ITU App explanation · 2020-06-19 · The app was designed to record communication over a period of time so all steps to communicate we noted and therefore useful to medical professionals

ITU Communication App

The app is designed for communication in intensive care. The app is designed around some key principles:

Communication builds from a key word or image Past patients and their relatives described the person who can talk doing the majority of the work when communicating. The person who could not talk would describe a key word any way they could and the relative or staff member would guess what context and meaning that could have. The app aims to allow the patient to communicate in a few steps as possible.

Communication can happen over a long period of time As well as communicating in the moment the app can be left with the patient and they can construct a message over a long period of time. Patients described having moments of lucidity and moments of hallucination, fatigue and confusion. The ability to communicate over a longer period of time means communication is not limited to specific times or on demand, so they can still ask a question during doctors rounds, even if they are not able to communicate at that moment.

The app was designed to record communication over a period of time so all steps to communicate we noted and therefore useful to medical professionals.

Personal data There are two potential levels of use for the app. One is that the app is a communal hospital owned device for communicating mainly in the moment. The other use is that it would be downloaded on to a personal device and used solely by one patient. The main difference will be the level of detail the app can build up and how specific the information can be. In this document the two design types will be referred to as ‘personal device’ and ‘communal device’.

Multiple routes in to a conversation The app aims to give options in order to say something. It can begin with a phrase or a keyword or even a drawing. This reflects that users will not always have the same level of time, energy and cognitive ability. Also all users do not think in the same way.

Wednesday 25th February 2015Hammersmith Hospital, London

6:35pm

Communicate

What will happen to me

Why am I here

Personal device homescreen

Patients described waking up in a state of confusion not knowing where they were and what would happen to them. This screen would be the default state for the app. It confirms the context for the patient and also allows the medical staff to input details of scans and upcoming treatments for the patient to read in their own time. Together this information should reduce confusion.

25th Feb You will have a scan.

John Smith

Doctors rounds are between 10 — 12 midday. The time now is 6.35pm


Back

Personal device information screen

Information screens can combine general ward information and specific patient related information.


6:35pm

Communicate


Why am I here


6:35pm

Communicate

Where am I?

Communal device homescreen

On the communal device the home screen can still reduce confusion by explaining where they are, generally on this screen and in more detail by pressing ‘where am I?’.


6:35pm

Communicate


Why am I here


6:35pm

Communicate

Where am I?

Communal device information screen

The screen could show details of what help is available and who all the staff are. Patients described mistrusting the staff as they didn’t know who they were. This should help with that.

Where am I?

Back

Hammersmith Hospital.

10 — 12 midday. The time now is 6.35pm

Doctors rounds are between

Your doctors:

Tell me about

I need ...

I am ...

Write a word

Pick a word

Back

Communication home screen

When the user presses ‘communicate’ they bring up the communication home screen. This displays the starting point for saying something. The options are designed to be the most suitable starting points for saying a key word or phrase. Also by the user pressing either of the top three options they are able to start communication in one touch, this follows the principle that the patient gets the communication in to the area of the conversation and the staff or family member starts guessing from there.

I need ...

Write a word

Tell me about

Pick a word

too cold.

too hot.

...more

in pain.

thirsty.

I am ...

Back

Communication process

Once one of the options is pressed the other half of the screen shows words that complete the statement. If the correct option isn’t there then the user can press ‘…more’ and bring up a library of options. On personal devices the options will change depending on which are most frequently used.


6:35pm

Communicate


Why am I here Tell me about

I need ...

I am ...

Write a word

Pick a word

Back

I need ...

Write a word

Tell me about

Pick a word

too cold.

too hot.

...more

in pain.

thirsty.

I am ...

Back

Communication process from the home screen

I am ...

I need ...

Write a word

Pick a word

my family

me

my home

my job

...more

Tell me about

Back

Communication process - subject areas

Some options may not have simple options and the user may want to be more specific. In this case the user can access subject areas and then choose specific words.

Nurse Nurse Nurse Nurse Nurse

Hospital Staff

Family

Send to someone...

Back

My home

My job

Pets

dad.

Security

mum.

Mortgage

son. daughter.

Post Garden

+ add

Tell me about...

Back

Communication process - subject areas

If the right word is still not available the user can press ‘+add’ to create their own new word.

I am ...

I need ...

Write a word

Wash Flowers

Coca-cola

Headache

Nurse Loud

Pick a word

Tell me about

more...

It is also possible to start the communication by choosing a key word instead of a phrase.

Communication process - pick a word

I am ...

I need ...

Write a word

Wash Flowers

Coca-cola

Headache

Nurse Loud

Pick a word

Tell me about

more...

