Iterative user centered design for development of a patient-centered fall prevention toolkit

Katsulis, Zachary P.; Ergai, Awatef; Leung, Wai Yin; Schenkel, Laura; Rai, Amisha; Adelman, Jason S.; Benneyan, James C.; Bates, David W.; Dykes, Patricia C.

doi:10.1016/j.apergo.2016.03.011

Cited by 39 publications

(37 citation statements)

References 4 publications

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“…Castilla et al described an HCD process for a telepsychology app, where they presented end users with icon and interface concepts in the first step of their design process, before moving on to a cognitive walkthrough methodology to evaluate the navigation of the interface. These and many other examples like them [ 23 - 25 ] show the wide variance in the application of HCD to health devices and systems. It also exhibits the broad range of usability and human factors testing activities available to engineers and designers to gather feedback.…”

Section: Introductionmentioning

confidence: 99%

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

Harte¹,

Glynn²,

et al. 2017

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BackgroundDesign processes such as human-centered design, which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of human-centered design can often present a challenge when design teams are faced with the necessary, rapid, product development life cycles associated with the competitive connected health industry.ObjectiveWe wanted to derive a structured methodology that followed the principles of human-centered design that would allow designers and developers to ensure that the needs of the user are taken into account throughout the design process, while maintaining a rapid pace of development. In this paper, we present the methodology and its rationale before outlining how it was applied to assess and enhance the usability, human factors, and user experience of a connected health system known as the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system, a system designed to continuously assess fall risk by measuring gait and balance parameters associated with fall risk.MethodsWe derived a three-phase methodology. In Phase 1 we emphasized the construction of a use case document. This document can be used to detail the context of use of the system by utilizing storyboarding, paper prototypes, and mock-ups in conjunction with user interviews to gather insightful user feedback on different proposed concepts. In Phase 2 we emphasized the use of expert usability inspections such as heuristic evaluations and cognitive walkthroughs with small multidisciplinary groups to review the prototypes born out of the Phase 1 feedback. Finally, in Phase 3 we emphasized classical user testing with target end users, using various metrics to measure the user experience and improve the final prototypes.ResultsWe report a successful implementation of the methodology for the design and development of a system for detecting and predicting falls in older adults. We describe in detail what testing and evaluation activities we carried out to effectively test the system and overcome usability and human factors problems.ConclusionsWe feel this methodology can be applied to a wide variety of connected health devices and systems. We consider this a methodology that can be scaled to different-sized projects accordingly.

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Section: Introductionmentioning

confidence: 99%

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

Harte¹,

Glynn²,

et al. 2017

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“…Past studies suggest that lack of EHR tools leads to poor provider-to-provider communication about patients’ fall risk 26 31–34. Conversely, access to EHR tools, such as risk assessments combined with targeted fall prevention strategies, has shown promise in reducing fall rates; however, not all hospitals can implement such tools due to lack of EHR sophistication 34 35. Prior research suggests that EHR sophistication varies by hospital characteristics, such as hospital size 36 37…”

Section: Discussionmentioning

confidence: 99%

Fall prevention implementation strategies in use at 60 United States hospitals: a descriptive study

et al. 2020

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BackgroundTo guide fall prevention efforts, United States organisations, such as the Joint Commission and the Agency for Healthcare Research and Quality, have recommended organisational-level implementation strategies: leadership support, interdisciplinary falls committees, electronic health record tools, and staff, family and patient education. It is unclear whether hospitals adhere to such strategies or how these strategies are operationalised.ObjectiveTo identify and describe the prevalence of specific hospital fall prevention implementation strategies.MethodsIn 2017, we surveyed 80 US hospitals participating in the National Database of Nursing Quality Indicators who volunteered for the study. We conducted descriptive statistics by calculating percentages for categorical variables and the median and IQR for count variables.ResultsA total of 60/80 (75%) of hospitals completed the survey. The majority of hospitals were not-for-profit (98%) and urban (90%); more than half were Magnet (53%), small (53%) and teaching (52%). Hospitals were more likely to use leadership strategies, such as updating fall policies in the past 3 years (98%) but less likely to reward staff (40%). Hospitals commonly used interdisciplinary falls committees (83%) but membership rarely included physicians. Hospitals lacked access to electronic health record tools, such as high-risk medication warnings (27%). Education strategies were commonly used; 100% of hospitals provided fall education at staff orientation, but only 22% educated all employees (not just nursing staff).ConclusionsOur study is the first to our knowledge to examine which expert-recommended implementation strategies are being used and how they are being operationalised in US hospitals. Future studies are needed to document fall prevention implementation strategies in detail and to test which implementation strategies are most effective at reducing falls. Additionally, research is needed to evaluate the quality of implementation (eg, fidelity) of fall prevention interventions.

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“…The risk of falls is increased by the increased number of risk factors. It is important to assess every patient's risk factors (Katsulis et al, 2010;McKechnie et al, 2017) and use this information for prevention (Lang et al, 2014;Twibell et al, 2015). It is important to strengthen patients' active role in healthcare (Twibell et al, 2015;Tzeng and Yin, 2014).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with falls in hospitals: outcomes for nursing care

Hajduchová¹,

Brabcová²,

Tóthová³

et al. 2019

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The aim of this research was to carry out an analysis of falls of hospitalized patients in 2017. They occurred at 16 selected wards in 4 hospitals in South Bohemia. The falls of hospitalized patients are the most frequent negative events in hospitals. Materials and methods: The data regarding falls in hospitals were coded and databased by authorized employees in "Monitoring of the risk factors of falls and their analysis". They were later statistically analysed using the SASD programme. A total of 280 falls were analysed. Results: Most falls occurred at subsequent care wards-48.9%. 44.3% of falls occurred at internal wards and 6.8% at surgical wards. Almost half (46.5%) concerned patients who had been hospitalized for 1 to 7 days. The average age of the patients who had fallen was 76.9 years. Most falls occurred in patients' rooms-78.0% and, in 93.3% of the cases, a medical worker was not present when the fall occurred. In the last 12 months, more than one third of patients have experienced a fall (39.8%). The riskiest period of the day was between 22:00 and 5:59 (35.8% of falls). Most frequently (31.6%), a patient fell off their bed. 41.8% of patients were not injured. The most frequent internal cause was imbalance or dizziness (57.1%) and 34.4 % suffered from confusion. Conclusions: Considering the above-mentioned results, we recommend a change in the control system and interventions using IT technologies and systems.

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Iterative user centered design for development of a patient-centered fall prevention toolkit

Cited by 39 publications

References 4 publications

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

Fall prevention implementation strategies in use at 60 United States hospitals: a descriptive study

Factors associated with falls in hospitals: outcomes for nursing care

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