Intensive care units are technologically advanced environments that are designed to safeguard the patient while their vitals are stabilized for further treatment. Audible and visual alarms are part of the healthcare ecology. However, these alarms are so many that clinicians suffer from a syndrome called 'alarm fatigue' and often do not comply with the task alarm is conveying. Measuring compliance with rules in the workspace and determining the success of a system belongs to the field of ergonomics and is based on data collected through task observations and scoring. In this paper, we will explore compliance with critical alarms by not only from their potential success or failure perspective but also from the perspectives of the clinician capacity, needs, and motivations to comply with alarms in critical environments. We will finally, reflect on further possible design strategies to increase compliance in critical care that are beyond following rules per se but through intrinsic motivation.@en

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.@en

Clinicians who are exposed to noisy environments are more likely to suffer from alarm fatigue, stress or sleep deprivation, and can finally become inefficient in the moment to respond to a critical situation. In other words, a lack of compliance or an inappropriate response to alarms is constantly observed in clinicians operating in critical care. In this paper, we introduce the issue of lack of compliance with medical alarms in critical care by contrasting the mandatory approaches stemming from safety and efficiency purposes (i.e., study of (cognitive) ergonomics) with a motivational approach (i.e., a user-centred study focusing on contextual inquiry). Based on in-situ observations carried out in intensive care units and the relevant literature review we define the obstacles for compliance deriving from psychological and contextual constraints and provide relevant insights to help designers and clinicians to fight with. Our aim is to initiate discussions regarding the main purpose of medical alarms and how to integrate them better in clinician workflow.@en

The value of sound design is increasing in the field of product development, and even more so in critical contexts such as healthcare. A well-designed sound can have an impact over job satisfaction, efficiency in work environment, user experience and well-being of healthcare staff and users as a whole. On the other hand, service design is a particular domain within design engineering focused on how the relationship between service providers and users can be improved. An emerging community highlights the utility of the tools and techniques to effectively include system stakeholders in the design and implementation of health technology and healthcare service design. Service design has been applied successfully in several projects to improve patient experience as well as in other areas of public sector. This paper states the potential contribution of service design to sound design, as another methodological approach in order to improve audible alarm design for product development in healthcare environment. Likewise, the paper offers designers and engineers possibilities to implement together both the tools and methods of service design and product sound design deriving from the review of existing literature and empirical conclusions compiled from observation and analysis of oncological treatment rooms at different hospitals.@en

The value of sound design is increasing in the field of product development, and even more so in critical contexts such as healthcare. A well-designed sound can have an impact over job satisfaction, efficiency in work environment, user experience and well-being of healthcare staff and users as a whole. On the other hand, service design is a particular domain within design engineering focused on how the relationship between service providers and users can be improved. An emerging community highlights the utility of the tools and techniques to effectively include system stakeholders in the design and implementation of health technology and healthcare service design. Service design has been applied successfully in several projects to improve patient experience as well as in other areas of public sector. This paper states the potential contribution of service design to sound design, as another methodological approach in order to improve audible alarm design for product development in healthcare environment. Likewise, the paper offers designers and engineers possibilities to implement together both the tools and methods of service design and product sound design deriving from the review of existing literature and empirical conclusions compiled from observation and analysis of oncological treatment rooms at different hospitals.@en

Neonatal Intensive Care Units (NICU) are environments with a high level of sensory stress. Medical advances and technology have contributed to increase the ratio of survival of premature infants but some devices and practices expose these babies to excessive noise and toxic sensory stimuli for which they are not prepared. This is related to an increase of neonatal morbidities, that are considered as minor sequelae, but that can greatly alter the life of the child and the family. Those responsible for hospital management and caregivers who want to take a step forward, need standards to guarantee the benefit of neonatal health and a proper physical and cognitive development of these babies. Design activity, from a Human-Centered Design approach (HCD), together with Developmental Centered Care (DC) contribute to identify and reduce adverse environmental conditions for newborns and premature infants. The purpose of this paper is to establish a method to provide design recommendations and good practice guidelines from evidence and especially from in-situ observations carried out in neonatal units by a multidisciplinary team (i.e., nurses, NICU supervisors and designers). Thus, we identify proposals to reduce stress situations and obtain potential benefits in the development of the hospitalized infant through adaptation of the NICU macroenvironment (i.e. the reduction of light and noise).@en