Me Family

Home Job

Food Greetings

Sport Hospital

Pick a word...

Back

My home

My job

Pets

dad.

Security

mum.

Mortgage

son. daughter.

Post Garden

+ add

...other

Pick a word...

Back

Picking a word from subject library

I am ...

Tell me about

I need ...

Pick a word

Pick letters

Draw

Video an action

...more

Write a word Back

Communication process - Write a word

It is also possible to start the communication by writing a word. There are multiple ways to do this to allow for ability at any given time. Drawing or mouthing a word may be easier than typing, these are actions patients described doing.

I am ...

Tell me about

I need ...

Pick a word

Pick letters

Draw

Video an action

...more

Write a word Back

Write a word...

GA B C D E F G H I J K L M N O

Rig_

Back AbcdeQwerty

When writing a word there are multiple options, one is picking individual letters to make a word.


I am ...

Tell me about

I need ...

Pick a word

Pick letters

Draw

Video an action

...more

Write a word Back

Write a word...

q w e r t y u i o p

a s d f g h j k l

z x c v b n m

New_

AbcdeQwerty

Space

Back

Alternatively the user can type using a keyboard. The will also be alternative letter picking layouts.



Hospital Staff

Family

Send to someone...

Back

Tell me about ...mum

...dadfamily

...son

...daughter

...other

<Back Start

me...

house...

job...

Tell me about my mortgage.

+ add more

Is this correct?

Once the user has picked a words or completed a phrase they will have a review screen to confirm or add to what they have written.

Communication process - confirmation


Hospital Staff

Family

Send to someone...

Back

Tell me about ...mum

...dadfamily

...son

...daughter

...other

<Back Start

me...

house...

job...

Tell me about my mortgage.

Back

Send to someone?

The communication may be intended for a specific recipient, this could be a family member or a member of staff. After the confirmation screen the user is given the opportunity to send the message to someone.

Send to someone


Hospital Staff

Family

Send to someone...

Back

Send to someone - pick person

They will be then given a list of possible people to send it to. The communal version will only have staff members but the personal version could include many different people inputted by family and friends.

Staff / Family mode

Name John SmithD.o.B. 1 June 1968Details

Communicate

Add content

Patient Activity Log

Staff / patient mode

By swiping the home screen in a certain way Staff and family can access a mode that the patient cannot see. The interface switches to portrait to signify it is a different mode. Contextual information can be added in this mode. Key words that may be specific to that ward or to that person depending on whether or not it is a personal or communal device. Personal devices can have a lot of detail added to make the app as relevant and useful as possible.

Initial Setup

Back

Name

Date of Birth

Admission date

Reason for admission

When are Doctor’s rounds

Strategy for catre?

Patient Details

Details of ITU stay


When the staff/patient mode is first accessed the app guides them through setup.

Add content

Back

Picture

Patient Details

Word Categories

Words

People

Places


As wel as contextual information like location, specific words can also be added.

TimelineDate Action For

25/2/16 18.36 I am...

25/2/16 17.55 I am...

I am... 25/2/16 16.00 Drawing

25/2/16 14.37 I am... in pain

25/2/16 11.09 Tell me about...

House

25/2/16 09.54 Tell me about my

daughter

Jane

24/2/16 23.55 Video

Back

Communication activity log

The app records any communication attempts. This means that all communication is useful. if a person repeatedly presses ‘i need…’ then you can use that as the starting point for communication. Also if a patient repeatedly says they are in pain at certain times then it is possible to see if the pain relief needs to be adjusted. On a personal device this could run for as long as the patient is using the app. On communal devices it would be reset every time someone new uses it.

Yes No

Communication cards

In addition to the app, there are communication cards. One example is a Yes/No card. This can be used if a staff or family member is using the app and need the patient to confirm options eg. which letter or word to press.

Reference

Style Guide

First Option Top

First option idle/chosen

Create content

Final Choice

Tell me about Tell me about

my family

+add more

mum.

Recently used words My Family

Back

Communicate

Second option idle

Title

Back button

Identified needs/scenarios that the patient experiences (From the point of view of the patient)__

1. I woke up and didn’t know where I was/what was happening

2. People don’t talk to me

3. I am... in pain/thirsty/sensation

4. I would like a...something in hospital, easily found and given

5. I want to know about...Person/place/work/money

6. I am confused/terrified/hallucinating

7. My mind is working but I can’t express what I feel/want

8. I can’t... Everything is exhausting/my hands are shaking/my vision is double

9. What works is...

Issues uncovered in research that the app aims to address

Documents

ITU App explanation · 2020-06-19 · The app was designed to record communication over a period of time so all steps to communicate we noted and therefore useful to medical professionals