Collaborative Multi-Touch Clinical Handover System for the Neonatal Intensive Care Unit

Rishikesan Kamaleswaran, Rina R. Wehbe, J. Edward Pugh, Lennart Lennart, Carolyn McGregor, Andrew James


Background: A critically ill infant admitted to a neonatal intensive care unit requires complex, critical, and coordinated care performed by multidisciplinary healthcare teams. Since the infant is not monitored by an individual over the entire duration of stay, clinical handover enables the necessary transfer of health information between physicians involved in the care.

Objective: Handover at present is largely conducted in an informal and ad hoc way. Many handover mnemonics have been developed to support efficient transfer of critical information. These mnemonics, however, remain largely unused.

Methods: A qualitative study in a quaternary neonatal intensive care unit, at The Hospital for Sick Children was undertaken to understand clinical handover and derive usability requirements. This is then used to inform a high level design of a multi-touch tabletop application for handover the design was then evaluated against senior neonatologists and neonatal fellows using rapid prototyping methods. 

Results: The results of the qualitative study showed that an effective handover application should at minimum include: tight integration with workflow and the physical environment, intuitive and simplicity, and minimalistic design following the ‘less is more’ philosophy.

Conclusion: There is a need to optimize handover such that the information transferred is standardized, and the loss of information and/or misinformation is minimized. We argue that natural user interface design employed in the proposed design will result in improved care and less information loss during clinical handover. 


Patient Handoff; Intensive Care Units, Neonatal; Biomedical Technology; Hospital Information Systems

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