Telemetry

Description

We obtained the baseline level of performance for remote monitor technicians who monitor up to 36 patients’ telemetry at a time. We found that workload was high, accuracy was only 50% and time on task increased with time.

We recommended removing unactionable alarms that contribute to noise by reducing patients on telemetry through stricter selection criteria and by increasing staffing to reduce the patient-to-technician ratio. We also recommend that mandatory breaks be introduced into technicians’ shifts to reduce fatigue and improve situational awareness. Finally, we recommended improving software interoperability of software being used to reduce switches between screens and also reduce eyes-off-screen time.

Background

• COVID-19 meant that healthcare workers wore face shields for long periods

• They were uncomfortable and hard to keep on for long

• Supply chain issues made it hard to access faceshields

• Hospital Innovation, Human Factors teams as well as Engineers from Virginia Tech were tasked in identifying a solution to these problems

Goals

• Design a faceshield that promotes comfort and decreases workplace exposures.

• Determine usability issues with current face shields

• Develop design criteria for a prototype

• Use an iterative human-centered design approach to design and deploy a faceshield that maximizes comfort, ease of use & perceptions of safety

Method

• We used a multi-phase design cycle that closely followed Human Centered Design principles

• A total of 4 phases that included one major exploration phase identifying design criteria and, 3 design & evaluation phases

• New designs were rapidly prototyped using a 3D printer

Phase I: Survey of Existing Faceshields

Identify Major Design Criteria & Major Usability Issues using,

A hospital-wide survey that helped identify major usability issues with existing faceshields & design criteria for new faceshields.

• Quantitative Analysis: MANOVA of Likert responses to the survey

• Qualitative Analysis: Thematic Analysis of survey responses

MANOVA showed that not one of the Faceshield used was significantly preferred by participants. Comfort & Preference scores were also low.

Phase II: Designing, Prototype & Evaluate Cycle

• A new faceshield design was given to frontline healthcare workers

• Participants were divided into two groups: Control & Intervention

• Participants were asked to rate the usability using a SUS Survey

• They were also asked to fill a survey daily for a week which ended with a focus group session

• The new design was highly usable in comparison to the control

• All the major issues reported showed fewer occurrences of usability issues in the new design when compared to the old design.

• Comfort and Safety were rated better for the new design.

Phase III: Further design iterations

• Feedback from Phase II was used to redesign the faceshield

• A cover was added above the forehead to reduce exposure risk

• The plastic sheet size was adjusted to prevent the shield from hitting the shoulder when turning the head

Phase IV: Final Design

• The top cover was split into two pieces following feedback about headaches caused by it

• General feedback from the final group of participants was excellent and the new design was preferred by participants in general

• They also took it off less often

Summary

• We identified design requirements for faceshield usability and iteratively designed prototypes

• Used quantitative and qualitative analysis to identify key elements of usability, and design criteria

• Iterative prototyping for fast turnover of designs helped us make an impact during the COVID pandemic

• Usability & Feedback of the design was positive

• Participants took the faceshield off less often

User Guide Design for our Healthcare Workers

Additional Info

Kurtz, C. E., Peng, Y., Jesso, M., Sanghavi, H., Kuehl, D. R., & Parker, S. H. (2022). Using a human factors-centric approach to development and testing of a face shield designed for health care workers: A COVID-19 case study for process and outcomes. American journal of infection control, 50(3), 306-311. doi: https://doi.org/10.1016/j.ajic.2021.10.033

Appendix A: Daily Survey for Phase II, III & IV