Optimizing Pediatric Induction Experiences Using Human-centered Design

Purpose: Anesthesia inhalation induction (falling asleep for a surgery using a medical mask) is often stressful for children. When children become anxious about induction, they may resist wearing the anesthesia mask. High anxiety during induction is associated with poorer outcomes after surgery, such as increased emergence delirium, increased pain and negative behavioral changes after discharge. The purpose of this project was to design an optimal anesthesia induction experience for children, with a focus on decreasing patient anxiety during inhalation induction. Design: Designing for the perioperative environment requires in-depth knowledge of existing processes, needs of key stakeholders, strengths/shortcomings of existing approaches, and iterative testing of design concepts. We used a human centered design model (design research) to approach this challenge. Methods: Hospital staff partnered with a design team at the Live Well Collaborative. Families and staff were consulted during all phases of the design process. The iterative design research process (research, ideation, refinement) was used to develop product and process concepts for optimizing the induction experience. Requirements for an optimal induction experience were defined during the research phase through reviewing the scientific literature, process mapping and benchmarking with other products. Product and process concepts were developed during the ideation phase. Concepts were tested and refined during the refinement phase. Findings: The research phase provided insights about the current anesthesia induction process and what interventions help engage children in medical care. Key insights included normalizing the anesthesia mask through medical play, providing patients with an increased sense of control preoperatively and during induction, and engaging multiple senses during the process. The ideation phase led to the development of several design concepts, including an app that is activated by breathing into the anesthesia mask. During the refinement phase, concepts were shared and refined with input from families and clinical staff. This phase led to the development of a novel zoo-themed gaming app. Conclusions: The design research process facilitated the creation of a new anxiety reduction tool for the perioperative environment. The breath-controlled induction app simultaneously employs multiple evidence-based anxiety reduction techniques and is designed to seamlessly integrate into the fast-paced perioperative workflow during key stress points. Testing in the clinical setting is needed to determine the effectiveness of the app for preoperative anxiety reduction.