journey. Conclusions on the current patient experience during isolation are as following: 1. a shattered sense of responsibility amongst different actors 2. different patient persona’s experience contact isolation differently 3. a difference in experience and behaviour of first time isolation patients and readmitted patients. To improve the patient experience during contact isolation, the second part of this thesis focusses on creating a solution. By combining the conclusions and the literature, a design vision is formulated: I want to increase the feeling of community amongst all actors in the contact isolation process, so that all individuals experience a sense of shared responsibility towards infection prevention in VUmc. A first step towards the design vision is created with the guidance of the following design goal: I want patients to develop a favourable attitude towards contact isolation during the first time into contact isolation by providing a tool that lets them experience partnership with healthcare providers and visitors in contributing to the safety of others. Building from the patient journey and the design goal, a solution, Bundel, is proposed. It aims to increase a feeling of shared responsibility amongst the different involved actors and stimulated collaboration between individual. Bundel provides necessary and desired information to patients and visitors at fitting times. The first time into contact isolation is slowed down by spreading the information a patient needs and wants over the isolation process. By providing all the information to patients from the start of the isolation process, they can discover the necessary information they are looking for when they are ready. In addition, visitors are increasingly involved in infection prevention, because the design makes their involvement necessary them. Bundel thereby stimulates them to personally find the necessary information. For nurses and other healthcare providers, Bundel facilitates the transfer from a ‘controller and corrector’ to a ‘guide and facilitator’ towards patients and visitors. Therefore, responsibility that currently mainly lies with the nurse, shifts to a more equally shared responsibility amongst all actors.","Healthcare; Patient journey; Contact isolation; Collective action; patient experience","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:0c72f8c2-9ab1-461d-8a6a-60bb48037e68","http://resolver.tudelft.nl/uuid:0c72f8c2-9ab1-461d-8a6a-60bb48037e68","Zorg zonder Zorgen: Het ontwerpen van een stress reducerende zorgomgeving voor mensen met een chronische ziekte en hun mantelzorgers","Verweij, Daniëlle (TU Delft Architecture and the Built Environment)","van der Zaag, Engbert (mentor); Jennen, Pierre (graduation committee); van Oel, Clarine (graduation committee); Spinnewijn, Raymond (graduation committee); Delft University of Technology (degree granting institution)","2019","This study was aimed at developing a design guide for stress reducing healthcare facilities for people with a chronic disease and their caregivers. This study was conducted with literature research, interviews and analyzing reference projects. The results of the literature research show the impact of stress on the different users, the importance of informal care in the Netherlands and proof that stress can be reduced by architecture in the healthcare environment, for all users. The interviews resulted in six psychosocial needs that where translated to a set of design principles with use of the reference projects. These design principles can be used as a design guide. A sustainable and stress reducing radiotherapy clinic was designed in Leeuwesteyn, Utrecht, implementing the design principles from the research. With multiple care functions, divided in three departments, the building foresees in all care needed (mental, physical and medical care). Main concepts are a clear routing, four atria and a nice view on greenery. Separate routings for employees and visitors, and a separate space for all the users are making this building stress reducing. Daylight is guaranteed in all spaces without depriving the privacy, with the use of special façade materials as metal mesh and vertical bamboo slats. Therefore, the building is a stress reducing environment for care without worries.","Healthcare architecture; stress reducing; healthcare design; Healthy Environments; Stress; informal care; Cancer Care; Radiotherapy","nl","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","","52.082868, 5.076988"
"uuid:0d451cac-8eca-4445-b801-fa2331d21071","http://resolver.tudelft.nl/uuid:0d451cac-8eca-4445-b801-fa2331d21071","Designing a promising way towards better (colorectal) cancer care in Dijklander Ziekenhuis","Heddes, Jolien (TU Delft Industrial Design Engineering)","Dehli, Silje (mentor); Simonse, LWL (mentor); Blaauwgeers, H.G.T. (graduation committee); Delft University of Technology (degree granting institution)","2019","Cancer is a complex disease which requires interdisciplinary care. There are various developments ongoing within cancer care and its complexity. A task reallocation which is boosted by the government and new standards from SONCOS make it compulsory to have a fixed point of contact for cancer patients. Dijklander Ziekenhuis wants to introduce case management for cancer patients. Hereby, it is needed to investigate the needs and wishes of the patients and the caregivers and take into account the status quo and strategy of the hospital. Based on the research activities, the advise to Dijklander Ziekenhuis is to implement case management to prevent patients for referral and communication errors. At the same time it is advised to take a unique position by offering guidance throughout the treatment process and especially in the approach towards consults. This could be done by providing extra support, coaching and (informational) tools during the treatment process. This advise is transformed into a design of three deliverables. A care pathway, a Business Case and an Implementation Manual. The new care pathway is designed in such a format that it gives substance to the future vision of the Cancer Centre. The modular format meets the wishes to deliver bespoke and patient-centred care while expertise is retained and the overall process is monitored due to the new module within the pathway: the bridge. The care pathway also can be a ‘secret weapon’ to be leading in cancer care due to the design in three layers what makes possible better communication towards patients. This is essential for shared decision making. With all these characteristics, the new Care Pathway appears to be a gold mine on the way to better (colorectal) cancer care within Dijklander Ziekenhuis. The Implementation Manual literally describes the promising way towards better (colorectal) cancer. The aim of the Implementation Manual is to transform the current Cancer Centre into the desired future Cancer Centre in which the new Care Pathway is integrated. There is chosen for a phased implementation approach including pilots. In this way, there is expected a minimal disruption to the patient care and possible problems can be resolved quickly. The Business Case is written to make sure that the preconditions that are necessary to work towards better (colorectal) cancer in Dijklander Ziekenhuis will be met. Preconditions were mainly budget and formation related. Within this study, it became clear that there are extra nurse specialists needed. On the other hand, relatively less medical specialists are needed.","care pathway design; Case management; business case; Implementation; Hospital; Care pathway; healthcare design","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:6da7ece7-77e2-4ca2-b4b2-d9623c052630","http://resolver.tudelft.nl/uuid:6da7ece7-77e2-4ca2-b4b2-d9623c052630","Towards a Responsible Implementation of Artificial Intelligence in Healthcare: The case of Royal Philips","Ruiz Reina, Juan Camilo (TU Delft Technology, Policy and Management)","van de Poel, I.R. (mentor); van de Kaa, G. (graduation committee); Duran, J.M. (graduation committee); Franco, Andrea (graduation committee); Delft University of Technology (degree granting institution)","2019","The introduction of artificial intelligence (AI) technologies in healthcare is expected to set a paradigm shift to medical practice because these systems will have a significant role in applications such as diagnosis-support and image analysis. However, this implementation does not come without risks. There are important ethical concerns that should be addressed beforehand to ensure public trust and acceptability. Privacy, safety, transparency, reliability and potential biases are some of the issues to consider. Responsible Research and Innovation (RRI) frameworks have been designed by academics to tackle this sort of problems but there is no application of these frameworks in the field of AI in healthcare. This problem is even more salient in the private sector, due to the unawareness of the RRI concept in industry. Consequently, the research objective of this project was to offer recommendations on how to implement RRI practices to avoid potential risks and improve the social acceptability of AI. For this, we studied the case of Philips and carried out interviews with the company’s experts in AI and corporate social responsibility (CSR). This information was complemented with a comprehensive study of the literature on topics related to AI in healthcare and RRI. The results from these activities were used to create a roadmap to introduce RRI practices in the AI innovation activities within Philips. The results showed that large companies should build upon their existing CSR practices to develop RRI. This will increase the acceptability of RRI within the research and development (R&D) teams. Based on that, we came up with 14 recommendations for the case of Philips. These actions range from current practices, such as continuing with the rigorous process of patient data selection and curation, to novel solutions such as including better interactive features in the design of telehealth platforms (i.e. virtual reality, video calls or social networks). Further research can be carried out in different companies to come up with common principles that contribute to the creation of a more comprehensive RRI framework for AI in healthcare.","Responsible Research and Innovation; Artificial Intelligence; Healthcare; Philips; PRISMA Project","en","master thesis","","","","","","","","","","","","Management of Technology (MoT)","",""
"uuid:171cb15a-8397-46ce-8d3f-04129519d14a","http://resolver.tudelft.nl/uuid:171cb15a-8397-46ce-8d3f-04129519d14a","Investigation of overprotection in pediatric cardiology","Tsai, Yun Jung (TU Delft Industrial Design Engineering)","Kleinsmann, M.S. (mentor); van Heur, Ruud (graduation committee); Van Deutekom, Arend (graduation committee); Delft University of Technology (degree granting institution)","2019","Humanity grows from making mistakes. However, there is a group of people, and their cost of mistakes might be higher than the average. They are therefore protected by others, and their opportunity to explore the world is deprived. This protective behavior could be unnecessary or excessive, which is defined as overprotection. To detect the overprotection issue in the field of pediatric cardiology, the researcher, together with Erasmus MC- Sophia Children's Hospital, set up a collaborative program. The ultimate goal of the program was to design a smart product-service system which can prevent overprotective behavior in children with congenital heart disease. The present thesis is the initial step of the collaborative program— investigation of overprotection in pediatric cardiology. It addresses the concept of overprotection (OP) and vulnerable child syndrome (VCS), studies on the health-related life of children with congenital heart disease (CCHD), and their parents (PCCHD), then proposes a reformulated design goal and three tangible design missions as the final result. In the literature review, theoretical knowledge of overprotection and vulnerable child syndrome is elaborated. Three factors are especially highlighted, respectively risk factor, challenge, and indicator. The risk factor indicates the event that may trigger overprotection development; challenge means the parental barrier of performing proper protection; indicator expresses the theoretical assessment of overprotection. These factors are further brought to the empirical study to see how they influence life of CCHD and PCCHD. Empirical insights are captured during the empirical study. A total number of eight interviews were conducted, and the researcher also attended a sharing event in which five CCHD gave speeches on their grown-up experience. Collecting the medical history, interaction with people around, and narratives or opinions about overprotection was the main purpose of the empirical study. Factors derived from the literature were continuously reflected and compared with the empirical data. Theoretical knowledge and empirical insights were further integrated and synthesized. Based on the empirical narratives, the applicability of the theoretical overprotection indicators in pediatric cardiology is evaluated. Two indicators are found to have the highest significance and thus are suggested as the prioritized behavior that needs to be prevented. In addition, extreme quotes and narratives are selected and formulated in a positive case and a negative case. The positive case indicates good patient-parent relation without overprotection reported, while the negative case means tension in patient-parent relation with overprotection reported. Each case contains a patient persona, a parent persona, a health journey map, and an interactive map. Besides discerning the existing factors, four beneficial triggers are generated and highlighted as the main determinants which contribute to the difference between the positive case and the negative case. The insights provide a hint for potential design directions— prevent risk factors, support users to overcome the challenges, and guide users toward the beneficial trigger. Based on the design directions, a reformulated design goal and three corresponding design briefs were proposed as the final result of the thesis. The design goal was framed as “Design a product-service system which facilitates rational discussions within children with congenital heart disease, their parents and medical experts, in order to achieve a consensus upon diagnosis-specific and personalized boundaries between proper-protection and overprotection.” The three design briefs are further written as three dependent design assignments that provide guidelines and suggestions to the following designers.","Healthcare; cardiology; parenting behavior; overprotection","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:b80680f4-71f5-495e-a831-a68e32850386","http://resolver.tudelft.nl/uuid:b80680f4-71f5-495e-a831-a68e32850386","The consultation of the future: A tool to make the communication between patients and specialists more emphatic in the digital world of 2030","van der Velden, Hanneke (TU Delft Industrial Design Engineering)","Goossens, Richard (mentor); Kroon, Caroline (mentor); Klein Nagelvoort-Schuit, Stephanie (graduation committee); Delft University of Technology (degree granting institution)","2019","In the future, healthcare becomes more challenging to reach and less personal. The workload for specialists is increasing (Rossen, 2018), the current health path for patients is extended and long (van Tongerloo, 2019) and more general practitioners do not want to have their own practice which results in lower accessibility (Smit, 2019). Besides, the computer is often in-between the communication of the patient and the specialist when entering the consultation room (Voormolen, 2013). These developments are opposite to the ones of the on-demand society we are currently living in: people have personalised information on-demand and expect companies to understand their needs and wants on the spot (Solis, 2017). However, healthcare is, at this point, behind. The Erasmus MC has noticed this gap, and therefore, the Erasmus MC wants to implement the value-based healthcare strategy. Within this strategy, the Erasmus MC wants to focus more on the patient experience and the patient’s participation in decision making during the consultation (Kimpen, 2019). So how to improve this patient experience, to align the consultation with the value-based healthcare system? Within this project, the current barriers of positive patient experience, before, during and after the consultation, are defined by an extensive literature and user study. The concept proposal, the renewed patient portal of the Erasmus MC, aims to translate these barriers into enablers of a positive patient experience. The renewed patient portal exists out of three elements: improve the patient’s knowledge around a disease by giving personalised information (1), track the patient’s data to get more personalised care (2), and prepare the consultation to start the conversation to the point (3). A case study for diabetes type 1 patients, focussed on the second element of the renewed patient portal, shows a tangible example of how the patient’s data can be used to give more personalised and on-demand care. The final deliverable of the case study is Mijn Erasmus I.D., a visual representation of the patient’s mental and physical data. Mijn Erasmus I.D. is a digital patient I.D. that is accessible via a platform for the patient and an interactive screen in the consultation room. An extensive validation study has proven that Mijn Erasmus I.D. turns all the found barriers into enablers of the positive patient experience. The aimed longterm effect is to create a more in-depth and personal conversation, within the same amount of time. Mijn Erasmus I.D. allows the specialists to understand the perspective of the patient better within the given amount of time by gathering the patient’s information up-front. An understanding of the patient’s perspective contributes to better health outcomes at a physical, psychological and social level (Street, Makoul, Arora, & Epstein, 2009). The research, the design goal, the concept proposal (the renewed patient portal) and the case study (Mijn Erasmus I.D.) are evenly important to inspire healthcare for future innovation.","patient experience; future of healthcare; communication","en","master thesis","","","","","","","","2020-09-27","","","","Integrated Product Design","",""
"uuid:9fc4b0d2-0674-47fa-90a8-529a0bd3d267","http://resolver.tudelft.nl/uuid:9fc4b0d2-0674-47fa-90a8-529a0bd3d267","Insight.me: Enabling a collaborative use of healthcare data","Falcão Duarte, Carolina (TU Delft Industrial Design Engineering)","Romero Herrera, Natalia (mentor); Pannunzio, Valeria (mentor); Delft University of Technology (degree granting institution)","2019","This thesis presents research on data and healthcare and proposes a design vision that enables collaborative use of self-tracked data. This work was developed within the Cardiolab as a graduation work in Strategic Product Design. It aimed to identify the needs and aspirations of practitioners and patients and, then, embody the findings on a design vision.
