How can designers help improve the care of patients in intensive care units? This is exactly the question we are addressing in the IMEDALytics research project.
In this article, we cover the significance of three context analyses that we carried out as part of this project — as well as the valuable knowledge we gained. Find out all the details surrounding problem assessment and project objectives in the first part of the article.
Understanding the system’s use context
So that we can guarantee a good user experience, we have to develop a comprehensive understanding of the intended user and the future system’s technical possibilities.
Contextual inquiries
After a scoping workshop with all project partners, we paid three visits to intensive care units at the University Hospital of Aachen and Dortmund Hospital. We were able to observe the everyday work across various intensive treatment units as well as accessing the medical expertise of the staff there — also our future users.
Contextual inquiries combine observations and interviews and are an essential part of this project for us as UX Designers. They offer us the unique opportunity to identify user contexts, users and important factors impacting healthcare professionals’ decisions and actions in their stressful working environments.
As well as this insight into real everyday work, the visits let us identify how we can integrate IMEDALytics into medical and nursing staff’s everyday life at the hospital so that the system actually provides support.
Learnings
1 Handovers
It was enlightening to observe that there are informal and formal information handovers as well as synchronized and asynchronized collaborations between members of staff. Shift handovers take place between
doctors and other doctors
nurses and doctors and
nurses and other nurses
Additional consultations are spontaneous — particularly when a second opinion is required. During examinations, yet more information is exchanged and decisions made as a joint effort.
2 Role sharing
While doctors see their patients at relatively long intervals and decide the appropriate therapy, nursing staff see their patients more often so are responsible for monitoring their status as well as achieving targets. Their observations on patient condition and the success of assigned measures form part of the doctors’ decision-making processes.
3 Documentation: digital and analogue
During our visits to the two hospitals, we found out that the units we visited differed drastically in how information is documented using digital systems. Doctor’s orders, prescribed medications, treatments and other care instructions were simultaneously logged by doctors and nurses. In one clinic, this documentation was digital, while the other used standardized sheets of paper — this makes a major difference in the context of our project!
4 Workload and stress
Staff workloads deviate between weekdays as well as during the course of one day, depending on how many patients are in the unit and how critical their conditions are. Then there are factors such as a constantly high level of noise from medical devices. Many generate acoustic feedback even during less critical events. In addition to this stress, staff had to make repeated, sometimes lengthy trips between individual rooms and were rarely able to take breaks.
