Elaborating the Human Aspect of the NIST Framework for Cyber-Physical Systems.

The National Institute of Standards and Technology (NIST) has developed a Framework for Cyber-Physical Systems (CPS Framework) that supports system engineering analysis, design, development, operation, validation and assurance of CPS. Cyber-physical systems (CPS) comprise interacting digital, analog, physical, and human components engineered for function through integrated physics and logic. For instance, a city implementing an advanced traffic management system including real-time predictive analytics and adaptation/optimization must consider all aspects of such a CPS system of systems' functioning and integrations with other systems, including interactions with humans. One Aspect (or grouping of stakeholder concerns) of the CPS Framework is the Human Aspect. NIST is engaging HFES in a panel discussion to elaborate Human Aspect concerns, especially relevant constructs, measures, methods, and tools.

An Exploration of the Nightstand and Over-the-Bed Table in an Inpatient Rehabilitation Hospital.

OBJECTIVE: This study seeks to determine where patients in a rehabilitation hospital keep the greatest percentage of their belongings, that is, in/on the nightstand or on the over-the-bed table. BACKGROUND: This study provides an inventory of patient items located on the over-the-bed table and in/on the nightstand. Understanding the functions of furnishings within the patient room is key for future preparation for designing a next-generation over-the-bed table or for redesigning a more useful nightstand. METHODS: The contents on the top of the nightstand; the contents in the top, middle, and bottom drawers of the nightstand; items next to the nightstand; and the contents on the over-the-bed table within patient rooms were inventoried and placed into categories using similar, patient item categories as the Brooks et al. (2011) study, which examined the contents of the nightstand and the over-the-bed table in assisted living and skilled nursing facilities. RESULTS: Overall, patients in a rehabilitation hospital had a greater percentage of their belongings on the top of the nightstand as compared to their belongings located in all three combined drawers of the nightstand. Overall, patients had a greater percentage of their belongings located on the over-the-bed table as compared to their belongings located on the nightstand. CONCLUSIONS: Tabletop surface area was used extensively in patient rooms at a rehabilitation hospital, but nightstand drawers were underutilized.

Examination of How and Why Over-the-Bed Tables Are Used: Use Cases and Needs from Healthcare Providers.

OBJECTIVE: This article presents the results of an exploratory study in which 14 clinical and staff subject matter experts (SMEs) at a regional rehabilitation hospital were interviewed in order to understand how and why over-the-bed tables are used. BACKGROUND: It is important to understand how and why a device or environment is used when designing it, and not just what features and functions are preferred. This knowledge is valuable both for contextualizing user feature and function preferences and for characterizing and prioritizing design challenges and opportunities. METHODS: Fourteen hospital clinical and support staff subject-matter experts participated in semi-structured interviews with scenario enactments in a medium-fidelity, full-scale mock-up of a typical patient room. During these interviews, they interacted with two personas played by actors and were asked to enact an example of a normal visit, from entering the room through treatment/service and then exiting. Data were analyzed via methodological triangulation including frequency analysis, content analysis, and affinity diagramming. RESULTS: The results include a use-case analysis with illustrative sketches, a list of needs statements, and final observations. CONCLUSIONS: Successfully using the over-the-bed table is dependent upon proper positioning, especially in bed during meals. There are fewer problems associated with over-the-bed table use while seated in a chair than when in the bed. The over-the-bed table is a key component in acute care, inpatient therapies. Clinicians are generally open to "smart" furniture in the patient room but question its cost-effectiveness, robustness, and flexibility. KEYWORDS: Evidence-based design, human factors, patient-centered care, quality care, technology.

Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.

OBJECTIVE: This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. BACKGROUND: Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. METHODS: Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. RESULTS: A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. CONCLUSIONS: Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients.

Examination of overbed tables: healthcare provider and user preferences.

OBJECTIVE: This exploratory study examined the preferences of healthcare providers and patients with respect to overbed table features and functions, as well as how the devices tend to be used. BACKGROUND: In order to improve the design of overbed tables, it is important to understand which features and functions of existing models are valued by healthcare providers and patients. METHODS: A sample of overbed table models was presented to volunteers, who were asked to choose which models' implementation of specific features and functions they preferred. Structured interviews incorporating both forced choice and free response questions were administered to the volunteers-healthcare providers and patients at a rehabilitation hospital. RESULTS: While the overbed tabletop and extendable tray are heavily used, all other features of the overbed table models are rarely used. Usability of the models exhibits the potential for improvement. Healthcare providers' and patients' feature preferences differ and occasionally conflict. CONCLUSIONS: Existing overbed tables are valued primarily for the top surface. Other features and functions of the overbed table present opportunities for refinement of design, durability, and usability. There are strong patterns of agreement and disagreement in the preferences of healthcare providers and patients with respect to overbed table design, use, features, and functionality. There is potential to improve overbed table designs from both the perspectives of the staff and the patient. KEYWORDS: Evidence-based design, hospital, human factors, patient-centered care, quality care, technology.

Group differences in preferences for a novel nightstand.

OBJECTIVE: Multiple user groups (patients and employees at a rehabilitation facility, community-dwelling seniors, and university students) participated in a study that examined their preferences for the features and functions of three novel nightstand prototypes. BACKGROUND: It is valuable to get input from different user groups in order to improve furniture usefulness and usability, especially furniture prevalent in clinical settings where users of all age groups are found. METHODS: Feedback was obtained from different user groups in both clinical (rehabilitation facility) and nonclinical (university) settings. This was done using structured interviews to ask participants about multiple features of the novel nightstand designs. RESULTS: There were several features that all groups preferred. There were also some distinctly opposing opinions between groups. In general, the patient group showed the most similarities to the other groups. CONCLUSION: This research explores differences and similarities in preferences for nightstand design across a variety of user groups. It yields ideas for improving the nightstand design to be useful for a wider group of people.

Toward a "smart" nightstand prototype: an examination of nightstand table contents and preferences.

OBJECTIVE: Two studies were conducted to obtain an understanding of the types of items seniors keep in their nightstands and to understand how users feel about the possibility of "smart" furniture. BACKGROUND: To enable aging in place and universal design, it is vital to understand the needs of a broad range of aging individuals, especially since there is little research on nightstand usage and design. METHODS: Study 1 allowed for the development of a structured inventory of nightstand use today in assisted living and rehabilitation facilities. Study 1 led to Study 2, demonstrating the need to conceptualize new ideas for smart nightstands. Feedback was obtained from intergenerational participants who could discuss their needs and preferences for a smart nightstand. RESULTS: In Study 1, more than 150 items were recorded and categorized into 25 different groups. The authors found that participants utilized the top portion of their nightstand as opposed to the lower sections; most items were found on top of the nightstand or in the top drawer. In Study 2, the authors found that the vast majority of participants are willing to consider the use of a smart nightstand. Participants discussed key functions and design preferences, which included carefully designed storage, the ability to move the nightstand up and down, contemporary design, and interaction through voice activation. CONCLUSION: Existing nightstands do not meet the needs of current users. This research provides greater understanding of the existing limitations associated with nightstands. Study 2 confirmed that user-centered design and the use of technology can be used to enhance daily living. Smart furniture may play a role in promoting the health and independence of diverse user groups.