Converting wandering behaviour into a guided activity: a case study of co-designing with People Living with Dementia based on theoretical models

For People Living with Dementia (PLwD), wandering behaviour can cause undesired consequences, such as falling, getting lost or even fatalities. For caregivers, taking care of PLwD with wandering behaviours is burdensome. If not intervened early, some wandering behaviours will escalate into crisis events. This design research aims to explore how to convert the wandering behaviour to a guided activity with the minimum input from caregivers by intervening early, that is, engaging PLwD, to avoid potential escalations. Based on Need-driven Dementia-compromised Behaviour (NDB) model, Crisis Development model and via a co-design approach, we developed De-light. De-light is a set of interactive sticks enhanced by light, audio and tactile experiences. Based on the degree of wandering behaviours of PLwD, De-light can be placed by the caregiver in a safe and suitable area in the nursing home to provide a controlled setting for guiding PLwD to perform physical activity. Our design research implies the possibilities of applying NDB model, Crisis Development model, and co- design approach in designing for the wandering behaviours for PLwD

Proficiency From Immersion: A Human-Centered Design in Cross-Cultural Surgical Training

Ensuring surgeons are well-trained in various skills is of paramount importance to patient safety. Surgical simulators were introduced to laparoscopy training during the last 2 decades for basic skills training. The main drawback of current simulation-based laparoscopy training is their lack of true representation of the intro-operative experience. To create a complete surgical surrounding, the required amount of resources is demanding. Moreover, organizing immersive training with surgical teams burdens daily clinical routines. High-end virtual reality (VR) headsets bring an opportunity to generate an immersive virtual OR with accessible and affordable expenses. Pilot studies reveal that personalization and localization are key needs of the virtual operating room (VOR). They are therefore key in this study. The focus of this study was to explore the effect of different human factors, such as domain knowledge, culture, and familiarity of VR technologies, on the perception of VOR experience. A human-centered design approach was applied to investigate the presence and usability of a VOR. Sixty-four surgical practitioners joined the study in the Netherlands and India. The surgeons were referred to as “experts” and surgical trainees as “novices.” The VOR system we used is composed of a laparoscopic simulator, a graphic virtual OR surrounding, and an Oculus Rift VR headset. Participants conducted the “complete Lapchol” task with the VOR. Afterward, four questionnaires were used to collect subjective ratings on presence and usability. Participant’s qualitative feedback was collected using a semi-structural interview as the final stage. Results showed the surgical knowledge only affected perceived mental demand when using a VOR. The cultural difference would alter the rating on the majority of items in these questionnaires. VR experience mainly affected the judgment on presence including “quality of interface” and “reversible actions.” The interaction effects between surgical knowledge either with culture difference or with VR experience were obvious. This study demonstrated the influences of cultural differences on the perception of immersion and usability. Integrating immersive technologies such as virtual reality and augmented reality to human-centered design opens a brand new horizon for health care and similar professional training

Converting wandering behaviour into a guided activity: a case study of co-designing with People Living with Dementia based on theoretical models

For People Living with Dementia (PLwD), wandering behaviour can cause undesired consequences, such as falling, getting lost or even fatalities. For caregivers, taking care of PLwD with wandering behaviours is burdensome. If not intervened early, some wandering behaviours will escalate into crisis events. This design research aims to explore how to convert the wandering behaviour to a guided activity with the minimum input from caregivers by intervening early, that is, engaging PLwD, to avoid potential escalations. Based on Need-driven Dementia-compromised Behaviour (NDB) model, Crisis Development model and via a co-design approach, we developed De-light. De-light is a set of interactive sticks enhanced by light, audio and tactile experiences. Based on the degree of wandering behaviours of PLwD, De-light can be placed by the caregiver in a safe and suitable area in the nursing home to provide a controlled setting for guiding PLwD to perform physical activity. Our design research implies the possibilities of applying NDB model, Crisis Development model, and co- design approach in designing for the wandering behaviours for PLwD

Converting wandering behaviour into a guided activity: a case study of co-designing with People Living with Dementia based on theoretical models