To develop the design vision, literature research was carried and user research was done with healthcare professionals and patients. Mixed methods were used to collect and analyze qualitative data.
The results have revealed that trust plays a key role in a data-based collaborative system. It enables users and professionals engagements and provides value to other stakeholders involved. Furthermore, the research has revealed that ethical uses of data are critical to unlocking interactions in such a system. Based on that, a platform called ""Insight .me"" was designed.
From a design perspective, this thesis emphasizes the need for enabling data as material for personal reflection and collaboration, besides, it reinforces the need of designing ethical and trust base businesses to deal with self-tracked and personal data.","Strategic Design; healthcare design; Design study","en","master thesis","","","","","","","","","","","","Strategic Product Design | Medisign","",""
"uuid:9df62bd5-1615-45ee-ba95-85d673199b2c","http://resolver.tudelft.nl/uuid:9df62bd5-1615-45ee-ba95-85d673199b2c","Actuator for oral care in edentulous elderly patients","Lluch Sicard, Salvador (TU Delft Industrial Design Engineering)","Willemen, A.M. (mentor); Goossens, R.H.M. (graduation committee); Domhof, Daan (graduation committee); Delft University of Technology (degree granting institution)","2019","There are currently no technological options in the market for the oral care of edentulous population. Dental Robotics, a company already involved in the production of dental care devices for elderlies, is interested in new technological solutions to attend this sector. The design is challenging as it has to meet several requirements: 1) be built upon an existing platform (the Air 1 handle), 2) to demonstrate potential for efficiently clean different mouth morphologies, 3) to use an actuator that requires minimal maneuver and is easily accepted by patients and be practical for nurses, and all these while showing manufacturing feasibility and production scalability. The methodology followed a combination of design thinking and lean startup, meaning a human centered, technology-based iterative and integrative process of prototyping and test. Through this progressive development, diverse strategies were applied, including literature research, field work observations and empathizing with the problem, comparison of market-available alternatives, exploration of materials and prototyping processes, evaluation of effectiveness and acceptance of different design versions, image analyses to evaluate cleaning capacity, manufacturing process, etc. The result is a validated prototype that meets the technical requirements and represents the optimal solution within the explored options; however, future progress could result from optimizing the motion of the Actuator, improve design features to make the assembly easier, explore different arrangements of tufts textures to increase comfort, increase the sample of mouth morphologies to better represent the edentulous elderly population in The Netherlands, to test the effect of the gum cleaner with Laser Doppler Flowmetry to find out if it could stimulate blood flow (Irrigation) on the gingiva, and for how long, and evaluate the long-term impact of this device in the reduction of Residual Ridge Resorption clinical tests. If proven, this could be an added value offered by the company. The proposal for oral care in edentulous elder patients developed in this work proved promising as market product after further performance and manufacturing process refinements.","healthcare design; Edentulism; Med-Tech; Oral care","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:2f789f26-8dc3-4e65-aa1d-068886618381","http://resolver.tudelft.nl/uuid:2f789f26-8dc3-4e65-aa1d-068886618381","Design of a 3D printer for healthcare in Sub-Saharan Africa","Hille Ris Lambers, Ludo (TU Delft Industrial Design Engineering)","Diehl, Jan-Carel (mentor); Doubrovski, Zjenja (graduation committee); Delft University of Technology (degree granting institution)","2019","With the introduction of the RepRap 3D printers, capable of printing most of its own parts, the cost of 3D printers dropped radically, making it an affordable and accessible technology, even for low resource settings. It is said that 3D printing can greatly increase accessibility to medical equipment in low resource settings because it enables local production and radically reduces costs. Within the Delft Global Initiative there are several research teams experimenting with the use of 3D printing for local production of low cost medical equipment in Sub-Saharan Africa. They quickly discovered that 3D printing in this setting is not as easy as it might sound. For one, the operating conditions were found to be much harsher in African, than in Western settings. According to researchers from Penn State University, current 3D printers lack in user-friendliness and robustness required to impact rural healthcare. Therefore, the goal of this project was to (1) identify the challenges for 3D printing in Sub-Saharan Africa, and (2) develop a final design proposal for a 3D printer for healthcare in this setting. The project started with an extensive analysis phase, where Kenya was chosen as a case study of a Sub-Saharan African country. The goal of this phase was to get a deep and qualitative understanding of the context of Kenya, and identify important implications for the design. In the design phase, an extensive amount of time and effort has gone into finding solutions for the challenges identified during the analysis. Solutions were developed to make the printer (1) able to operate on an unstable grid, (2) able to deal with excessive dust and high temperatures, (3) maintain a maximum printing uptime, (4) allow the printer to be used by anyone and finally (5) to allow the printer to be compactly transported. The first deliverable is a list of valuable insights that provides a deep and qualitative understanding in the context of Kenya in relation to 3D printing. This can primarily be used for the development of a 3D printer for low resource settings, but might also be valuable for initiatives working on closely related products in a similar setting. The second deliverable, in the form of a final design proposal, consists of a Prusa i3 printer adapted to fit the context of Kenya. It features a flexible power supply with backup battery, protection against dust and high temperatures, an automatic part ejection system, easy use through smartphone and lastly it is can be compactly transported and quickly assembled. The design proposal was evaluated by a panel of experts from Kenya and the US. They rated the final design to fit the intended user and context very well, but also stressed that it could be tailored more to the healthcare sector. The proposal was considered a better solution than what is currently on the market. More work should be done in the field of usability.","3D printer; healthcare; Sub-Saharan Africa","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:41305465-b828-4208-bb99-4c0fc2492dc3","http://resolver.tudelft.nl/uuid:41305465-b828-4208-bb99-4c0fc2492dc3","A game about safety culture: creating awareness among healthcare professionals about culture and behaviour regarding patient safety through serious gaming","Boogaard, Mina (TU Delft Industrial Design Engineering)","Goossens, Richard (mentor); Mooij, Sylvia (graduation committee); Delft University of Technology (degree granting institution)","2019","The start of this project is a first version of a serious game that was designed by the company MEDD. This is an independent design and consultancy agency for healthcare. They designed this game as part of their ‘Met Elkaar Durven Doen’ toolbox, which they use in trainings and workshops. The Haga Hospital is the co-design partner of the game, and during the week of patient safety, a first version of this prototype was played by healthcare professionals of the Haga Hospital. The main aspect of the game are the question cards. These cards are divided into three themes: Patient Experience, Risk Management, and Culture and Behaviour. Within these themes, the players get knowledge based questions, questions to discuss, or small assignments. In a questionnaire done by MEDD in the Haga Hospital and through the reactions of the healthcare professionals that played the game, can be concluded that these three themes are themes that healthcare professionals would like to learn more about. The assignment within this project is to further develop the existing design and make it applicable to other hospitals and healthcare organisations. The Safety Game is meant to create awareness and a deeper knowledge an understanding of safety and quality within hospitals. To provide background to why this is necessary, a literature review and field research are done. From this research can be concluded that an open culture is important to manage risks in the hospital. Unfortunately, most hospitals have a blame culture, where healthcare professionals don’t correct each other or speak up in fear of the consequences. To change this blame culture into an open culture, the behaviour of the healthcare professionals needs to change. To make healthcare professionals aware of their type of culture and how to change this, a serious persuasive game can be used. To design this serious persuasive game, the Persuasive Game Design model is used. The research provided the insights to fill in the Real World Experience and the Gamification Design. From the research the goal was defined: Designing a meaningful, serious, persuasive game for healthcare professionals to gain lasting awareness on their behaviour regarding safety and how they influence their own safety and that of others. In the ideation phase, three concepts were developed. From these three, a concept was chosen that is based on the idea of an escape room idea. The final design consists of a small house that represents the hospital, a patient card, question cards in the earlier mentioned themes, a padlock to lock the hospital, three puzzles in the same themes as the question cards, and puzzle pieces. This design is tested in the Haga Hospital with healthcare professionals. The final design, the game ‘Cultuur rondom Veiligheid’, is proven to create awareness regarding culture and behaviour, and how this influences (patient) safety, thus reaching the design goal. The base of the final design can be used to be adjusted to fit other healthcare organisations or keep the game up to date by MEDD.","Healthcare; Serious Game; Persuasive Game Design; Medisign; safety; Safety Culture","en","master thesis","","","","","","","","","","","","","",""
"uuid:74561db2-3a25-4773-81a4-fbc86d2a284f","http://resolver.tudelft.nl/uuid:74561db2-3a25-4773-81a4-fbc86d2a284f","The Elderly Movement: Elderly in charge of their own flows in life again","Alkema, Rosanne (TU Delft Architecture and the Built Environment)","Jurgenhake, B.M. (mentor); Reinders, L.G.A.J. (graduation committee); Lafeber, J.W. (graduation committee); Nase, I. (graduation committee); Delft University of Technology (degree granting institution)","2019","The aging society causes problems on three different scales. For cities in general, for the residential housing for elderly and for people who live (elderly) and ‘work’ (healthcare organizations) inside the buildings. The existing elderly homes as well as public spaces can not accommodate the growing numbers of elderly anymore. Due to this fact and the transitions in the elderly care policy, there is need to rethink the architecture of home and living environments for elderly. We must start to think about new concepts for a more inclusive environment for elderly. The goal of this project is to provide Harderwijk with an urban structure where elderly can dwell, live life and interact with each other but also with other target groups, because we have to get rid of hiding elderly in nursing homes, they should become part of society again! With other target groups I think for example about people who need revalidation, so create a link with the hospital which is located nearby the site. The urban structure will provide residences but it will also become a vital network which prevents loneliness and creates a vibrant community. This new social ecosystem will put the elderly in the centre of society. Nowadays, the pace of the world is so fast that not only elderly, but people of all ages, get anxious, overwhelmed and overstimulated quite easily. They will take a step back from society due to this fast pace and that’s where loneliness kicks in. In order to make elderly part of society, it is important to slow down the city to the speed of the elderly. Make them feel comfortable and safe, in that way you will motivate vulnerable elderly to go out again. So, in order to create an inclusive environment for elderly you need to start at the urban fabric. Only a building can not solve the problem, the whole urban network around it should be upgraded as well.","Architecture; Elderly; Flows; Healthcare architecture; Age-friendly cities","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","Designing for Care","52.3460437, 5.6130631"
"uuid:fd802e4c-dcbc-48b6-a5e9-2033b82ee0bf","http://resolver.tudelft.nl/uuid:fd802e4c-dcbc-48b6-a5e9-2033b82ee0bf","The development of a minimum viable product to facilitate the venipuncture procedure","Hooft Graafland, Joy (TU Delft Industrial Design Engineering)","Diehl, Jan-Carel (mentor); Bakker, Martien (mentor); Delft University of Technology (degree granting institution)","2019","This report showcases the development of a product to aid the venipuncture procedure. Venipuncture is a procedure where intravenous access is obtained for several purposes. Finding a location and vein to insert the needle is the most important step of this procedure. Nearly 90% of hospitalised patients have to undergo the procedure. Despite venipuncture being the most performed procedure at hospitals, almost 50% of all cases fail at the first needle insertion attempt with adults and more than 60% with children. This failure leads to several complications such as bacterial infection, extravasation or phlebitis.
The product must be able to be used for all skin types and all healthcare contexts. For this, multiple end-users and use cases are within the scope of the project. To cover all use cases, a minimal viable product is developed. This is a product which has all minimal functionalities to make the product viable. The minimal viable product can be altered with minimal adjustments to make it fit to a specific context.
