‘My five moments for hand hygiene’: a user-centred design approach to understand, train, monitor and report hand hygiene

2007 ◽  
Vol 67 (1) ◽  
pp. 9-21 ◽  
Author(s):  
H. Sax ◽  
B. Allegranzi ◽  
I. Uçkay ◽  
E. Larson ◽  
J. Boyce ◽  
...  
Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Melanie J Martin ◽  
Nora Ng ◽  
Laura Blackler ◽  
Toby Garrood

Abstract Background Patients with rheumatoid arthritis are generally seen at arbitrary intervals in secondary care. Patients with active disease may not always be seen at the most appropriate time and those with low disease activity may be seen more frequently than necessary. The NHS Long Term Plan expects outpatient appointments to be reduced by up to a third, with digital transformation a key enabler. The remote capture of patient-reported outcome measures (PROMs) has the potential to facilitate more flexible and responsive outpatient services. Methods This project aimed to design a digital remote monitoring platform to test the hypothesis that PROMs can be used to proactively monitor and trigger consultations when patients need them most. The Rheumatoid Arthritis Impact of Disease (RAID) questionnaire, a validated multidimensional PROM, was used. Waiting room testing with patients informed the design of an acceptable mobile device format of the RAID. Recruitment criteria and acceptable cut-offs for defining flare were agreed by the rheumatology multidisciplinary team. Patients in low disease activity or remission (DAS <3.2) were invited to the service via SMS. All patients were informed regarding the governance of handling patient data and an opt-out option was offered. Patients were sent an automated monthly SMS with a PROM link and weekly reminder SMS if required. They also had the option to send in SMS messages at other times or add free text comments. Patients submitting a RAID score of ≥ 4 received a SMS with a link to the rheumatology advice service advising a remote consultation. The SMS-based service went live in January 2019 and all incoming communication was monitored on a daily basis. Results 104 RA patients are currently using the remote monitoring service with 10.3% (13/117) opting-out. 847 monthly PROMs have been sent via SMS. The PROM completion rate has been 68.9% (range 59.0-85.1%). 120 RAID (21.8%) scored 2-≤4 indicating low disease activity and 136 RAID (24.7%) ≤ 2 indicating disease remission. 480 SMS have been sent manually to patients who have engaged in two-way communication or returned a RAID score ≥4. 44 telephone advice appointments were triggered through the remote monitoring service by patients in disease flare. 80% (35/44) of remote consultation were considered to have to have averted a face to face consultation with the remaining 20% providing advice alone. Interviews have been conducted with PROM ‘non-completers’ to learn and inform further service design. Conclusion This project has demonstrated how a user-centred design approach to utilising technology can support access to rheumatology care when patients need it most, such as disease flare. The identification of patients self-reporting low disease activity using multidimensional PROMs may enable more efficient utilisation of clinical capacity through patient-initiated appointment deferment and lead to improved patient-centred care. Disclosures M.J. Martin: Honoraria; Novartis, Abbvie. Grants/research support; National Ankylosing Spondylitis Society. N. Ng None. L. Blackler None. T. Garrood None.


10.2196/30364 ◽  
2021 ◽  
Author(s):  
Angelica Wiljén ◽  
John Chaplin ◽  
Vanessa Crine ◽  
William Jobe ◽  
Ensa Johnson ◽  
...  

2018 ◽  
Author(s):  
Laura Pickup ◽  
Alexandra Lang ◽  
Lara Shipley ◽  
Caroline Henry ◽  
James Carpenter ◽  
...  

BACKGROUND A novel medical device has been developed to address an unmet need in standardising and facilitating heart rate recording during neonatal resuscitation. In a time critical emergency resuscitation, where failure can mean death of an infant, it is vital that clinicians are provided with information in a timely, precise and clear manner to capacitate appropriate decision making. This new technology provides a hands free, wireless heart rate monitoring solution that easily fits the clinical pathway and procedure for neonatal resuscutation. To understand the requirements of the interface design for this new device, a human factors approach was implemented. This combined a traditional user-centred design approach with an Applied Cognititive Task Analysis (ACTA) to understand the tasks involved, the cognitive requirements and the potential for error during a neonatal resusciation scenario. OBJECTIVE 1. To understand the cognitive requirements of clinicians for a novel medical device to facilitate neonatal resuscitation; 2. To apply a human factors approach and a traditional user-centred design approach to provide a device interface specification. METHODS Fourteen clinical staff were involved in producing the final design requirements. Two paediatric doctors supported the development of a visual representation of the activities associated with neonatal resucitation. This was used to develop a scenario based workshop. Two workshops were carried out in parallel and involved three paediatric doctors, three neonatal nurses, two advance neonatal practitioners and four midwives. Both groups came together at the end to reflect on the findings which emerged during the separate sessions. RESULTS The outputs of this study have provided a comprehensive description of information requirements during neonatal resuscitation, and enabled product developers to understand the core and preferred requirements of the user interface design for the device. The study raised three key areas for the designers to consider, which had not previously been highlighted. These related to interface layout and information priority, size and portability of the device and auditory feedback. CONCLUSIONS This study demonstrates the value of the ACTA approach to inform the development of resuscitation devices, and more generally for medical device development.


Author(s):  
Ghasan Bhatti ◽  
Roland Bremond ◽  
Jean-Pierre Jessel ◽  
Fabrice Vienne ◽  
Guillaume Millet

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