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Future Adaptive Building: Mass-Customized Housing for an Aging Population
Published in Branko Kolarevic, José Pinto Duarte, Mass Customization and Design Democratization, 2018
Depending on the health needs of the resident, these could include one or more of the following: A respiratory module containing oxygen supplementation.Non-invasive positive pressure ventilation (CPAP and BIPAP), and nebulized medications.A renal module containing equipment for home hemodialysis or peritoneal dialysis.A feeding module containing an IV support and ancillary equipment required for a nocturnal enteral feeding system via a nasogastric tube.
Use of Problem-Solving Tools of TRIZ to Address Equipment Design for Home Care
Published in Jack M. Winters, Molly Follette Story, Medical Instrumentation, 2006
When hospital systems, with high complexity and many resources, are moved into the home setting, with its lower complexity and fewer resources, design problems often sabotage the result. Additionally, intended (or unintended) users in this setting many have a greater diversity of abilities. These problems reach new heights when some companies move very complex health care operations into the home (e.g., home hemodialysis). In many cases, the proposed solutions to these problems are a compromise, such as developing a slightly simpler version of the system than that used in hospitals, rather than “breakthrough thinking.” In this chapter, an approach called TRIZ is developed, which has potential for resolving issues in equipment design for home care.
Cognitive Patient Ergonomics
Published in Richard J. Holden, Rupa S. Valdez, The Patient Factor, 2021
Blandford and colleagues (e.g., Rajkomar et al., 2015) used a distributed cognition approach to analyze how patients with kidney failure use hemodialysis systems at home. The general distributed cognition approach (Hazlehurst et al., 2003) was instantiated as a framework (Distributed Cognition for Teamwork) with information flow, physical layout, social structure, and artifact models describing how patients use the technology. The framework guided the design of methods for collecting and interpreting observation and interview data to understand how system components interacted to constrain and facilitate self-care performance, identify sources of use problems, and suggest causes of incidents that compromised safety. According to their analysis, home hemodialysis is an activity system involving several agents (the patient, informal caregivers, providers) and artifacts in addition to the technology system itself (the hemodialysis machine). It is embedded in and interacts with other systems such as the home system (physical and social contexts) and the dialysis unit system (part of the healthcare system). The framework situates a traditional HCI task analysis (how the patient uses the dialysis machine) into a more comprehensive analysis of the interacting dimensions of the home hemodialysis activity system. For example, central to the dialysis activity at home are the steps that patients or their informal caregivers must do to operate the machine, including preparation (e.g., starting auto-disinfection of the machine, inserting needle into the patient), treatment (e.g., programming parameters, monitoring machine readings), and termination (e.g., remove the needle from the patient, treat wound).
Flow balance optimization and fluid removal accuracy with the Quanta SC+ hemodialysis system
Published in Expert Review of Medical Devices, 2020
Clive Buckberry, Nicholas Hoenich, Paul Komenda, Mark Wallace, John E Milad
It is estimated that the number of patients receiving renal replacement therapy globally will increase to 4.9 million by 2025 [1]. The majority of patients receiving hemodialysis do so as outpatients in stand-alone or facility-based dialysis units, typically 3 times per week for a minimum of 4 hours each time. The regimen of kidney replacement therapy can be burdensome for patients and their support networks, and is associated with poor health outcomes; it is also costly for healthcare funders [2]. Home hemodialysis (HHD) is a more cost-effective treatment option in the long term [3] and provides patients with the ability to dialyze on a flexible schedule more frequently and/or for longer periods. Importantly, when patients are treated in their own homes, they have lower rates of dialysis-related complications, hospitalizations, and mortality [4–6]. Moreover, HHD also provides patients with quality-of-life improvements [7].
Haemodialysis at home: review of current dialysis machines
Published in Expert Review of Medical Devices, 2018
Sabrina Haroon, Andrew Davenport
Safety features are essential for hemodialysis treatments to ensure that an accurate prescription is delivered to the patient with a minimally acceptable error. For home hemodialysis patients, additional safety features are required as the patient may be dialyzing at home alone or maybe asleep as with those on nocturnal therapy. This however needs to be balanced against unnecessary alarms that would be switched on if patient’s were undertaking dialysis treatments in satellite center. Published data from an established HHD program reported severe adverse events of 0.009 per patient-year of home hemodialysis and 0.038 per 1,000 dialysis treatment [52], with the majority of these very infrequent cases due to needle dislodgement followed by air embolism [52].