To increase first-attempt success rate, the Veindicator is developed. This product will have minimal viable functionalities to aid the venipuncture procedure. The Veindicator is a device which uses Near Infrared spectroscopy to visualise veins. Near infrared spectroscopy analyses the transmission and absorption of photons within the near infrared spectrum. Veins contain deoxygenated hemoglobin which, when exposed to near infrared radiation, almost completely absorb this radiation. By utilising the absorption characteristics of deoxyhemoglobin, veins can be distinguished from surrounding tissue. To further enhance the contrast of the vein pattern and the surrounding tissue, the exposure of NIR is increased. Looking at the optical absorption window, a light source is used with a wavelength between 700 - 900 nanometer within the electromagnetic spectrum. Here, the deviation between the attenuation coefficients of deoxyhemoglobin and human tissue are the highest. The image of the enhanced veins is captured and contrast is further increased by the use of digital image processing algorithms. Finally, the enhanced vein pattern is extracted from the image and via a projector, displayed back onto the skin. The projection increases the visibility of the veins and therefore aids the venipuncture procedure.
In an attempt to improve patient outcome, provide a better service and reduce the workload at the outpatient clinic, the LUMC launched a novel project called ""the BOX"". The BOX allows patients to self-monitor their vitals after a myocardial infarction (MI) or heart surgery, thus reducing visits to the hospital.
Patients are given a Wi-Fi scale, a watch with a pedometer, a Wi-Fi blood pressure meter (BPM) and a one-lead EKG/ECG monitor. The devices are produced by two different companies (Nokia/Withings and Alivecor) and are connected to the mobile phone of the patients. Patients have to measure their vitals on a daily basis and are instructed to contact a professional in case of emergency. Preliminary results show a good acceptance from the patients and high willingness to self-monitor their disease. This new product-service reduces the number of regular visits to the outpatient clinic by 40%, which are replaced by video conference.
In this context, the cardiology department plans to take the next steps to expand this service and provide effective and quality care using e-Health medical devices. Nevertheless, they are dependent on different stakeholders to do so. On the one hand, the companies that sell the medical devices (like the ones included in the BOX) control the patient data, and grant access to the hospital. A change in their business model can affect patient safety, privacy and the systems that the hospital has to put into place. On the other hand the patient must use the devices. Self-monitoring is an important behaviour for self-management, required for various chronic illnesses such as diabetes, hypertension, and heart diseases. But, having a plethora of devices and applications is not accessible for all the patients, which is a critical requirement for the LUMC as a part of a public institution that focuses on providing healthcare services to the general population. Moreover, a hospital requires stability for the long-term in order to implement technological solutions that directly affect patients.
The described situation is an interesting opportunity to look at product/services through different lenses (public sector) and design within the institution. Although, it also has the constraint/limitation that doctors are not engineers/producers. In addition, it is a vast problem to tackle, thus the necessity to focus on one area as the research is done.","myocardial infarction; self-monitoring; cardiology; product-service design; healthcare","en","master thesis","","","","","","","","","","","","Integrated Product Design | Medisign","",""
"uuid:f3747b7f-d420-411a-8332-c0383cfebb75","http://resolver.tudelft.nl/uuid:f3747b7f-d420-411a-8332-c0383cfebb75","Myo: A discreet device to monitor atrial fibrillation for elderly people","Petrocchi, Filippo (TU Delft Industrial Design Engineering)","van Heur, R.J.H.G. (mentor); Ruiter, Iemkje (graduation committee); Lombardi, David (graduation committee); Delft University of Technology (degree granting institution)","2019","In collaboration with Cardioline Spa, this graduation project presents the development of a discreet device to monitor atrial fibrillation among elderly people. By means of user research and contest analysis, the project is aims at delivering a new product-system device for the company, for Healthcare institutions and for private patients. The project is characterized by three main phases: the first one is about the analysis of the holter monitor world ; the second is related to synthesizing the research results into one concept; and the third one focuses on validating and test the concept proposed. According to the three pillar of Industrial design engineering the research was divided into the three macro areas of: People, Business and Technology. The people linked with the holter monitor system investigated during several activities including Interviews were 14 elderly patients, one General practitioner, one cardiologist and two nurses. Furthermore, to dive deeper into the experience I underwent a 24 hour holter monitor experience. The magnitude of the cardio healthcare business side was explored by the analysis of the main Healthcare trends. In addition, special attention was given to Cardioline’s past innovations and some guidelines for future innovations were outlined. The technology side was also investigated. The Scope of the technology analysis was to understand the current state of the art of ECG technology and its related evolution over the years.
There was a special focus on the transition from the current situation to the mobile health and to why biosensors are preferred to the standard holter monitor. To close the technological part, a perceptual map was made in order to compare the Cardioline product with its competitors. The perceptual map was also used to decide on the transition from the current product to the future product. All the data collected during the analysis phase was collected in a list of requirements composed of demands (hard requirements) and wishes (soft requirements). Afterwards a brainstorm session was run taking into account some of the main problem revealed. After several iterations, the brainstorm results were synthesized into three concepts which were presented during the midterm presentation. Feedback was provided by chair, by mentor and by the Company mentor. Suggestions were used to determined the final user scenario, the final system layout and the final concept. The final concept consisted of a wearable device which records and transmits ECG signal to the smart phone. The smart phone collects and transmits data to the cloud server where the user and Doctor, if authorized, can have access. With a special focus on the setting up phase, a test was performed. The scope of the test was to check if specific concept features were correctly driving the user towards the hypothesised behaviour. The test revealed good and improvable aspects of the product-system designed. The improvable aspects were used to refine the final concepts.
Finally, together with Cardioline supervision, several engineering ecommendations were elaborated. Those recommendations were related to the concept material, to the electronic components","atrial fibrillation; Healthcare; Comfort; Wearable Technology; heart","en","master thesis","","","","","","","","","","","","Integrated Product Design","",""
"uuid:0674d6de-ecaf-44e4-a3bc-61a66841557d","http://resolver.tudelft.nl/uuid:0674d6de-ecaf-44e4-a3bc-61a66841557d","The Equipment Journey as a tool to design safe surgical equipment for low-and middle income countries: Electrosurgery used as an example","Hesselink, Larissa (TU Delft Industrial Design Engineering)","Diehl, Jan-Carel (mentor); Sonneveld, Marieke (graduation committee); Delft University of Technology (degree granting institution)","2019","In low- and middle income countries there is a need for safe and affordable high quality surgical equipment. Nowadays, electrosurgical units are part of the standard equipment in operation theatres worldwide, since electrosurgery comes with many advantages such as reduced blood loss. However, the technology of electrosurgery also carries several safety risks such as alternative electrical pathways or current leakage which often have burn wounds as a result. The problem is that electrosurgical equipment was not designed with the low-resource healthcare context in mind. And as research shows many hazardous situations are frequently caused by electrosurgical equipment use in low-resource countries (Oosting, 2018). The aim of this study is to determine how the low-resource healthcare context triggers safety risks to occur. Therefore, the general technology related risks, the journey of the electrosurgical equipment in terms of activities, and the user characteristics are researched. In the user study special attention is paid to the users’ knowledge about electrosurgery. The research data was collected by conducting a literature study, and by using a qualitative case study approach. In a Kenyan national hospital fourteen surgeries were observed and semi-structured interviews were held with users of the electrosurgical equipment. The data was used to map out the electrosurgical equipment journey including all the phases and activities the equipment is involved in. Additionally, user profiles were created. The results show that the electrosurgical equipment journey contains following phases: procurement, pre-treatment, surgical treatment, post treatment, maintenance, repair and disposal. The main users of the electrosurgical equipment are the biomechanical engineering technician (BMET), the nurse, the surgical assistant, the surgeon and medical students. What is striking is that only the BMET learn about the principles of electrosurgery during his/her education.
The study results reveal that the interplay of safety risks generally related to electrosurgery, contextual factors, and user characteristics trigger several safety concerns. The risks lead from the selection of too high power settings to incorrect placement of the return electrode plate, and not knowing how to react in case of an system error. The study reveals that many of those safety concerns are caused by the medical staff’s lack of knowledge about the principles and risks of electrosurgery, and by an interface design that does not consider these user characteristics and needs. On this basis, a new interface of the electrosurgical unit and additional information stickers for safe equipment use are developed during this project. The equipment journey is used to pinpoint safety concerns and related root causes which are planned to resolve. Furthermore, the journey helps to determine where the design intervention should be placed. It is recommended to further develop the design concepts in the future and test their usability with intended users. The equipment journey for discovering safety concerns appeared not only to be valuable within this project. An evaluation of the equipment journey revealed that the tool is also valuable for other designers/researchers to empathize with the low-resource healthcare setting, and to gain insights into the journey of the equipment and the related safety concerns. Future research should explore if the equipment journey is also suitable for mapping out the journey and safety concerns of other surgical equipment.","Equipment Journey; Electrosurgery; Electrosurgical unit; Low-resource healthcare context; global health; Safety risks; Risk analysis; risk assessment","en","master thesis","","","","","","","","","","","","Design for Interaction","",""
"uuid:554d45da-2295-4df0-ba23-6dcad2533116","http://resolver.tudelft.nl/uuid:554d45da-2295-4df0-ba23-6dcad2533116","Samen Leven: A research about elements in architecture which contributes to a healthier environment","Himmit, Imane (TU Delft Architecture and the Built Environment)","de Wit, L.M.M. (mentor); Jennen, P.H.M. (graduation committee); Willekens, L.A.M. (graduation committee); Quist, W.J. (mentor); Delft University of Technology (degree granting institution)","2019","This research and design is about ""Het Gemeenschap Gezondheidshuis; Samen Leven"". A research about the change of healthcare nowadays; where people want to stay at home longer and have care at home. But also where the needs of a patient are more central. The main question is: what elements of architecture contributes to a healthier environment, to create a home like feeling for everyone with different cultural backgrounds. In the design this was the mainfocus. In the design these aspects where applied in the forms of a single room area, where the rehabilitated had the choice to whether stay in there rooms, make use of the common kitchen of have a coffee in the public coffee bar. In this same bar passants have the oppertunity to drink a coffee as well, without having the feeling to be in a place of recovery.","health; architecture; healthcare; interiors; stairs; society","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","","51.921445, 4.483129"
"uuid:cad22ace-717f-481e-9087-febba7588a1d","http://resolver.tudelft.nl/uuid:cad22ace-717f-481e-9087-febba7588a1d","A perfect fit: creating supportive housing for the autistic","van Beek, Laura (TU Delft Architecture and the Built Environment; TU Delft Architecture)","van de Pas, R.R.J. (mentor); Jennen, P.H.M. (mentor); Willekens, L.A.M. (mentor); Vitner-Hamming, D. (graduation committee); Delft University of Technology (degree granting institution)","2019","In contemporary society, a large part of the housing stock for people with autism focuses on living with house mates and in-house support (Berger et al., 2005). It seems, through several extensive questionnaires, that 65% of those individuals seek another housing situation, namely independent housing of some sort (Begeer et al., 2013). Design of these types of apartments should be done with great care, since individuals with autism can suffer extensively from ill-designed surroundings (Schrameijer, 2013; Alexa, 2017). Nowadays, most housing that is available, still feels very institution-like and is scarely furnished. For this research, the following main question will serve as guidance: Which architectural elements can increase the well-being of people with autism within their home environment? The research focuses on three elements: literature study, typological research, and questionnaires/interviews with residents and personal tutors. The results deriverd from this research, are divided in problems and solutions, which then are further categorised in themes: sensory, social, and spatial. As a conclusion, I have strived towards creating conclusive guidelines for design. I have applied these design principles in my graduation project which contains a new modern little courtyard, as well as the transformation of an old school building. In these designs, I aim to show how the principles can be applied in several ways: more rigorously in the new development, while being more restrained and subtle in the transformation project. Firstly, sound appears to be the most disturbing factor in housing situations: this notion kept reoccuring in the research. Other annoyances were: glare and reflection of sunlight; abundance of darkness during the night; an unlogical routine space; lack of personal space; feelings of unsafety; forced social interaction; problems with wayfinding; lack of personalisation opportunities. To solve these problems, several solutions have come up during the research. These solutions have been summarised with addition of design suggestions, including: application of a high amount of sound insulation materials; use of matte finishes; providing a spatial layout that supports (and creates expectations for) routine; design fully equipped houses with addition of common rooms in the building; allow for social interaction, both planned as well as accidential; create opportunities for personalisation; design transitions thoughtfully. These research elements have resulted in the design of a modern Dutch little courtyard (e.g. 'hofje'), where the design has been adapted to the residents through all scales: from urban to interior level.","autism; supportive housing; sensory architecture; design guidelines; Leiden; Healthcare architecture; Dwelling","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Explorelab","","52.159633, 4.495654"
"uuid:63639827-63a5-44b8-b244-e266e767df38","http://resolver.tudelft.nl/uuid:63639827-63a5-44b8-b244-e266e767df38","MRI-driven design of customised 3D printed gynaecological brachytherapy applicators with curved needle channels","Laan, Rianne (Student TU Delft); Nout, Remi A. (Leiden University Medical Center); Dankelman, J. (TU Delft Medical Instruments & Bio-Inspired Technology); van de Berg, N.J. (TU Delft Medical Instruments & Bio-Inspired Technology; Erasmus MC)","","2019","Background:
Brachytherapy involves placement of radioactive sources inside or near the tumour. For gynaecological cancer, recent developments, including 3D imaging and image-guided adaptive brachytherapy, have improved treatment quality and outcomes. However, for large or complex tumours, target coverage and local control with commercially available applicators remain suboptimal. Moreover, side effects are frequent and impact on quality of life. This signifies that brachytherapy treatment conformity can improve. Therefore, the aim of this study is to develop 3D printed personalised brachytherapy applicators with a custom vaginal topography and guided needle source channels, based on the patients’ anatomy. -
Methods:
Customised applicators were derived from MRI data of two gynaecological cancer patients. Needle channels were planned by the Radiation Oncologist during image segmentation. Applicators contained multi-curved channels for 6F needles (ProGuide, Elekta) and were manufactured using a digital light processing-based 3D printer. Needle channel radius constraints were measured by analysing needle insertion forces in a 3D printed template, and imposed on the designs. -
