Project Overview
The focus was to:
• Prepare a patient’s loved one for what to expect in the ICU
• Provide information about the ICU, its staffing, ICU procedures and therapies
• Empower the patient’s loved ones to participate in patient care
• Provide information 24 hours a day in an easily accessible, user friendly, interactive and innovative way, allowing users to determine what information they read, when they read it, and to revisit the information as many times as needed.
• Easily change and update the application in response to feedback from families and clinicians, keeping it current and effective.
Organisation
The Alfred Hospital Intensive Care Unit
Team
Carlos Scheinkestel, Josh Ihle, Steve Philpot, Steve McGloughlin
Jason McClure, Tim Leong
Small Studio & Little Shed Software
Project Brief
To the best of our knowledge, this innovative and interactive communication tool for patients and their families is the first of its kind in Australia.
Prominent signs as well as reception clerks direct families to six iPads, securely and strategically located in the ICU reception area, locked to display only The Alfred ICU application.
The application’s content is managed on a free content management system (CMS) that can be directly updated by the ICU clinicians and immediately available on all iPads via wireless Internet connectivity.
The initial homepage displays a short introductory video introducing the user to the ICU, explaining, in plain language, what it means to be critically unwell and providing a virtual video tour of the unit and what to expect when entering a cubicle, including some of the noises.
Via real time links to the roster, the user is informed which Intensivist is caring for their loved one by simply selecting the patient’s bed number. The application also contains a photo and brief biography for each Intensivist and it enables requests for a family meeting to be relayed to the relevant Intensivist via SMS and e-mail.
The user is then free to navigate through over 100 pages, many of which can be printed wirelessly within the waiting room, such as nearby accommodation, public transport and eateries, with maps highlighting the location and contact details).
A significant innovation is a “Procedures and Therapies” section describing all common ICU interventions and their risks
Project Need
We regularly assess family satisfaction not only with the care their loved one has received but also with the quality of our communication, and the consistent feedback we receive is that the ICU experience is daunting and disempowering.
Published literature suggests that high quality communication with families and regular meetings with senior medical staff improve family satisfaction and reduce anxiety1 .
Family members currently receive copious amounts of information from multiple sources or need to seek it in multiple places. The information delivery is variable as is, not surprisingly, the subsequent understanding.
We wanted to collate the information into a single user-friendly iPad application incorporating videos, audio, maps and readable content to facilitate maximal understanding of the information provided and to ensure consistency of delivery.
We believe this iPad application offers immeasurable value, in the form of consumer satisfaction, engagement, and understanding. The benefits of mitigating stress during the admission of a loved one to ICU are well described2, and we believe this innovation is a powerful and skillful way to realize this.
A significant innovation is a “Procedures and Therapies” section describing all common ICU interventions and their risks, and a consent form covering ICU procedures for the next of kin to sign if the patient is unable. Obtaining consent before common ICU procedures is not standard practice anywhere else in Australia.
User Experience
This project’s main focus was to address the needs of the consumers and attempt to make their time in the ICU a little easier.
The Alfred ICU admits more than 2800 patients per annum and provides most of the Victorian State Services and a number of National Services. So families sometimes travel from afar and may be at the hospital for many weeks, spending considerable amounts of time in the waiting room.
The application provides the user with practical information, such as accommodation, local dining, and surrounding public transport, all of which are available in maps that can be printed. This helps to make the user’s time in an unfamiliar environment a little easier.
During development, workshops were conducted with family members to address the type of information that would help them prepare for the ICU environment. A working group of medical, nursing and allied health professionals developed and refined the content and met regularly with the external digital production company commissioned to develop the application. This process took 4 months.
Evaluations by hospital staff, patients and families that had previously been in ICU further refined the application.
Analytics informing us of the most visited pages and a questionnaire embedded within the application for direct feedback help us continuously improve it to focus on meeting the needs of our customers.
The consent form was developed following extensive discussions involving Alfred ICU, Alfred’s Human Research Ethics Committee (HREC), Alfred Executive and General Counsel Alfred Health.
Project Marketing
This application is continuously being developed and refined as a result of ongoing consumer feedback, Google analytics and new ideas.
The Alfred’s Intensive Care Unit (ICU) is dedicated to the delivery of best possible patient-centred care and provision of quality, timely and appropriate information.
The Alfred's ICU is always changing, continuously improving processes and performance. The application was designed for this philosophy and is readily changed and updated to remain current and relevant.
Because this application is wholly owned by us and was designed with this in mind using freely available non-proprietary software and an open source content management system (CMS), this can be done “in-house” by the ICU clinicians as frequently as deemed necessary.
The current content is quite specific to the Alfred ICU, but the content management system will allow different content to be uploaded making the application readily adaptable to other sites and marketable in the future.
Project Privacy
Confidentiality is particularly important in the medical profession. Everything contained in this application is already freely available in the public domain. Furthermore, all the information that is made available is generic.
There is no patient specific information, and the application therefore does not breach confidentiality or privacy.
ICU staff consented for their photos and biographical information to be included and the requests for family meetings via SMS and e-mail are generated within the application without divulging e-mail addresses or mobile phone numbers.
Medical
This category relates to applications that provide or promote a medical service or information.
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