The intensive care unit (ICU) is a dehumanizing technical environment causing complications that are all captured in the term post-intensive-care syndrome (PICS). The patient’s well-being could be improved by moving away from this hostile environment toward more patient-centred care. Therefore this report explores how to improve the daily ICU experience from a critically ill patient’s perspective.

Environmental influences in the ICU, like noise exposure, are important contributors to PICS (Abuatiq, 2015). Hearing is the most prominent sense of ICU patients. Thus, the Erasmus ICU is designed to keep sound out. It has been shown that there is no clear relationship between reduced volume levels and physiological improvement (Drahota et al., 2012), and the absence of sound does not necessarily create a positive environment (Truax, 1984). Therefore, this project aims to consider sound in a positive manner since sound is only perceived as noise when it does not fit the patient’s state of being.

After many former patients were interviewed and an Erasmus MC ICU nurse was observed, it turned out that it is hard for patients not to focus on their feelings of frustration, loneliness, discomfort, shame, panic, confusion etcetera and still keep a positive mindset. Thus, the design aimed to redirect the patient’s focus by connecting the patient to the environment.

The Thirteen Fundamental Needs for Human-Centered Design typology was utilized as a source to design a positive experience for the ICU environment. Six fundamental needs (Stimulation, Recognition, Relatedness, Autonomy, Security, and Comfort) were uncovered. Strengthening these needs could improve the patients’ experience.

Mapping a patient’s daily routine showed that need fulfilment changes according to the eventfulness, the presence, or absence of people or sound inside the ICU. A patient’s journey revealed that the absence of people right after leaving causes the most harm to the patient. Thus, the decision was made to focus on this transition moment.

Eventfulness can be determined by measuring sound pressure levels (SPL) in dB in the ICU. So the transition moment from an eventful (high SPL) to an uneventful (low SPL) environment can be detected and vice versa.

New visual/auditory stimuli were developed. These can be introduced to benefit patients’ recovery (Arbabi et al., 2018). The stimuli consist of sounds of nature in combination with a nature-based projection. The audio and the visual stimuli change according to the SPL in the room. This design intervention helps guide the patient into the new environment. It is a subtle way to notify the patient that something is happening. Furthermore, it can distract the patient (when bored or during treatment) and decrease the difference between higher and lower sound pressure levels.

The design was developed, embodied, and finally tested in a simulated ICU environment. The evaluation of the design intervention showed that all participants appreciated the design intervention, mainly because they were distracted from boredom, stress/anxiety, negative thoughts (loneliness) or discomfort. It made the experience more comfortable or relaxed.

Finally, three use cases were presented, redirecting the focus from anxiety, boredom, and loneliness. Additionally, recommendations were made.

ICU is the place with the most advanced monitoring and support machines in a hospital. But surrounded by all these machines, ICU patients are also like machines instead of humans. Scientific advances have been proved to greatly improve the cure rate. Meanwhile, patients' well-being has been gradually treated as important as curing the disease itself. With the trend of human-centred intensive care, new services are required to better satisfy patients’
needs.

Artificial intelligence can be a strong force to improve the quality of care in ICU. Apart from taking advantage of the existing monitoring data and EHR data to improve the cure rate, A.I. also has great potential to promote social support for ICU patients.

The purpose of this project is to design a roadmap for A.I. to provide social support for ICU patients, in order to improve the patient wellbeing and contribute to a humane ICU.The design solution is an application called Cricare that includes nine services: 1. Orientation; 2. Autocomplete; 3. Voice Simulator; 4. Music Creator; 5. Environment adjuster; 6. Chatbot; 7. Virtual Psychologist; 8. Peer support; 9. Goal setter.

A questionnaire evaluation with nurses was conducted to test the desirability, importance, and effect on providing social support and effect on patient wellbeing. The results show Cricare is the potential to contribute to a humane ICU. After feasibility evaluation, a primary roadmap was created to develop Cricare.

This report describes a graduation project for the MSc program Strategic Product Design. The client in this project is the Erasmus MC in the Netherlands and commissions this project incorporation with the Critical Alarms Lab (CAL) of the TU Delft. The Erasmus MC and CAL want to improve the experience of the Intensive Care Unit (ICU) both for patients and for the stakeholders surrounding the patient. They are also interested in using Artificial Intelligence (AI) and data to benefit ICU patients. A research project is set up to find how the experience for ICU patients can be improved and how AI can play a role in the ICU. Therefore, the research questions of this project is defined as: “How should the intensive care unit of the Erasmus MC innovate in the coming years to give critically ill patients a humane experience?”. The research resulted in a future vision that describes different values for the ICU of the Erasmus MC. Also, it is described what consider concerning humanization and Artificial Intelligence in the ICU of the future. Secondly, the research results in design guidelines that can be used by the Erasmus MC or designers to design for the ICU and ICU patient. The investigation into the ICU, the ICU patient, stakeholders with influence on the ICU and the future vision come together in a website. This website can be used to retrieve information, used as a guide or function as an inspiration for designers for healthcare.