Results:
Two customised needle applicators are presented. Interstitial needle channels have tapered ends to increase needle protrusion angle accuracy. Additional structures were included to serve as anchor points in MR images for applicator and needle modelling and reconstruction during treatment planning. An insertion force analysis yielded a radius constraint of 35 mm to minimise the risk on needle jamming or buckling. For radii larger than 50 mm, no differences in insertion forces were found. -
Conclusion:
A novel method to design and produce vaginal topography-based 3D prints for personalised brachytherapy applicators, derived from patient MRI data, is presented. The applicators include curved needle channels that can be used for intracavitary and guided interstitial needle placement. Further spatial optimisation of brachytherapy source channels to the patient anatomy is expected to increase brachytherapy conformity and outcome.","Brachytherapy; Gynaecology; Personalised healthcare; Medical devices; Needle steering; Additive manufacturing","en","journal article","","","","","","","","","","","Medical Instruments & Bio-Inspired Technology","","",""
"uuid:7f6b32bf-83ca-4482-a5e3-a6e55d903bd5","http://resolver.tudelft.nl/uuid:7f6b32bf-83ca-4482-a5e3-a6e55d903bd5","Scheduling Non-Urgent Patient Transportation While Maximizing Emergency Coverage","van den Berg, P.L. (TU Delft Discrete Mathematics and Optimization; Erasmus Universiteit Rotterdam); van Essen, J.T. (TU Delft Discrete Mathematics and Optimization; Centrum Wiskunde & Informatica (CWI))","","2019","Many ambulance providers operate both advanced life support (ALS) and basic life support (BLS) ambulances. Typically, only an ALS ambulance can respond to an emergency call, whereas non-urgent patient transportation requests can be served by either an ALS or a BLS ambulance. The total capacity of BLS ambulances is usually not enough to fulfill all non-urgent transportation requests. The remaining transportation requests then have to be performed by ALS ambulances, which reduces the coverage for emergency calls. We present a model that determines the routes for BLS ambulances while maximizing the remaining coverage by ALS ambulances. Different from the classical dial-a-ride problem, only one patient can be transported at a time, and not all requests are known in advance. Throughout the day, new requests arrive, and we present an online model to deal with these requests.","integer linear programming; non-urgent patient transportation; online scheduling; OR in healthcare","en","journal article","","","","","","","","","","","Discrete Mathematics and Optimization","","",""
"uuid:60b791d7-85c8-4f93-8997-ee5ea16878ab","http://resolver.tudelft.nl/uuid:60b791d7-85c8-4f93-8997-ee5ea16878ab","Medication-related harm in older adults following hospital discharge: Development and validation of a prediction tool","Parekh, Nikesh (Brighton and Sussex Medical School); Ali, Khalid (Brighton and Sussex Medical School); Davies, John Graham (King’s College London); Stevenson, Jennifer M. (King’s College London); Banya, Winston (Royal Brompton and Harefield NHS Foundation Trust); Nyangoma, Stephen (Royal Brompton and Harefield NHS Foundation Trust); Schiff, Rebekah (Guy's and St Thomas’ NHS Foundation Trust); van der Cammen, T.J.M. (TU Delft Applied Ergonomics and Design); Harchowal, Jatinder (The Royal Marsden NHS Foundation Trust); Rajkumar, Chakravarthi (Brighton and Sussex Medical School)","","2019","Objectives To develop and validate a tool to predict the risk of an older adult experiencing medication-related harm (MRH) requiring healthcare use following hospital discharge. Design, setting, participants Multicentre, prospective cohort study recruiting older adults (≥65 years) discharged from five UK teaching hospitals between 2013 and 2015. Primary outcome measure Participants were followed up for 8 weeks in the community by senior pharmacists to identify MRH (adverse drug reactions, harm from non-adherence, harm from medication error). Three data sources provided MRH and healthcare use information: Hospital readmissions, primary care use, participant telephone interview. Candidate variables for prognostic modelling were selected using two systematic reviews, the views of patients with MRH and an expert panel of clinicians. Multivariable logistic regression with backward elimination, based on the Akaike Information Criterion, was used to develop the PRIME tool. The tool was internally validated. Results 1116 out of 1280 recruited participants completed follow-up (87%). Uncertain MRH cases (â 'possible' and 'aprobable') were excluded, leaving a tool derivation cohort of 818. 119 (15%) participants experienced 'definite' MRH requiring healthcare use and 699 participants did not. Modelling resulted in a prediction tool with eight variables measured at hospital discharge: Age, gender, antiplatelet drug, sodium level, antidiabetic drug, past adverse drug reaction, number of medicines, living alone. The tool's discrimination C-statistic was 0.69 (0.66 after validation) and showed good calibration. Decision curve analysis demonstrated the potential value of the tool to guide clinical decision making compared with alternative approaches. Conclusions The PRIME tool could be used to identify older patients at high risk of MRH requiring healthcare use following hospital discharge. Prior to clinical use we recommend the tool's evaluation in other settings.","healthcare use; hospital discharge; Medication harm; older adults; risk prediction","en","journal article","","","","","","","","","","","Applied Ergonomics and Design","","",""
"uuid:0ac9e92f-38ec-4d24-bc99-e320ec8af10c","http://resolver.tudelft.nl/uuid:0ac9e92f-38ec-4d24-bc99-e320ec8af10c","Designing a service for the management and prevention of periprosthetic joint infection cases","Vijfvinkel, Michaël (TU Delft Industrial Design Engineering; TU Delft Product Innovatie Management)","Beekman, Quiel (mentor); Albayrak, Armagan (mentor); Bodewes, Hilbrand (graduation committee); Delft University of Technology (degree granting institution)","2018","This thesis describes the design process of a service/tool for the management and prevention of periprosthetic joint infection (PJI) cases. PJI is a complication that follows total joint replacement and is devastating for the patient. It causes physical and mental strain and the patient's health never returns to close to what it was prior to the complication. It furthermore lays a financial burden on hospitals and society. The assignment for this thesis is initiated by Zimmer Biomet, the leading manufacturer for orthopaedic medical devices and joint prostheses. It is expected that providing services and tools that aid in the management and prevention of PJI cases will become a future strategy of Zimmer Biomet. The research in this thesis defines that the biggest problem concerning the management and prevention of PJI cases is the presence of a knowledge gap between guidelines defined by experts and appliable knowledge by staff. The multidisciplinary team (MDT) dashboard is a solution to this problem. This dashboard aids in the diagnosis and decision for treatment method of PJI cases. It is used both prior to and during the MDT meeting, which is a meeting during which a team of physicians from varying disciplines discuss PJI cases to arrive to a just diagnosis and optimal decisions for treatment methods. The dashboard provides visual aids, to help all members communicate their substantiation and to ensure that every aspect is discussed. It furthermore gives a non-binding advice, based on the patient data and guidelines developped by PJI experts. A digital prototype of the dashboard and a strategy are also presented. After validation of both these elements, further elaboration is given on the technical and organisational implementation of the dashboard, into hospitals. It is concluded that the dashboard is feasible, desirable and viable and that it will aid in the management and prevention of PJI cases. Next to aiding surgeons and MDT members, it will improve patient outcome and will serve an economic and societal goal. It is therefore recommended that Zimmer Biomet continues the development and pursues the implementation of the dashboard.","Healthcare; Design; Innovation management; Implementation; Service design","en","master thesis","","","","","","","","","","","","Strategic Product Design","",""
"uuid:d4089d96-22e4-42f1-ab1d-7fa6e2c1b0e1","http://resolver.tudelft.nl/uuid:d4089d96-22e4-42f1-ab1d-7fa6e2c1b0e1","Healthcare Sustainability Mode and Effect Analysis: Design, validation, and clinical application of the HSMEA tool to improve the environmental sustainability of healthcare","de Ridder, Else (TU Delft Mechanical, Maritime and Materials Engineering; TU Delft Biomechanical Engineering)","Dankelman, J. (mentor); Klein, J. (graduation committee); de Koning, J.I.J.C. (graduation committee); Quist, J.N. (graduation committee); Friedericy, Hans (graduation committee); Delft University of Technology (degree granting institution)","2018","Sustainability is becoming more important in numerous industries, including healthcare. Action to achieve sustainability is undertaken by various means, such as the Green Deal Healthcare. Several tools exist that can assess the environmental impact of a certain industry or company, but no tools exist that aid in actively lowering this environmental impact. Therefore, the HSMEA (Healthcare Sustainability Mode and Effect Analysis) tool was developed. This method is based on the Lean philosophy and HFMEA (Healthcare Failure Mode and Effect Analysis) tool and consists of six steps that aid in making a healthcare process more sustainable, in terms of waste production, energy use, or water use. With this tool, processes that contribute to these factors are identified in a highly structured and systematic way, and practical solutions are created and executed for these situations by a multidisciplinary team. This tool was validated in the academic hospital in Leiden, the Netherlands (Leids Universitair Medisch Centrum). Next, it was applied to two clinical case studies, assessing two processes that are currently present in the operating rooms of the LUMC. The HSMEA tool showed that with the implementation of four solutions, great improvements can be achieved in terms of waste and CO2-equivalents production and recycling rate. These four interventions are currently being implemented in the LUMC. This novel sustainability tool has therefore proved its usefulness and clinical applicability in a healthcare setting. By implementing this tool throughout the hospital, it will support the hospital reaching its sustainability goals.","Sustainability; Healthcare; Operating room; Waste; Energy; Water; Quantification; CO2 footprint","en","master thesis","","","","","","","","2022-12-01","","","","","",""
"uuid:c2783fe0-4b86-4a88-803c-2d43a708119a","http://resolver.tudelft.nl/uuid:c2783fe0-4b86-4a88-803c-2d43a708119a","Floating for Health: A floating solution for the lack of healthcare facilities in rural flood-prone regions of West Bengal, India","de Pater, Bas (TU Delft Architecture and the Built Environment; TU Delft Architectural Engineering)","Snijders, A. (mentor); Bilow, M. (graduation committee); van Loon, F.D. (mentor); Delft University of Technology (degree granting institution)","2018","""Floating for Health"" is a project of the Architectural Engineering graduation studio at the Delft university of Technology. This research and design project explores the problems of rural flood-prone areas in low-income regions and proposes a solution for the lack of healthcare facilities. The context that has been chosen is the region of West-Bengal in India, which experiences yearly floods during monsoon season. Due to Global warming this region is expected to experience more severe weather events over the next 50 years, this puts an enormous strain on the life of the inhabitants in these low-income rural areas. Flooding events in these regions create polluted water which can easily spread water-borne diseases and the water disrupts infrastructure to access healthcare. The focus of this project is to create a modular solution that is amphibious so local healthcare facilities can be constructed and remain accessible during floods. The proposal is a building system that can be pre-fabricated or fabricated on site and allows for communities to construct their own facility. This plywood building system consists of plywood parts and wedges to minimize the need for specialty tools and precision. The basic building system is designed as a main structure with the possibility of adding facade elements and roofing. These additions allow for local craftsmen to contribute to the design and create a final aesthetic that fits in local tradition. The proposed design is specified for West-Bengal but the basis of the building system could be used for regions all over the world.","Flooding; Floating; Architectural engineering; Building system; Plywood; Healthcare; Clinic; India; West Bengal; Low tech; Vernacular architecture","en","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences","",""
"uuid:ba8e72a0-6ccb-4ebc-a5de-6f0f319bba6e","http://resolver.tudelft.nl/uuid:ba8e72a0-6ccb-4ebc-a5de-6f0f319bba6e","A Customized Novel Halo with Displacement Based Pin Tightening for Pre-Operative Gravity Traction to Treat Severe Scoliosis","Botterman, Wolf (TU Delft Mechanical, Maritime and Materials Engineering)","Zhou, J. (mentor); Bosma, Jesse (mentor); Popovich, V. (graduation committee); de Winter, J.C.F. (graduation committee); Delft University of Technology (degree granting institution)","2018","Severe scoliosis is a deformity of the curvature of the spine, mostly occurring in children. It is currently treated by performing Halo Gravity Traction (HGT) to reduce the curvature prior to surgery. In this procedure, a Bremer halo ring is fitted around the child's head and connected to the skull with a numberof pins. During the 3-month treatment period, step-wise increased weight is applied to pull the ring upwards so as to elongate the spine. With the current design of the Bremer halo ring, the pins are tightened while measuring the amount of torque applied, influences each other during tightening, loosenover time and leave visible scars on the forehead. Furthermore, the Bremer halo ring is not customized.In the present project, a novel halo with a different tightening technique was designed, manufactured and evaluated with the aim of solving the above mentioned shortcomings of the Bremer halo.A Surface Tessellation Language (STL) file was generated from Computed Tomography (CT) images of a male cadaver head. Based on the desired ring stiffness and the geometry of a custom-designed halo for the cadaver head, a model was created in Solid Edge ST 10. The model was analyzed and adjustedby using the Finite Element Method (FEM). The customized halo ring was then produced by means of Selective Laser Sintering (SLS) and then equipped with strain gauges in order to derive the forces acting on the skull by the pins during tightening. The customized novel halo and the Bremer halo were compared with respect to moment arm and pin orientation, both influencing the local pin site behavior. The moment arms, pin positions and pin orientations of the 3D model of the novel halo were validated in reality by consecutive application of the halo to the cadaver head. The halo was analyzed by measuring the pin force degradation over a period of 24 h, which was hypothesized to be caused by the visco-elastic behavior of the skull of the cadaver head. The tightening procedure was analyzed on a block of steel to determine the influence on the axial pin reaction forces.The novel halo showed smaller and more consistent lengths of moment arm than the Bremer halo. Furthermore, one pin of the Bremer halo showed a difference of >15° from 90°, which has been regarded as contributor to pin loosening. The novel halo was predicted to be able to keep sufficient axial pin force without pin re-tightening during the traction period. The intended axial pin forces of the novel halo were achieved with an accuracy of 94.5%.With the customized novel halo, pins were tightened based on the displacement of the C-contours, resulting in an increased accuracy of pin force during tightening. The anterior pins were designed to be located in the musculus temporalis region, thereby leaving no visible scars and to be less prone to loosening due to a lower anterior ring stiffness. In conclusion, customizing the halo ring brings opportunities toengineer and control important parameters which contribute to better wearing comfort, higher pin force accuracy and less pin loosening, although it is yet a costly and time-consuming procedure.","HGT; Halo; Gravity; Traction; Scoliosis; Customized design; Pediatric healthcare","en","master thesis","","","","","","","","2020-09-13","","","","","","52.0862805, 5.1799357"
"uuid:8cc337ec-fc61-41da-9483-177d687d3007","http://resolver.tudelft.nl/uuid:8cc337ec-fc61-41da-9483-177d687d3007","Empowering the accessibility of safe global electrosurgery: Safe electrosurgery should be available for everyone, everywhere","Ouweltjes, Koen (TU Delft Industrial Design Engineering)","Diehl, Jan-Carel (mentor); Oberdorf, Jos (mentor); Delft University of Technology (degree granting institution)","2018","Msc. Roos Oosting and the Global Health Design Lab initiated development of affordable and high-quality electrical surgery units (ESU) as a step towards improving surgical care. The ESU is used as an operating tool to assist the surgeon for a high variety of essential surgical procedures. The ESU consists of a high frequency generator with an interface to adjust power settings, a return electrode and an a monopolar handheld that is used to perform the surgery. The main advantages of electrosurgery for low and middle income countries (LMICs) settings is that it is widely applicable, helps to stop and prevent bleeding, allows for precise cutting, facilitates better wound healing in less hygienic environments and has a valuable contribution to time efficient execution of surgical procedures.
