Perception and Use of a Patient Care Window to Improve Care and Family Engagement

Pediatric intensive care unit (PICU) patients, caregivers, and providers are faced with complex health information in a demanding healthcare setting, creating a need for improved patient-centered care. Novel digital health has the potential to facilitate information transfer, thus improving patient engagement and family-centered care. While more developmental research is needed on new types of technology that could potentially improve patient-centered care, providing an interactive monitor to patients and families that is able to be customized to their needs may be one way to achieve this.

This project implemented and evaluated large customizable interactive monitors (LCIMs) in the PICU at the Children's Hospital of Wisconsin. These 42-inch flat panel touch screen monitors were integrated with the hospitals electronic medical record and were activated upon patient admission. The LCIMs were available in each patient's hospital room for viewing without a log-in requirement and were used by providers as well as patients and families. The display included vital signs, laboratory results, medications, and interventions.

The specific aims of the project were as follows:

• Determine the specific needs of PICU patients and families that could inform changes to the design and use of the LCIM to enhance use and family and patient engagement. 
• Determine the specific needs of PICU physicians and nurses that could inform redesign of the LCIM to enhance use. 

Researchers collected data using semi-structured interviews with PICU physicians and nurse practitioners, focus groups with nurses and caregivers, and surveys administered to all three user groups. Results showed that all providers were aware of the LCIM, but most noted there was no formal training on its features, functions, reason for implementation, and purpose. The main LCIM uses for providers were to view a snapshot of the current data, to interact and zoom in to view more detailed data, and finally to use it as a teaching tool for families or other providers.

The nurse's survey indicated low to moderate ratings of the tool's ease of use, and low to very low ratings of usefulness, social influence, and training. Two thirds of parents reported interacting with the LCIM, while one third reported seeing the tool, but not touching it. Parents who used the system were more likely to be satisfied with it, and many felt empowered to initiate conversations with providers based on information seen on the monitor. These findings can be used to improve understanding of patients, caregiver, and physician information needs. Researchers encourage future research to focus on both in-room inpatient IT and other novel systems intended to improve care delivery and patient engagement.