For People Living with Dementia (PLwD), wandering behaviour can cause undesired consequences, such as falling, getting lost or even fatalities. For caregivers, taking care of PLwD with wandering behaviours is burdensome. If not intervened early, some wandering behaviours will escalate into crisis events. This design research aims to explore how to convert the wandering behaviour to a guided activity with the minimum input from caregivers by intervening early, that is, engaging PLwD, to avoid potential escalations. Based on Need-driven Dementia-compromised Behaviour (NDB) model, Crisis Development model and via a co-design approach, we developed De-light. De-light is a set of interactive sticks enhanced by light, audio and tactile experiences. Based on the degree of wandering behaviours of PLwD, De-light can be placed by the caregiver in a safe and suitable area in the nursing home to provide a controlled setting for guiding PLwD to perform physical activity. Our design research implies the possibilities of applying NDB model, Crisis Development model, and co- design approach in designing for the wandering behaviours for PLwD

Reducing the Environmental Impact of Syringes at the Intensive Care Unit

This research project, part of the Green Intensive Care Unit (ICU) initiative at the Erasmus University Medical Center (EMC), is focused on reducing the environmental impact of syringes at the ICU by designing solutions based on circular economy principles. Based on a Material Flow Analysis of the EMC ICU, syringes and their packaging have been identified as one of the main environmental impact hotspots. Therefore, this project aimed to redesign the syringes, their packaging, and their use, according to circular design strategies suitable for medical products to decrease their environmental impact, while remaining convenient and safe in use for the healthcare staff and patients. Research was executed to understand the context from multiple perspectives. The outcomes demonstrated that decreasing the impact of syringes is not only related to the design of the syringe itself. Manufacturing, preparation, use and disposal, all contribute to the environmental impact of the syringe. Various possible interventions were derived to reduce its impact: 1.Adapting the infection prevention protocol and behaviour of the staff;2.Separating infectious waste from general hospital waste;3.Redesigning the syringe itself;4.Optimising the filling process of syringes. The final design is an optimised filling process for prefilled sterilised syringes (PFSs), based on circular strategies such as reduce, reuse, rethink and repurpose. Interventions include: eliminating a redundant sterilisation phase, reducing residual medication and changing from steam to gamma sterilisation. This resulted in decreasing the amount of waste, material, energy and water consumption, while offering similar convenience and safety for the staff and patients of the ICU.</p

Know-me: a toolkit for designing personalised dementia care

Personalisation is a crucial element in providing person-centred care for people with dementia. This paper presents the development and evaluation of a design toolkit to facilitate the work of designers and healthcare professionals in personalising dementia care. This toolkit, named “Know-me”, was grounded in the findings of Ergonomics in Aging, Co-design, and Data-enabled Design, derived from literature review and from the field during a four-year doctorate project. “Know-me” was designed to be easily accessible, flexible, and engaging, providing concrete and hands-on guidance for designers and healthcare professionals to use in designing for personalised dementia care. A proof-of-concept evaluation of the “Know-me” toolkit was conducted via student projects on design for dementia care. During this process, we found that “Know-me” could be adapted flexibly so that the care team could use some of the tools by themselves. A feature-by-feature comparison of the “Know-me” toolkit with similar state-of-the-art toolkits was conducted, and based upon this, the strengths and weaknesses of the “Know-me” toolkit are discussed. This preliminary study indicates that the “Know-me” toolkit is a helpful addition to the current pool of toolkits on designing for dementia care

Patient selection process for 1-day total hip arthroplasty

Osteoarthritis (OA) is a degenerative joint disease and OA of hips and knees tends to cause the greatest burden to the population. In the case of hip joint failure, a Total Hip Arthroplasty (THA), a surgical replacement of the hip joint with an artificial prosthesis, is required to relieve patients from pain and regain mobility. In order to deal with the growing number of THA surgeries, optimize the cost effectiveness, reduce the length of hospital stay and minimize the risk, rapid recovery protocols have been introduced worldwide for elective primary THA. The next challenge for the orthopedic care was outpatient THA, aiming to send the patient to home the same day of surgery. To improve patient safety and managing expectation of the patients and medical professionals the current outpatient THA care pathway was analyzed and redesign suggestions were made. Pre-assessment where clinical patient data is integrated with patient characteristics (mental and physical condition, life circumstances, etc.) seems very important to support the orthopedic surgeon with sufficient data to make an informed decision whether a patient is suitable for outpatient THA. According to the results, current patient selection process is mainly guided by clinical patient data and should be extended with patient characteristics. The relevant data provided by one of the medical professionals should be transparently available for the other medical professionals to support shared decision-making. The patients should be involved more actively in their healthcare process and advice they receive should be tailored and personalized according to their life circumstances