A few low-end devices exist that—due to their stripped down, fully analogue and simple design— do not fully meet the demands that are needed for safe global usage of the ESU. As a result, the devices are used inappropriately and this can have serious clinical consequences for the patient, even more in low-resource settings like sub-Saharan Africa (Oosting, 2018).
The design goal of the project has been the development of a reliable, safe and intuitive user-interaction with the ESU system and a tailored design for maintenance in a variety of use-contexts in LMICs. The new design of the electrosurgery unit should be understandable for all electrosurgery users, thus surgeons with limited electrosurgery experience as well as specialists and surgical assistances.
The developed ESU system is designed to capture the primary needs and functionalities to perform surgery according to the 15 essential surgeries stated by the World Health Organization (WHO). These functionalities have been integrated in a safe and intuitive user interaction with both the high frequency generator as well as the monopolar handheld.
For situations where existing equipment and devices cannot fulfil the unique needs of LMICs, the process of designing tailored solutions should involve extensive consultation with end-users, as this is critical to promoting correct device use and protecting patient safety (Ng-Kamstra, 2016). Consequently, substantial qualitive research has been done by interviewing 15 Dutch surgeons that work or have worked in developing countries. This created an holistic framework on the user-interactions and barriers with the electrosurgical unit prior, during and after a surgical procedure and legit assumptions on required functionalities in use and sustainable maintenance prior to designing.
The developed concepts have been extensively tested with the intended target group by means of an explorative study in Kenya. Even though the developed ESU system requires future improvements to create a sustainable success, the designed system empowers the future accessibility of electrosurgery for LMICs. The ESU system increases safety and an intuitive user interaction concerning the limited electrosurgery experience and enhances reliability for maintenance in the variety of use contexts in LMICs. The developed trade-off has shown the great potential this designed ESU system can have on global surgery. Hopefully, this ESU system can in all sincerity make global electrosurgery accessible for everyone and everywhere.
The central aim of this project has been to find out how different patient profiles benefit from different interaction features in the rehabilitation device ‘BioCoach’, to effectively support them in their rehabilitation process.
This project investigates how a tailored version of the BioCoach could meet the needs and wishes of three different patient profiles: the ‘optimistic’ patient; the ‘managing’ patient; and the ‘modest’ patient.","Tailored healthcare; Rehabilitation; Medisign; Patient profiling; Design","en","master thesis","","","","","","","Campus only","","","","","“Tailored Healthcare through Customer Profiling” research programme","",""
"uuid:e3be942c-b1d4-44da-ada8-4c2019922542","http://resolver.tudelft.nl/uuid:e3be942c-b1d4-44da-ada8-4c2019922542","'Het Interactieve Bouwlab': A new concept to increase the subjective well-being of children hospitalized in the Intensive and High care ward.","Vlaanderen, Josephine (TU Delft Industrial Design Engineering)","Pohlmeyer, Anna (mentor); Beekman, Quiel (graduation committee); Verkerk, Ed (graduation committee); Delft University of Technology (degree granting institution)","2018","Goal.
At times high care patients have no distraction from the negative experiences that come with their hospitalization, a lot of negative feelings arise. They often feel lonely, for not having the possibility to play with peers. Luckily, the new playroom can create opportunities for these children to interact with peers. To include bed-bound children as well, the design goal was to come up with a concept that would: create interactions in the playroom that give high care patients, aged 6-11 years old, a sense of belonging towards each other, also when confined to their beds.
Challenge.
Although all these patients have in common that they are hospitalized on the high care ward, they also know many differences in interests, development and physical abilities. To provide the patients with a sense of belonging towards each other, the challenge was to create a concept that every child can use in its way, but at the same time enables them to play and socially interact with each other.
The final design.
‘Het Interactieve Bouwlab’ is a play environment in the playroom where children can build with LEGO in an interactive environment. To create a meaningful interaction, the bed-bound child can control this environment via the ‘Bouwlab’ App, while also sharing a video and audio connection. The concept is designed with no predefined game rules to support open-ended play in which the users can create their games and building plans. However, to spark the imagination, a weekly theme will be announced where the users can build for.
Evaluation.
The user tests showed that ‘Het Interactieve Bouwlab’ has the potential to give the patients a sense of belonging towards each other since it stimulated social play and made the children willing to interact with each other.","Subjective well-being; Pediatric healthcare; Play","en","master thesis","","","","","","","Campus only","","","","","","",""
"uuid:f48642ca-0899-4c0e-9116-76941c1c56bd","http://resolver.tudelft.nl/uuid:f48642ca-0899-4c0e-9116-76941c1c56bd","BETTER TOGETHER - The short-term care centre as means for integrated care - a qualitative study","Tjoa, Li Ling (TU Delft Architecture and the Built Environment; TU Delft Management in the Built Environment)","van Oel, C.J. (mentor); Koolwijk, J.S.J. (graduation committee); Delft University of Technology (degree granting institution)","2018","The ageing population and healthcare reform leads to a changing demand for short-term care. Health-related care and service providers offer several types of short-term care, but lack a clear vision and associated real estate strategy. Therefore, care processes are not always arranged efficiently, and real estate does not add value to the performance of the organisation. This affects the quality of care that clients receive. The aim is to gain insight in the care processes of six different types of short-term care in order to establish 1) to what extent (horizontal) integration is possible, 2) to determine the requirements for real estate, and 3) to identify possibilities for organisational change. The intention is to increase insight into the possibilities and prerequisites of optimizing short-term care through a closer alignment with the real estate strategy.
A qualitative interview study (n=16) within one health-related care and service provider was conducted with respondents holding a management position. In order to add validity, two focus group sessions (n=10) were held to discuss the findings and identify barriers and prerequisites towards integrated short-term care.
Findings show that short-term care is currently paired with long-term care although the goals and care environments differ substantially. All types of intermediate care, geriatric rehabilitation, respite care and Wlz crisis care can be integrated to some extent from the care and client perspective, along with a general practitioner, day centre and primary care treatment centre. Concentration of services on a location or within a building that is not associated with long-term care is recommended. It can result in more efficiency, higher quality and integrated care, and better expectation management. The client’s preference of care close to home needs to be taken into account as well. Certain barriers on macro, meso and micro level were identified. Respondents indicate that clear communication and creating a physical identity through real estate can solve some of the discussed barriers.
A limitation of the research is that it was conducted within the boundaries of one organisation, limiting the transferability of the data due to the specifics of the organisation and context. Furthermore, real estate recommendations are made based on short-term care processes, but financial feasibility is not considered. This requires further research.
Subsequently, the results of the research were applied to a design location in Amsterdam Nieuw-West. The building combines social housing for the elderly with facilities for the neighborhood, to ensure more liveliness in and around the building. By mixing the elderly with other generations, both groups can benefit from each other’s help. The shared spaces are designed in a way that the residents can meet each other in a natural way. Since the apartments are intended for social rent, the housing is relatively small; 30m2, 45m2 & 60m2. The apartments are not only designed for the elderly, but also suitable for other target groups, like single households, students and starters. By small adjustments, such as sliding walls, the housing can still enable aging in place.","Architecture; Elderly; Informal encounter; built environment; social interaction; Social housing; social architecture; loneliness; Amsterdam; Healthcare architecture; Aging in place","mul","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Health","","52.356947, 4.787218"
"uuid:603765b3-30be-47b1-b7c5-5556b2d3c434","http://resolver.tudelft.nl/uuid:603765b3-30be-47b1-b7c5-5556b2d3c434","Ruffle: helend spelen","Touw, Alexandra (TU Delft Architecture and the Built Environment)","Nottrot, R.J. (mentor); Cuperus, I.J.J. (mentor); Willekens, L.A.M. (mentor); Vitner-Hamming, D. (graduation committee); Delft University of Technology (degree granting institution)","2018","Being ill, treatment at health centres causes anxiety and stress with children. This has a negative effect on their wellbeing, healing process and more important, their cognitive, motoric and social development. The goal of this thesis is to describe a set of generic properties for the built environment to reduce this negative effect by stimulating the imagination of children, aged 3 to 6 years. The generic properties are derived from the analyses of spatial elements, present during activities, in which the imagination is active: playing and perceiving art. Through play they develop their motoric, social and cognitive skills, including their imagination. In addition, not all children in healthcare institutions are able to play, therefore also perceiving art is studied. Through observations at different play areas and the (spatial) analyses of these areas, playgrounds (designed by Aldo van Eyck), fantasy worlds of children and different artworks a set of properties is determined; a place which stimulates the imagination must be created by the composition of different elements. In this composition their scale, number, variety and interrelationship are taken into account. Each of these elements can be described by their properties: height & planar differences, contrast, whether they can exists of loose materials, can be manipulated or that they support enclosure. The composition of these elements and the abstraction of their shape creates a framework of information. Certain aspects are visible and other aren’t. This results in the stimulation of the imagination. These results are translated into a design tool and forms the starting point for the design of a treatment and prevention centre for obese or overweight children. Obesity is a problem which has increased the past few years and probably will become bigger. This centre is located in Zuidwijk, Rotterdam. The percentage of children with obesity is higher in this area than in other parts of Rotterdam or The Netherlands. This centre exists of a treatment centre, sport centre and restaurant. The centre doesn’t only focus on the treatment of children, but also on the prevention and the promotion of a healthy life style of the children, their families and the neighbourhood","Healthcare architecture; Children; Stimulating imaginaton; Obesity; Rotterdam; Design tool","nl","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Explorelab","","51.873558, 4.489602"
"uuid:f376edbc-8c07-41d9-a165-7a7571ba125c","http://resolver.tudelft.nl/uuid:f376edbc-8c07-41d9-a165-7a7571ba125c","Bridging Borders in Healthcare: Designing a decision aid for internationalization of FocusCura","van Duijn, Thomas (TU Delft Industrial Design Engineering; TU Delft Product Innovatie Management)","van der Vorst, Roland (mentor); Beekman, Quiel (graduation committee); Scheffer, Ronald (graduation committee); Delft University of Technology (degree granting institution)","2018","Healthcare innovation company FocusCura is one of the largest providers of eHealth in The Netherlands. Even though they are already active in other countries, they do not yet have a structured decision-making process for an international go-to-market decision. A decision aid for the business development department of the company solves this problem. To develop a decision aid academic and empirical research took place in three steps. First, to understand the internationalization strategy, process, and actions that provide the content for the decision aid. Second, to know more about decision aids and structured decision-making processes, that determined the decision aid structure. Third, generative research that provided company criteria for the design of the form. After configuration, this resulted in an improved internationalization process and a decision model that follows that. Building on that, a design process delivered a decision aid concept that meets the form criteria. It is tested with the end-user and optimized. The final foreign market-entry decision aid design followed from that. This design guides the user through the process of completing the decision model with a canvas and cards. A case study of the market-entry decision for the German personal alarms market then provided validation of the final design. This also indicated that FocusCura should enter that market. The result proved that the decision aid design structures the decision-making process and provides support to the decision maker.","Internationalization; Decision aid; Design; Market-entry; Healthcare","en","master thesis","","","","","","","Campus only","","","","","","",""
"uuid:7a975ce4-1529-4065-bcdb-b323cf0747a0","http://resolver.tudelft.nl/uuid:7a975ce4-1529-4065-bcdb-b323cf0747a0","Improving the patient experience for children at the paediatric acute medical unit","Simons, Rochelle (TU Delft Industrial Design Engineering)","Melles, Marijke (mentor); Simonse, LWL (mentor); Elsbeek, E. (mentor); Delft University of Technology (degree granting institution)","2018","An acute admission is a disruption from daily life and affects the child patient and his or her family. To reduce this disruption of daily life, the VKC is planning to build a Paediatric Acute Medical Unit (P-AMU) in the coming years. The VKC (Vrouw-Kind Centrum; Woman-Child Center) is the center of excellence in the field of all woman and child healthcare inside of the AMC and VUmc alliance. Their mission puts a strong focus on patients that participate and have control. The key values of the VKC are to be ‘Open’, ‘Sensitive’, and ‘Innovative’.
