Co-designing a new patient monitoring system in hospital emergency care.
We worked with healthcare professionals, patient and public representatives to allow them to mediate the decision-making process.
Sandra Neves
sandra.neves@ipleiria.pt
01.12.20 — 31.06.23
Context
Portuguese hospital emergency departments are struggling to treat patients quickly and safely due to the increased number of patients going into emergency department. Overcrowding and staff shortage has the potential to impact patient safety. It is important for emergency department ward staff to detect clinical deterioration to ensure patient safety in emergency care.
Safetrack, a multidisciplinary project involving academic expertise in health, informatics and electronic engineering, and companies in software development, medical devices, and commercial medical solutions worked together to explore how emergency departments in hospital could better respond to patient safety issues during patients’ hospitalization.
Approach
Involving a participatory approach, design researchers worked together with healthcare professionals, patient and public representatives to co-design a new patient monitoring system to support early detection of clinical deterioration to promote patient safety and understand the potential of the Safetrack to support healthcare professionals to deliver quality of care.
Findings
Healthcare professionals such as nurses and doctors were identified as highly knowledgeable participants, due to their experience in working in such a complex health context. Both healthcare professionals and patient and public representatives were very positive about the idea of developing a patient monitoring system for early detection of clinical deterioration and saw how it could be used to alert healthcare professionals of critical health deterioration in patients, as well as to improve communication and make clinical practices more effective.
The envisioned future patient monitoring system
Key opportunities
A focus to provide information
The emergency triage nurse only has between 3 to 5 minutes to screen a patient. We found that creating informing moments, which describe what the patient is going to experience before triage, was considered important in order to enable people to receive information about the benefits of a monitoring system to guarantee patient health care safety and quality during their time in the emergency department.
Facilitate the applying and activating of the monitoring system
There is a common view that the patient monitoring system should begin in triage. It was understood that applying and activatig the monitoring system on the patient should assist the triage nurse who has limited time for screening.
Receiving notifications
Enabling healthcare professionals to receive alerts “in real time” of a patient’s clinical deterioration was considered crucial to better respond to critical health issues.
Visualizing information
Various formats for displaying information can assist health professionals in the managing and coordinating of health care in the emergency department in a hospital.
Automatic information records
The information generated through the patient monitoring system should facilitate healthcare professionals in managing a variety of clinical information.
Ensuring the protection of personal information
Issues of data protection were highlighted and considered important to ensure personal information is confidential and protected.
Prototyping
The first steps of the prototype of the new patient monitoring system is the result of the information generated in Phase II and a series of discussions among the various specialists of the SafeTrack Project Consortium – design researchers, designers and electronic engineers – who have supported its development. The new patient monitoring system calls for the prototyping of two components: 1) the sensor to measure the vital signs and 2) the graphic interface to display the information.
Sensor prototyping (version 1)
Graphic interface prototyping (version1)
Next steps
We are currently seeking out new funding opportunities for this project to move forward. Essential for future research steps will be the meaningful involvement of clinical staff and patient representatives in the development of the prototype to ensure that the resulting monitoring system meets their needs. An iterative prototyping process will be used to translate people’s ideas and perspectives into tangible forms that can be refined and subsequently tested ‘in the real context’ to understand how the new monitoring system might support patient safety and clinical practice in emergency care.
Participants
We are very grateful to all participants for their time and enthusiasm.
Wiseware, Lda.
ciTechCare - Center for Innovative Care and Health Technology
CDRSP - Centro para o Desenvolvimento Rápido e Sustentado de Produto
Centro Hospitalar de Leiria
Dreamplas, Lda.
Epjmédica - Artigos Médicos E Hospitalares, Lda.
Co-funded by Programa Operacional Regional do Centro (Centro 2020), under the programme Portugal 2020, through Fundo Europeu de Desenvolvimento Regional (FEDER) – CENTRO-01-0247-FEDER-070111 and supported by Fundação para a Ciência e a Tecnologia (FCT) (UIDB/05468/2020), Laboratório de Investigação em Design e Artes (LIDA), (UI/05704/2020), Center for Innovative Care and Health Technology (ciTechcare) and Politécnico de Leiria.
