Hospital work is characterized by intense mobility, a frequent switching between tasks, and the need to collaborate and coordinate activities among specialists. These working conditions impose important demands on hospital staff, whose attention becomes a limited and important resource to administer. Nurses in particular, need to constantly monitor the status of patients in order to assess their condition, assist them and/or notify physicians or specialists. Given their work load, it is not rare for them to miss important events, such as a catheter being disconnected due to the patient movement or the need to change a urine bag that has been filled. Pervasive technologies by being able to continuously monitor patients could provide awareness of the patients’ health condition. This awareness must be subtle, expressive, and unobtrusive without intruding on hospital workers’ focal activity. In this chapter the authors explore the use of ambient displays to adequately monitor patient’s health status and promptly and opportunistically notify hospital workers of those changes. To show the feasibility and applicability of ambient displays in hospitals they designed and developed two ambient displays that can be used to provide awareness patients’ health status to hospital workers. The first display takes into account the mobility experienced by nurses during their work to supervise the activities of daily living (ADL) conducted by patients. The second display is a flower vase that notifies nurses the urine output of patients and the status of their urine bag.
Hospital staff face working conditions that are substantially different from those of office workers, for which traditional desktop computers were developed (Bardram, J. E., & Bossen, C., 2003; Bardram, J. E., & Bossen, C., 2005; Moran, E. B., Tentori, M., González, V. M., Martinez-Garcia, A. I., & Favela, J., 2006). Most hospital staff need to move continuously around the premises to access people, knowledge, and resources in order to perform their work effectively (Bardram, J. E., et al, 2005). Thus, mobility characterizes work in these environments. For instance, physicians make daily rounds to assess and diagnose patients, changing their location to find colleagues or locate artifacts (patient records, x-ray images, medications) placed in bed wards, laboratories or offices. Therefore, information in hospitals is not generally concentrated in a single place, but distributed among a collection of artifacts in different locations. Consequently, hospitals can be seen as an information space and it is by “navigating” this space that hospital staff can access the information required to support their goal (Bossen, C., 2002).
Indeed, nowadays highly mobile hospital workers spend more than 50% of their time on-the-move, making it difficult for them to be aware of the status of the patients they are responsible for (Moran, E. B., et al., 2006). For instance, sometimes hospital workers have patients placed in different rooms or even in different areas of the hospital. Consequently, hospital workers have been held liable for their failure to monitor and promptly respond to patients needs (Smith, K. S., & Ziel, S. E., 1997). This has motivated the introduction of pervasive technologies in hospitals to allow hospital workers to closely monitor patients. For instance, a hospital in Boston is testing an ultrasound tracking system that can determine the location and vital signs of patients (O’Connor, M. C., 2006). These pervasive technologies being introduced range from wireless networks, PDAs (Chin, T., 2005), RFID tags for patient tracking (O’Connor, M. C., 2006), voice-activated communication devices (Stanford, V., 2003), and sensors for patient monitoring (Pentland, A., 2004). Indeed, widespread adoption of sensors that monitor the patients’ vital signs and other indicators promise to improve care and reduce medical costs.
Thus, pervasive technologies for hospitals are increasingly supporting heterogeneous devices that range from handheld computers that can be used to capture and access limited amounts of information, to PCs that can be used at fixed sites for longer periods of time, and semi-public displays located at convenient places that can be used to share and discuss information with colleagues (Favela, J., Rodríguez, M. D., Preciado, A., & Gonzalez, V. M., 2004; Markarian, A., Favela, J., Tentori, M., & Castro, L. A., 2006). Hence, hospital workers today need to interact with different devices with a wide range of functionality (Bardram, J. E., 2005). Consequently, carrying out a single activity typically involves the use of several systems that call for the user’s undivided attention where several information sources battle for a piece of space in the already limited screen real state.