The P-AMU will provide 24/7 care, and focuses on rapid and effective diagnostics, formulating treatment plans, and starting the execution of said plans within a maximum of 72 hours. The current plans for the P-AMU are made from an organizational or management perspective. The patient perspective is not yet included in this stage of development. Literature research showed many benefits of an AMU from the organizational perspective with the main benefit being; containing chaos in one place makes the other regular nursing departments more plannable and will improve the quality of care. The main goal is for children to go back home as quickly as possible. Medical professionals consider this to be in the child patients best interest.
To include the patient perspective in the plans, design research was conducted to fully understand the patient experience during the paediatric acute admission process. The result identified two main themes; unsure: not knowing when, where, and what to expect; and bored: which occurs during the many moments of waiting. This uncertainty consists of two kinds; the medical uncertainty and the uncertainty about the process, where the medical uncertainty is a stable factor and the uncertainty about the process is a variable. The patient journey clearly showed more fluctuation in patient’s emotions and more innovation opportunities at the ED in comparison to the paediatric nursing department. Therefore, improving the patient experience at the P-AMU already starts at the ED.
The design goal was formulated as followed:
‘‘Design a tool that improves the communication of child patients and parents with the healthcare system about the acute admission process, and that puts the children in control in a playful and understandable way, in order to make the feel less unsure and bored during the acute admission.”
An iterative design process was performed where child patients, medical professionals, and technical and design experts provided feedback from their perspective on the intermediate designs. This eventually led to the development the final concept design ‘Mijn Buddy’. ‘Mijn Buddy’ is a digital application designed for children, aged 8-13 years old, that provides insights in order to reduce the uncertainty about the acute admission process, which will eventually lead to a better patient experience. The connection of ‘Mijn Buddy’ with EPIC, the digital patient record, makes sure the journey is personalized and adjusted to a patient’s individual situation, so the right information is provided at the right moment. It helps child patients and parents to manage their expectation by providing information about what, who, where, and when things will happen.
An interactive prototype was developed to evaluate ‘Mijn Buddy’ with both a number of child patients and (non-patient) children in their home environment, as well as pediatricians and ED-doctors. The feedback and outcomes of this evaluation study were very positive. ‘Mijn Buddy’ increased the knowledge about an acute admission for appendicitis, so it can be assumed it will reduce the uncertainty about the process. Children perceived it as fun and easy to use. Not only did child patients that were unfamiliar with the hospital and their journey see a clear added value, familiar patients also perceived the information provided by ‘Mijn Buddy’, like who to expect and when, as useful. Recommendations to further improve the design were also identified from this evaluation study, such as showing the possibility of a transfer to another hospital in the patient journey.
However, more research is needed since ‘Mijn Buddy’ was only tested with one kind of acute admission (appendicitis), whereas there are a variety of reasons for an acute admission. Further research and pilot tests are needed to implement the application in the current healthcare system. ‘Mijn Buddy’ has the potential for many future extensions and build-ins like feedback surveys and pain measurements. Furthermore, with small adjustments ‘Mijn Buddy’ can also be valuable for a larger age-range. It is recommended to bring ‘Mijn Buddy’ into the market in various phases with continuous testing, adjusting, and developing.","patient experience; acute admission; children; healthcare; application","en","master thesis","","","","","","","Campus only","","","","","Design for Interaction","",""
"uuid:b3c40f0e-8791-4c44-a56c-1a107c4413eb","http://resolver.tudelft.nl/uuid:b3c40f0e-8791-4c44-a56c-1a107c4413eb","Het Westerpoorthuis: Een huis voor ons leven, met elkaar ouder worden","Delfos, Marleen (TU Delft Architecture and the Built Environment)","de Wit, Leontine (mentor); van de Voort, Jan (mentor); Willekens, Luc (mentor); Vitner, Daan (graduation committee); Delft University of Technology (degree granting institution)","2018","Towards 2030, the amount of single households of 65 years and older will double to 40 percent. Due to changes in the political environment elderly can only move to a nursing home if the demand of care is high enough. Consequently, there will be a bigger group of elderly that needs to live longer independently in their urban neighborhood. In the current urban structure, there is still a lot to improve and develop to make the neighborhood a place for all generations, where people can live their whole life. As the physical range of activities and social network of elderly are becoming smaller over the years, they often experience feelings of loneliness. They will become more dependent on the availability of informal care in their near social network. The stimulation of contact with other people and especially other generations could increase the social network of the elderly. This leads to the main question of this research; what architectonic elements enhance contact among elderly and between elderly and other generations in an neighborhood in the city of Rotterdam?
The design assignment comes forward out of the result of the research of the (changing) needs of ‘city-elderly’ and the research of the elements that enhance contact within the neighborhood. The design can be seen as a case study in which a new perspective on the typology of independent elderly living is given, in combination with a program and functions that can enhance contact between generations. The design consists of a cluster of buildings within the existing city structure with a combination of living for the elderly, welfare, care and neighborhood functions.
Emergency services often arrive too late. Only one out of three ambulances succeeds in meeting the standard. The arrival time depends on several steps in the process. There is a challenge in the end of the process where the collaboration between ambulances, the reporting room and emergency departments (EDs) can be enhanced. By doing this, the arrival times might improve due to an increase in efficiency.
The design goal was ‘Design an IoT based logistic concept that improves the collaboration between reporting room, ambulance staff, and EDs by giving the ambulance staff direct insight in patient stops set by EDs, and giving EDs insight in arriving ambulances’.
With the CommunicAid, the ambulance nurse fills in several fields in the ‘digitaal ritformulier’ (DRF). Based on this and several external factors the system decides which ED is most eligible. The real-time information will be shared with the certain ED and the reporting room. With the CommunicAid, patient stops at the ED will be set digitally. As soon as an ED does this, the reporting room gets an announcement and the DRF notifies it. It will make sure that the certain hospital is not available anymore in the DRF. One hour later, the patient stop is automatically canceled so the ED becomes available again. IoT is required for the information flows between the different devices.
However, implementing the system brings complications with it. In the healthcare sector, all parties work in their own systems that are not able to ‘talk’ to each other. To make it even more complex, also the systems differ between regions. This makes it complicated, expensive and unrealistic to design a solution that fits every region, unless we start from scratch. The CommunicAid should be used as a wake-up call to prove that IoT indeed can improve the ambulance service in the Netherlands.
The societal impact of implementing the CommunicAid in the Rotterdam-Rijnmond region will be direct and positive. Rotterdam-Rijnmond is chosen because the system is designed based on the outcome of the field research. Most elaborate research took place in this region. For the ambulance nurses the communication improves and time will be saved; the system prevents long waiting times at the ED. By creating insight in the arriving ambulances at the ED, the ED nurses can anticipate on the arriving ambulance patients and in this way efficiency can be increased. For reporting room employees implementing the CommunicAid will reduce their workload by automating communication flows.
An important future goal should be to harmonize the operations in acute healthcare in all regions for all involved parties. The dream is that all parties in all regions finally operate in one system for a perfect collaboration. VodafoneZiggo can start this major change in the ambulance service by supplying IoT-connections required for implementing the CommunicAid.
During the analysis phase a list of requirements and demands was created. Combined with the design vision, these are used to generate ideas. From the ideas, three design directions were defined: the smooth surface, clamp cavity and expansion clamp. For each direction the advantages, limitations and unique values were determined. The expansion clamp was expected to be the most promising design direction. It makes use of a fixation device between the longitudinal surfaces by using an expansion clamp. After a second ideation session the most promising concepts have been chosen and presented. To compare the and evaluate the concepts, a Harris profile was created. By analyzing the Harris profile there was chosen to elaborate upon the mechanical expander.
By turning, pushing or screwing a mechanism is activated, panels on the side will spread and put pressure on the implant. There was chosen to use a leaf spring to enable the axpansion. Multiple iteration steps were made to come up with the most ideal design. The features, dimensions, materials and production processes were determined for all parts of the expander. An additional locking plate is designed to fit the expander and bridge the component to the healthy femur above.
In the last chapter, the final design and its main features are presented. Validation is done by talking to an expert, dr. Verburg, and reflecting on the demands, wishes and design vision that were stated after the analysis. In conclusion, it is likely that the expander with the additional locking plate will provide a more solid fixation of a periprosthetic fracture by integrating the femoral component of a TKR. However, it should be mentioned the design has not been validated and tested on its functionality. The expander can be seen as an addition to the currently used LISS plates. Current designs of locking plates can easily be adjusted to fit the expander. Therefore, it is likely that the product will be accepted by the market. Several recommendations have been defined for further development of the fixation technique based on the validation and risk analysis of the final design.","Periprosthetic Fractures; Total Knee Replacement; Medesign; Healthcare; Distal femur; Reinier de Graaf Gasthuis","en","master thesis","","","","","","","Campus only","","","","","Integrated Product Design","",""
"uuid:d66681f9-69d3-4cc2-9b52-6e20301032dc","http://resolver.tudelft.nl/uuid:d66681f9-69d3-4cc2-9b52-6e20301032dc","Diastole Systole: Designing a gamified online health ckeck platform, that persuades users to improve their lifestyle with tailor made challenges and humorous characters","Ortiz De Zaldumbide Lucero, Pablo (TU Delft Industrial Design Engineering)","Melles, Marijke (mentor); Bendor, Roy (mentor); Delft University of Technology (degree granting institution)","2017","This project is originated from a starting business relationship between &ranj and NIPED, under the management of &Samhoud. In this project &ranj is in the task of gamifying the Persoonlijke Gezondheidscheck (PGC), an online health check platform designed by NIPED, to better persuade their users to change their behaviour and improve their lifestyles. With the help of this platform, users will be more aware of their own health status, they will assess the impact their behaviour makes in their own health and lifestyle, and they will learn how to prevent illnesses and unhealthy habits.","Game Design; Persuasive Game Design; Behaviour change; Healthcare; Lifestyles; sense of humor; humour; prevention","en","master thesis","","","","","","","Campus only","","","","","Design for Interaction","",""
"uuid:e3a845b1-4346-4cd2-abf7-2c5297a4af1c","http://resolver.tudelft.nl/uuid:e3a845b1-4346-4cd2-abf7-2c5297a4af1c","Rethinking Roosenberg","van Hoogstraten, Nina (TU Delft Architecture and the Built Environment)","Stuhlmacher, M.E. (mentor); Fokkinga, J.D. (graduation committee); Cornelisse, F. (graduation committee); Delft University of Technology (degree granting institution)","2017","","Dementia; Healthcare","nl","master thesis","","","","","","","","","","","","Architecture, Urbanism and Building Sciences | Interiors Buildings Cities","",""
"uuid:6bafb303-0bec-4ff7-8b9e-e0d22e4bafcf","http://resolver.tudelft.nl/uuid:6bafb303-0bec-4ff7-8b9e-e0d22e4bafcf","Improving collaboration in the work-directed care for knee-replacement patients: Facilitating collaboration between the occupational physician and orthopaedic surgeon in the return-to-work guidance of knee-replacement patients, by design","Spaenij, Anna (TU Delft Industrial Design Engineering)","Groeneveld, Bob (mentor); Melles, Marijke (mentor); Kuijer, PPFM (mentor); Frings-Dresen, MHW (mentor); Delft University of Technology (degree granting institution)","2017","Currently 30% of all knee prosthesis patients do not return to work after surgery. This is partially caused by the insufficient guidance of the patient's care providers. the most important care providers in this are the occupational physician and orthopaedic surgeon. The current collaboration is experienced by both the occupational physician and orthopaedic surgeon as impersonal, uninvolved and inefficient. This leaves the patients to feel insecure and uncertain before and during rehabilitation. The developed platform combines all information concerning the patient's function recovery and work reintegration in one overview available for care providers and patient. The platform stimulates direct communication and mutual support based on their separate areas of expertise.","collaboration; Work-participation; Rehabilitation; Workability; Healthcare; Orthopaedics; Occupational physician","en","master thesis","","","","","","","Campus only","","","","","Design for Interaction","",""
"uuid:d6c0014c-8b62-4144-8fbe-f910c0d89b73","http://resolver.tudelft.nl/uuid:d6c0014c-8b62-4144-8fbe-f910c0d89b73","Integrated product system for children under five for India and Kenya: Tackling scalability and usability in complex healthcare systems by Context Variation by Design approach","Bhajantri, Vinay (TU Delft Industrial Design Engineering)","Diehl, Jan-Carel (mentor); van Engelen, Jo (graduation committee); Delft University of Technology (degree granting institution)","2017","Low and Middle Income Countries (LMICs) face major issues throughout the continuum of primary healthcare for child care (0-5 years). Altogether more than 10 million children die each year in developing countries before they reach their fifth birthday. WHO and UNICEF created an Integrated Management of Childhood Illness (IMCI) strategy to tackle this global issue. This design aims to improve the usability and scalability of this strategy at user level across India and Kenya.
