Exploring the Next Generation Intensive Care Unit of The Future - Sleep Deprivation and Delirium

01/2020 - Present

Five Group Members

A co-design studio centered on the near-term and longer-term needs within the surgical intensive care units at the Arthur G. James Cancer Hospital and the Ohio State University Wexner Medical Center. Working directly with healthcare professionals and immerse themselves in working environments. The end goals for the OSUWMC Department of Surgery would include an objective and broad-based assessment of the current ICU experience/environment and the opportunity for the healthcare professionals to join us in the design-led exploration of future scenarios of use.

Workshop 1 Preparation

​Possible Avenues for Investigation:

  • Awareness for caregivers and patients

  • Changing the communication between caregivers and patient

  • Environmental changes/consideration

  • Medical intervention

  • Considering patient care activities that wake-up patients

  • Tech interventions (VR)

Workshop 1

Our group divided into two groups to conduct interviews and participant activities simultaneously. Several recurring themes that we narrowed down after our presentation.

Our discussions led to five themes to explore in the next workshops.

The themes fall under the team's aim to prevent sleep deprivation and delirium. 

  • Information about delirium- patient's family

  • System of care to prevent delirium- care provider

  • Orienting the patient with time, place and self to prevent delirium- care provider, patient's family, patient

  • Mobility- patient's family, care provider, patient

  • Physical environment- care provider, patient, patient's family

 
Workshop 2 Preparation

We continue to investigate the following questions:

  • What is it about mobility that prevents or alleviates symptoms of delirium?

  • What is the best scenario for the physical environment?

  • How to correctly involve family?

 

In the second workshop, we are providing make-tools to the co-designers to use to generate ideas that are exploring "real life world" (worst) and "magic wand world" (best) scenarios of sleep deprivation and delirium.

We're providing each co-designer with a combination of images, "what if?" cards, "magic wand" cards, and assorted paper shapes to use as tools to present their ideas.

The "what if?" cards have potential situations listed on each (i.e., the patient has communication limitations, no family members, or has high-risk factors).

"Magic wand" cards include examples of low (i.e., preferences for architectural attributes and outdoor views),  and high technology (i.e., VR, Alexa, and in-patient online conferencing) and an open prompt with "money is no object".

Workshop 2

This week was our second co-design workshop at the James. The participants contributed their ideas about problems that exist in the ICU and possible solutions for the ICU patient's sleep deprivation and delirium. 

The participants used what-if cards to define the issues and were prompted to elaborate on the subjects with visual images or verbal explanations. They were asked how they envision the issues could be resolved; magic wand cards and images were typically used to describe the solutions. We learned that not all participants, even the same roles, share the same opinion of problems and solutions relating to sleep deprivation and delirium.

The following themes were discussed in this week's workshop:

  • Reorienting the patient

  • Increase mobility

  • Improve the physical environment

  • Introduce mindfulness interventions

  • Control noise

 
Workshop 3 Preparation

Participants' contributions were organized by attainability (achievable now or in the future). We began to develop plans for the next workshop's activity to be centered on what would be should be experienced in the ICU room's environment; ie, How does it make you feel? If it had a smell, what would that be? 

 

Our team will provide the virtual reality as a tool for the participants to prototype the ICU patient room. Assets will be available within the VR room setting for the participants to choose and place wherever they would like within the VR room. The assets will represent objects and activities that may be used/located within the room. Some assets will be general shapes (e.g., cubes and planes) to be used to represent whatever object the participant chooses if a specific asset doesn't exist for their use.

We are providing the participants with a choice from 3 levels of comfort in using VR to prototype: 

  • The participant will wear the VR head-mount device and actively move the represented objects within the virtual environment.

  • The participant will wear the VR head-mount device and instruct the team member (within the VR world) what objects to select and where to place.

  • The participant will not wear the head-mount device but observe the VR model "from outside" and reference the provided monitor while instructing the team member (within the VR model) what objects to select and where to place them within the VR model. 

to be Continued...