Area of Concentration (Petal): Innovation

Specialty: Emergency and Critical Care Medicine

Keywords: Biodesign, Ethnography, Clinical Needs Assessment

Background: Innovations in the management of critically-ill patients in ICU and ED settings are crucial for enhancing patient outcomes. However, the implementation of new technologies is often hindered by insufficient understanding of clinical needs, complex workflows, and outdated infrastructures. This study explores a novel integration of ethnographic methods with the Biodesign process to more effectively pinpoint unmet clinical needs in acute care environments.

Objective: To assess the feasibility and effectiveness of a biodesign approach enriched with ethnographic techniques in identifying critical clinical needs within emergency and intensive care settings.

Methods: Conducted by two medical students, this ethnographic needs assessment spanned four weeks across various EDs and ICUs. The process was divided into three phases: preliminary needs identification, midpoint evaluation, and needs confirmation. Data were gathered through unstructured interviews, observational studies, and rapid content analysis, culminating in a structured compilation of needs statements. A Pugh decision-making matrix, supplemented with specific innovation criteria, was utilized to prioritize the identified needs.

Results: A total of 179 hours of clinical immersion resulted in 64 interviews with 14 stakeholder categories across five settings in four hospitals. Initially, 45 needs in EDs and 41 in ICUs were identified. Following evaluations, a refined list of 72 clinical needs was established. The prioritization process highlighted the top 10 needs, revealing key themes in disease-specific challenges, general clinical issues, and communication workflows in acute care.

Conclusions: This study validates the integration of ethnographic methods into the biodesign process as an effective strategy for identifying and addressing clinical needs in acute care settings. By highlighting specific areas for potential innovation and quality improvement, this approach may serve as a model for similar assessments in diverse healthcare environments, encouraging further research and development of new technologies.