Context Variation by Design approach is used to focus on usability and scalability. In this approach, insights from different contexts are studied to find shared or opposing requirements.
The product consists of a diagnostic device with a capability of providing four diagnostic information within the IMCI workflow. The product is designed to be scalable across various users with varying expertise and geographical contexts of India and Kenya.","Design; industrial design; BoP; Context Variation by Design; healthcare design","en","master thesis","","","","","","","Campus only","2019-08-28","","","","Integrated Product Design","",""
"uuid:28f49e64-a7b4-46f0-8ef1-b7b605371c3b","http://resolver.tudelft.nl/uuid:28f49e64-a7b4-46f0-8ef1-b7b605371c3b","Distribution Network Design: An Empirical Study in General Electric Healthcare Service Parts Delivery Network","Kaynak, Duygu (TU Delft Technology, Policy and Management)","Rezaei, Jafar (mentor); Tavasszy, Lorant (mentor); Heijnen, Petra (mentor); Dechenais, Anthony (mentor); van der Zee, Fokko (mentor); Delft University of Technology (degree granting institution)","2017","A distribution network design is of importance to systematically organize the flow of products from supply points to demand points. A distribution network is not only crucial before sales but also after sales because regardless of the initial quality of product, malfunctions occur. These malfunctions need to be repaired by replacing defective parts, which are delivered through after sales distribution network and all activities, carried out from the report of the malfunction until the product is up and running, are called after sales services. The replacement parts are called service parts or spare parts and this thesis project focuses on the distribution network design for delivery of these items. Customer surveys point out that high quality after sales services has become a criterion for selecting supplier companies. A shorter response time to failures and availability of service parts in the storage are given importance. Because after sales services became a field that companies can differentiate themselves from the competitors, practitioners have an increasing interest on establishing the optimal distribution network design to meet customer expectations while being cost-competitive.
The researchers have addressed service parts distribution with a strong focus on inventory management. However, distribution network design involves more decisions such as number of facilities, facility locations, allocation of customer demand to these facilities, and storage capacities. In addition, the managerial aspects and strategies for service parts logistics in business case studies are derived from electronic, automotive and aviation industries. Considering these, there is a knowledge gap about distribution network design for service parts in healthcare industry. This thesis project aims at filling this gap by introducing a general mathematical model for distribution network optimization based on an empirical study, conducted in General Electric Healthcare service parts delivery network.","service parts; spare parts; medical devices; healthcare logistics; distribution network design; mathematical modelling","en","master thesis","","","","","","","","2019-12-31","","","","","",""
"uuid:37b15ff2-fd3a-4b3f-88fc-bcff78531a39","http://resolver.tudelft.nl/uuid:37b15ff2-fd3a-4b3f-88fc-bcff78531a39","The Cuban Cure: Culture and identity in global science","Patelli, Nicola (TU Delft Architecture and the Built Environment)","Smidihen, Hrvoje (mentor); Delft University of Technology (degree granting institution)","2017","The thesis explores the paradigms that inform the design of the New Headquarters for the Cuban Pharmaceutical Industry.","Cuba Pharmaceutics Healthcare Headquarters","en","master thesis","","","","","","","","","","","","","",""
"uuid:4046b3da-83ef-437d-a169-426afd28fd91","http://resolver.tudelft.nl/uuid:4046b3da-83ef-437d-a169-426afd28fd91","Non-intrusive patient monitoring to prevent pressure ulcers: Algorithm Subgroup","Brinkhorst, Douwe (TU Delft Electrical Engineering, Mathematics and Computer Science); Liesker, Bas (TU Delft Electrical Engineering, Mathematics and Computer Science)","Leus, G.J.T. (mentor); Llombart, Nuria (graduation committee); Gravemaker, Menno (graduation committee); Mor, A. R. (graduation committee); Delft University of Technology (degree granting institution)","2017","The founders of Momo Medical envisioned a health care product that would help nurses worldwide with pressure ulcer prevention. Pressure ulcers are a chronic wound that affects the skin of patients who do not regularly change bed posture. As it currently stands, nurses lack the manpower and time to change the postureof patients in a timely manor. Thus, a goal was set to create a product that would reduce this strain on nurses.The goal was to design a non-intrusive product that keeps track of the posture of a patient on a hospital bed, and send an alarm if this has not changed in a set amount of time. A constraint with this was that the product has to lay directly underneath the mattress of the patient. Furthermore, the product has to make use of as few sensors as possible. With these constrains, the project group was divided in three subgroups: the sensor, the algorithm, and the testing subgroup.This report will focus on the design, implementation, and evaluation of the algorithm. The algorithm has to be designed to process the sensor data and return, with 90% accuracy, the posture of the patient. It also has to be able to determine with 99% accuracy whether or not there is a patient on the bed. An optional objective was to design an algorithm to determine the heart and respiration rate of the patient, with 80% accuracy, but this was of lower priority. It was soon decided to give priority to posture detection and not further investigate detection of the heart and respiration rate.In the final product, the information about the patient’s posture will be displayed in a graphical user interface (GUI). This GUI has to be user-friendly and intuitive to use by the nurses. During the prototyping phase, however, a different GUI was used, one that displayed various debugging information. This prototype GUI was necessary to test the various algorithms.Several different mathematical models have been investigated, implemented, and tested. These models range from taking the variance of the sensor data, to deploying a Fourier transform on a polynomial curve based on the sensor data. With preliminary test data, an accuracy of 93% was achieved using a neural network. With the final testing data however, only the neural network reached the required accuracy of 90%, though only just, at 90.8%. With future iterations of the algorithm, more research and data collection is advised, as neural networks work better with larger data sets.","Pressure ulcer; healthcare; automation; algorithm; neural networks","en","bachelor thesis","","","","","","","","2022-07-05","","","","Electrical Engineering","Improving healthcare with technology",""
"uuid:1ad48428-0d5d-4174-be59-5bf567f53721","http://resolver.tudelft.nl/uuid:1ad48428-0d5d-4174-be59-5bf567f53721","Architecture & Loneliness: Designing against loneliness among the elderly","de Vrede, Amber (TU Delft Architecture and the Built Environment)","Willekens, Luc (mentor); Cuperus, Ype (mentor); Wagenaar, Cor (mentor); Delft University of Technology (degree granting institution)","2017","","built environment; architecture; loneliness; elderly; healthcare design; social architecture","en","master thesis","","","","","","","","","","","","","","50.8441925, 5.690127"
"uuid:e9ea2ff5-9c15-4db9-a6af-fe195bd47341","http://resolver.tudelft.nl/uuid:e9ea2ff5-9c15-4db9-a6af-fe195bd47341","Economical feasibility of prefabricated solutions in healthcare design and construction industry","Moiseenko, Ivan (TU Delft Architecture and the Built Environment)","Vrijhoef, Ruben (mentor); de Jong, Peter (graduation committee); Hermkens, Arnold (graduation committee); Delft University of Technology (degree granting institution)","2017","For almost five years, healthcare design and construction sector is in my focus.
I started my experience in this field from design proposal of health-improving and rehabilitation center in Moscow which was my master thesis in Moscow Architectural Institute (MArchI) in 2012. After graduation I also worked as an architect in large architectural bureau which is specialized in design and construction of healthcare and resort facilities. Healthcare architectural typology is one of the most complicated ones because it deals with great number of technical and technological issues, which dictate the final spatial and design solutions in many ways. Moreover, technical regulations and demands in this type of buildings are one of the strictest ones based on the core functions and nature of the process. To find a rational balance between technology and architectural aesthetics in healthcare is a great challenge for architect.
In 2013 I started my MSc Architecture program in Politecnico di Milano in order to extend my architectural vision and to get European experience and understanding of the profession of architect. Because of the fact that I already had experience in the healthcare sector at that time, I chose the topic of healthcare as my graduation subject in Milan. There is a special department in Politecnico di Milano dedicated to design problems of healthcare facilities. The head of the department, professor Stefano Capolongo, was my supervisor of the graduation project which was dedicated to modular and prefabricated solutions in healthcare design. The main focus of my thesis was to design spatial solutions for general hospital where all functions and departments can be arranged into modular and prefab scheme by using the same span of the structural grid. Questions of modularity, transportability of the modules to the construction site, universality of the layout which allows to put different functions within the same module were the main ones in my research. In order to test my hypothesis and findings I designed renovation project for the real general hospital in one of the Russian provincial cities. The idea behind this step was to test possibility to extend existing healthcare facilities in a modular and prefabricated way which allows to minimize interruptions in the daily activities of the hospital while being under renovation, reduces time schedule for the renovation project in construction phase and increases the quality of the complete work based on in-factory production and assembly process.
The focus of my Milan project was mainly on spatial and technological aspects of modular healthcare design. Since I am particularly interested in medical design and construction sector, as I already mentioned, I decided to continue my research in this field while working on my graduation project in TU Delft on Management In the Built Environment Master program in order to understand the entire process of modular construction not only from architectural, but also from managerial, technological, logistic and financial points of view. The main question of this research is whether modular solutions in hospital construction more economically feasible than traditional on-site construction methods, considering the entire life cycle process of the hospital building? By answering this question, I will understand and evaluate financial, managerial and logistical aspects of hospital construction, which will give me the complete picture of effectiveness of modular construction in hospitals.
I would like to say thank you to my mentors, Peter de Jong and Ruben Vrijhoef, who supported me along this year and organized a number of interviews with the set of experts who helped me to get the picture of processes in modular construction. Special appreciation to all experts and specialists, who kindly agreed to meet and answer to my questions. All their interviews can be found in appendixes of this report. Special thank you to my family who supports me in my career and helps me to get the things I am working on.","modular construction; prefabrication; healthcare design; feasibility; modularity","en","master thesis","","","","","","","","","","","","","",""
"uuid:47597a05-3039-4e22-904a-90c6027ccf8e","http://resolver.tudelft.nl/uuid:47597a05-3039-4e22-904a-90c6027ccf8e","Sustainability assessment method for healthcare buildings: criteria for materials selection in the Portuguese context","Castro, Maria F.; Mateus, Ricardo; Bragança, Luís","","2017","The health sector has a strong influence on the economy of nations and their policies and is based in a group of buildings where the quality of the indoor and outdoor environment is quite important. The impacts of these buildings are relevant compared to other buildings because they are directly related to human health. The healthcare providers are not serving patients but serving people. It is their role to design and deliver services to meet the needs of people at the most difficult times in their lives. Regarding materials and reversible building design, it is fundamental to consider the technical, economic, financial and environmental issues in the criteria of a Building Sustainability Assessment (BSA) method. The sustainability categories and indicators should address, among others, durability, eco-efficient materials, furniture layout and flexibility and occupant’s comfort. When speaking about healthcare buildings, it is also necessary to consider safety and adaptability. In this context, the aim of this paper is to discuss the context of sustainability assessment methods in the field of healthcare buildings and to present a proposal for the incorporation of Materials criteria in a new Healthcare Buildings Sustainability Assessment (HBSA) method. The used research method is innovative since in the development of the list of sustainability criteria it considers the opinion of main healthcare buildings’ stakeholders, the existing healthcare assessment methods and the ISO and CEN standardisation works in the field of sustainability assessment of construction works. As result, the proposed method is composed of twenty-two sustainability categories that cover the different dimensions of the sustainability concept and it is aimed to support decision making during the design of a new or retrofitted healthcare building in urban areas.","Assessment methods; Healthcare buildings; Indicators; Materials criteria; Sustainability","en","conference paper","","","","","","","","","","","","","",""
"uuid:4eb0446b-8638-4e2d-a798-e5c9ea84d099","http://resolver.tudelft.nl/uuid:4eb0446b-8638-4e2d-a798-e5c9ea84d099","Creating a comfortable working environment for cath lab physicians: Design of a body support","Mul, J.","Goossens, R.H.M. (mentor); Beekman, A.Q. (mentor)","2017","This project is about developing a solution for cath lab physicians. A cath lab physician is a medical doctor, with a background in cardiology, neurology, electro physiology or radiology, who performs cath lab procedures. A cath lab procedure is a minimal invasive procedure in which a catheter is brought into the body of a patient via a small incision. Cath lab physicians suffer from injuries due to the heavy physical workload of their job. The lead apron they wear to protect themselves against the radiation used during the procedures, in combination with long periods of standing, are the main cause of these injuries. An analysis is performed to get more insight in the nature of the injuries and of the environment of the physicians. To start prototyping in an early stage, a short ideation phase took place directly after the analysis. As a result, this phase brought requirements, wishes and concluded with two design directions. A stool with some new features was the best solution. This stool was designed to support the user. The seat will prevent the injuries on the legs while the integrated sternum support reduces the forces in the back muscle. A test was performed to validate the effect of the sternum support. The test shows a reduction between 10% and 15% of the tension in the back muscle. Further research will have to show if the use of the designed solution will actually prevent hernias in the future.","Cath lab; Physicians; Healthcare; Medical; Support; Body support; Protection","en","master thesis","","","","","","","Campus only","2018-04-28","Industrial Design Engineering","Industrial Design","","","",""
"uuid:aea7de92-af33-4811-b51d-7141b56d4396","http://resolver.tudelft.nl/uuid:aea7de92-af33-4811-b51d-7141b56d4396","Connected Sleep Position Trainer: Developing Design Guidelines for the Servitization of NightBalance","Muñoz Alcántara, M.","Hultink, H.J. (mentor); Sturkenboom, N. (mentor); Vrijland-van Beest, E. (mentor); de Hoog, G. (mentor)","2017","The following thesis report describes the process and outcomes of the graduation project from the MSc Strategic Product Design at Delft University of Technology, carried out for the company NightBalance. NightBalance is a medical company with a product that provides therapy as a treatment for patients with position dependent sleep apnea disorder. The goal of this project was to investigate and identify opportunities for increasing patient’s use and adherence to NightBalance’s new device with the use of a connected care service. After an iterative process of exploration, analysis, conceptualization and evaluation, the project proposes the creation of a patient focused connected care service that uses short subsequent therapy phases and programs to help patients improve specific aspects of their disorder, one at a time. The proposed service is enabled by the company's device combined with a new digital environment. The earlier creates interventions and collects progress data during the patient’s sleep, while the latter adapts the therapy goals to each patient’s progress, and provides step by step guidance from specialists to achieve those goals. In this report, the author starts by showing the insights of the project’s research and analysis in three main areas: Benefits for the organization from the introduction of a connected care service, learnings, and potential pitfalls from analogue cases. Opportunities and limitations for the introduction of such a service from the company’s situation and current developments. Points of pain and delight from the patient’s experience with the disorder and treatment, as well as drivers that have an influence on their compliance. Later, the combination of these insights lead the author to a phase of ideation, where concepts are generated to achieve the project’s goal and improve the offering that NightBalance delivers to its patients. The generated concepts are then evaluated with medical specialists and the R&D team of NightBalance, which pointed out the most promising one for further development. The last chapter of this report presents the complete description of the proposed connected care service and its components. It also outlines an implementation plan, points out potential benefits and pitfalls for the different stakeholders of the healthcare chain, and gives recommendations for the company to tackle those pitfalls. Finally, the report ends up with a collection of reflections from the author on the project’s process and results.","sleep apnea; connected care; service design; strategic design; user centered innovation; Healthcare","en","master thesis","","","","","","","Campus only","2019-04-25","Industrial Design Engineering","Product Innovatie Management","","Strategic Product Design","",""
"uuid:0fcbc6ed-8faa-47a6-ad3d-6eac685a7cb4","http://resolver.tudelft.nl/uuid:0fcbc6ed-8faa-47a6-ad3d-6eac685a7cb4","Consumer driven business models for healthcare","Arts-Posthoorn, C.C.C.","Simonse, L.W.L. (mentor); Kleinsmann, M.S. (mentor)","2017","","consumers; healthcare","en","master thesis","","","","","","","Campus only","","Industrial Design Engineering","Product Innovation Management","","","",""
"uuid:e486a19e-6c27-405d-b77c-38e3389234bb","http://resolver.tudelft.nl/uuid:e486a19e-6c27-405d-b77c-38e3389234bb","Architectural prevention: A Healthcare transition in time and space","Mudde, P.B.","Van Bennekom, H.A. (mentor); Vollers, K.J. (mentor); Asselbergs, M.F. (mentor)","2017","The thesis is focused on the preventional side of Healthcare in Havana, Cuba. The project enhances Healthcare prevention by organizing it spatially within the city. Healthcare becomes more part of the public domain and therefore of the dailylife.","buurthuis; Havana; Cuba; healthcare; prevention","en","bachelor thesis","","","","","","","","","Architecture and The Built Environment","","","","",""
"uuid:3a4047fd-19ca-4c8d-a13f-575fbff7597a","http://resolver.tudelft.nl/uuid:3a4047fd-19ca-4c8d-a13f-575fbff7597a","Supporting the Situational Awareness at the Emergency Department","Gillis, Y.N.","Beekman, Q. (mentor); Goethals, F. (mentor); Romero Herrera, N.A. (mentor)","2017","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","en","master thesis","","","","","","","Campus only","","Industrial Design Engineering","Industrial Design","","Design for Interaction","",""
"uuid:c6f50309-9a01-4e54-bf16-becdc0dc6167","http://resolver.tudelft.nl/uuid:c6f50309-9a01-4e54-bf16-becdc0dc6167","Beamforming for novel matrix arrays: Fresnel Zone Beamforming and Stolt Migration","Fool, Fabian (TU Delft Applied Sciences)","Verweij, Martin (mentor); de Jong, Nico (graduation committee); Vos, Rik (graduation committee); Pertijs, Michiel (graduation committee); Delft University of Technology (degree granting institution)","2017","Currently a lot of effort is put into developing matrix arrays which allow for volumetric imaging and new applications. There are however multiple problems. Compared to arrays currently in use which have in the order of 128 elements, matrix arrays can easily contain 1000 to 10000 elements. If all elements would be connected independently, the cable would become very thick. Therefore, beamforming methods are required that can operate with fewer transmit and receive channels. Furthermore, the room for electronics on the chip is limited. So, the required electronics for the beamforming methods should be kept simple.
In this thesis we will propose beamforming methods that are able to operate with fewer channels. This will be done separately for the transmit and receive part, but they do in no way exclude each other. To be able to focus pulsed waves in transmit we propose a method based on Fresnel zone plates which are used in optics to focus continuous wave light. Our method only requires a single continuous-wave excitation signal to be present, which is connected and disconnected on demand to each element. We have evaluated our method with measurements and simulations. As compared to the conventional focusing method, the spatial resolution is not affected by our method, but the Contrast-to-Noise ratio is 5\% lower for shallow depths and up to 20\% lower deeper into the medium. Overall though, the differences were relatively small and so it is clear that our new focusing method works very well. If needed, better results can be obtained by trading in frame rate. In this case the results are almost indistinguishable from the conventional focusing method.
To solve the problem with image formation, we have developed a frequency domain two stage beamforming method for use with matrix arrays, which does not require all element data to be present. This has been done for two matrix types. For the first method we have confirmed with simulations that it performs similar to the respective results obtained with two 2D frequency domain two stage beamforming method that have already been experimentally verified. For the second method we have evaluated the performance with simulations and measurements. Our method was able to obtain a 25\% better spatial resolution as compared to Dynamic Receive Focusing(DRF), without additional artefacts. As an alternative to the last method, we have also developed a frequency domain beamforming method that does require all element data, but only requires a single insonification by a spherical wave. This method did perform worse than the method discussed before in both simulations and measurements, but it does outperform DRF applied to spherical wave data.
Background: To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation to move from a centrally directed system to a socalled regulated market system. The deregulation of real estate investment that accompanies the new healthcare delivery system offers healthcare organizations new opportunities, but also more responsibility and greater risk in return on investment. Consequently, healthcare organizations must find new methods of financing. Private investment is one of the options.
Methods: Three healthcare systems were analyzed on the basis of a literature review and document analysis, then schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on privatesector financing and its implications for healthcare real estate decision making in the Netherlands, the United Kingdom, and Germany.
Results: The strengths and weaknesses of three healthcare systems with differing proportions of private and public investment in hospitals were explored. Research revealed a gap between intended effects and actual effects with regard to quality and cost. Costly private finance does not necessarily lead to “value for money.” Transferring real estate decisions to private investors decreases the influence of the healthcare organization on future costs and quality.
Conclusions: The three healthcare systems show substantial differences between public and private responsibilities. Less governmental involvement affords both opportunities and risks for hospitals. Private investment may lead to innovation, improved efficiency, and cost reduction, provided that the costs and benefits of decisions are not separated between different stakeholders. A missing link between infrastructure provision and healthcare delivery may impede design innovation and optimal adaptation to work processes and could lead to an inefficient allocation of risks and benefits.
Both developments will probably change the way healthcare organisations manage their real estate, the location choices they make and the building typology they choose. Real estate will become an increasingly strategic source of profitability and overall performance, similar to capital, human resources, information / knowledge and technology.
In the literature on Corporate Real Estate Management (CREM) different models have been developed to link real estate strategy to business strategy (Jonge et al., 2008). In this paper we explore whether these models can be applied to support hospital organisations in their decision-making about real estate. These models are used to build an analytical framework that will be used in a PhD research study called Better healthcare for lower costs, real estate strategies in a changing context. The main issues of this PhD research are the changing context and scope of Corporate Real Estate Management for hospitals and its impact on real estate decisions in relation to general corporate management.","Building typology; conceptual framework; corporate real estate management; healthcare; hospitals; urban setting","en","conference paper","HaCIRIRC","","","","","","","","","","Real Estate Management","","",""
"uuid:75cf7af6-6849-4b58-829a-9e265725de79","http://resolver.tudelft.nl/uuid:75cf7af6-6849-4b58-829a-9e265725de79","The Case for a Generic Implant Processor","Strydis, C.; Gaydadjiev, G.N.","","2008","A more structured and streamlined design of implants is nowadays possible. In this paper we focus on implant processors located in the heart of implantable systems. We present a real and representative biomedical-application scenario where such a new processor can be employed. Based on a suitably selected processor simulator, various operational aspects of the application are being monitored. Findings on performance, cache behavior, branch prediction, power consumption, energy expenditure and instruction mixes are presented and analyzed. The suitability of such an implant processor and directions for future work are given.","implant; low power; low energy; compression; encryption; checksum; microarchitecture; personalized healthcare","en","journal article","IEEE","","","","","","","","Mechanical, Maritime and Materials Engineering","Microelectronics and Computer Engineering","","","",""
"uuid:eb62aa77-d8e3-4aac-8142-b602d4bbe5ed","http://resolver.tudelft.nl/uuid:eb62aa77-d8e3-4aac-8142-b602d4bbe5ed","New Market, New Challenge, New Opportunity (2): User Context Research","Jiehui, J.; Kandachar, P.","","2008","China has a largest population in the world (1.3Billion) and 0.9 Billion is rural population. Most of rural people earn less than US$3/day, and they are called “Base of the economic pyramid (BoP)”. A new research project has been initiated on “The Healthcare Design for China Rural BoP” to the PhD of first author. This paper is about one part of this research: user context research. Two main processes will be introduced in this step: Qualitative research and quantitative research. Some healthcare needs in China rural like “Cancer early detection” has been found as the insights of this research.","rural healthcare; base of the pyramid (BoP); user context research","en","journal article","IEEE","","","","","","","","Industrial Design Engineering","Design Engineering","","","",""
"uuid:4c857931-20d7-4590-8747-db0066f49268","http://resolver.tudelft.nl/uuid:4c857931-20d7-4590-8747-db0066f49268","New Market, New Challenge, New Opportunity (1): Overview of China rural healthcare & Design methodology","Jiehui, J.; Kandachar, P.","","2008","China has a largest population in the world (1.3Billion) and 0.9 Billion is rural population. Most of rural people earn less than US$3/day, and they are called “Base of the economic pyramid (BoP)”. Compared with high level market, BoP is a new market, which means a low individual profit, but a large population. This paper discusses the healthcare issues in rural China (BoP) and study their healthcare needs through field study and case studies. This research is carried out within the framework of “Design for Sustainability at Base-of-the-Pyramid (BoP)” programme of the School of Industrial Design Engineering at Delft University of Technology. And the aim of this research is to provide a low cost advanced healthcare product design, which will meet poor’s needs and create a business case for commercial partners.","rural healthcare; base of the pyramid (BoP); design for sustainability","en","journal article","IEEE","","","","","","","","Industrial Design Engineering","Design Engineering","","","",""
"uuid:aceca755-65b6-47a4-bef7-719802e806f1","http://resolver.tudelft.nl/uuid:aceca755-65b6-47a4-bef7-719802e806f1","Building on Experiences: The Hospital Stakeholder Participation Method","Beekman, A.Q.","Stappers, P.J. (mentor); Kleinsmann, M.S. (mentor)","2008","Royal Haskoning BM (healthcare department at Hoofddorp)* operates actively in the healthcare market, designing and consulting within care housing projects. Anticipating changes in the healthcare sector, Royal Haskoning foresees a strategic value that could profit the contractor by involving hospital stakeholders (employees, visitors and patients) in the early stage of the design phase of hospital building projects. User participation in architecture has been implemented but to a limited extent. Compared to user participation in product design, the involvement has many shortcomings, e.g. the user group of patients and visitors has never been involved, the stakeholders were only involved in the evaluative end phase of the building design process and there was often a mismatch in communications between hospital stakeholders and architects. In order to enable the design team (the architects) to benefit from the hospital stakeholder involvement, a common language must emerge which facilitates the design team to access stakeholder experiences and use these experiences for information and inspiration in the early phase of the hospital building design process. This common language should be a commonly shared design language that hospital stakeholders and the design team use to communicate verbally and visually. The common design language is the foundation of the Hospital Stakeholder Participation Method and includes both conventional design research methods (observation and interviewing) in order to obtain observable and explicit stakeholder knowledge, and generative techniques (group session, sensitising and generative tools) in order to obtain tacit and latent knowledge. Implementation of this method in an early stage of the design process would expose fully the hospital stakeholders’ experiences that contribute to an optimal hospital environment. *Since 2009: 4Building b.v.","Participatory design; Contextmapping; Healthcare; Housing; Architecture","en","master thesis","","","","","","","","","Industrial Design Engineering","Product Innovation Management","","","",""