Nursery Project Write-Up Using Markdown Nicky Liu, Reva Kumar, Anna Zhong, Finn Leahy

Inspiration

The creation of our Hackathon Project “Nursery” originates from our personal experiences in hospital facilities in the process of accessing treatment for family and other individuals. In the midst of the critical pandemic, a member on our team had a family member who underwent numerous intensive surgical treatments in an understaffed hospital. With the severity of the condition, the only available hospital facility was three hours away, forcing them to fly in a helicopter to the location. There at the hospital, in the gradual accumulation of tasks in a frantic work setting, the medical professionals missed certain steps of the treatment process, rendering permanent damages to the family member, along with a stressful and scary memory for her family. Many other people face similar things, as 1 out of 4 Americans have had a stressful or harmful experience when hospitalized (Bates et al.). Additionally, 75% of nurses have expressed that they felt stressed when the hospital was usually busy during the Covid pandemic (American Nurses Foundation). Motivated by the opportunity to take initiative and ensure such experiences do not repeat onto other patients, while understanding the nurses’ complications with scheduling for an endless list of treatments for awaiting patients, we created “Nursery” with the aspiration of alleviating the immense daily pressure placed on critical healthcare workers in their natural working environment.

What it does

Our app is specifically made to address the issue of understaffed hospitals, leading to the overburdening of additional responsibilities onto nurses, leaving them with highly difficult schedules. The inefficiencies of patient scheduling and assignments may cause certain patient needs to be neglected alongside mistakes in administration time of medications. Nursery presents a solution in resolving this issue as an app that acts as a nurse dashboard, providing synchronized information regarding their pediatric patients and a consistently updated upcoming tasks list through our algorithm. Patient data is accessible across the app, allowing for multiple nurses to familiarize themselves with patient information without repetition of questions. Specializing in the area of pediatric patients, Nursery possesses considerable benefits from both perspectives of the health professional and the patient themselves. It supports pediatric nurses with the individual needs of pediatric patients compared to typical adults with its built-in feature of a database of favorites and preferences for each patient and emotional responses to certain tasks to better prepare nurses to support patients. The upcoming tasks for the nurses can be sorted in either the chronological format of time remaining prior to the necessary task or individually patient-based as the remaining tasks throughout the day for that specific child. Through assisting the efficiency of the nursing tasks, we hope to positively impact the patient’s experience during stressful procedures in the hospital environment.

Creation Process

To start off our project, we initiated our brainstorming of the major existing issues in the topic of logistical management within hospital facilities in the current day context. As we brainstormed, we began to share personal stories of our experiences with the healthcare system, lending inspiration and motivation to the creation of our final project. After a broad discussion of ideas of improving logistics and data management, we narrowed down our focus to two main themes that stood out to our interests: First, we wanted to focus our project on improving the work experiences of healthcare workers in managing their daily logistics in order to minimize their burden in an understaffed environment. Second, we planned for our project to specifically benefit the patient experience in pediatric contexts as those patients are often underrepresented in the innovation of medical technology due to children’s needs being brushed off as not pertinent to pressing issues.

However, as we considered the story of our fellow team member and her family’s experience in the hospital, it was brought up that the doctors pointed out the importance of family accompanying the patient in the process of treatment to minimize fear. In the context of long term hospital stays, we worry that not all pediatric patients may have constant company in the treatment process. Therefore, we want to account for this consideration and improve their experience by caring for their preferences and emotions through the database within our algorithm. We highly considered the pertinent issues within hospital experiences such as wait times and location convenience in scheduling abilities, which we sought to address. With these interests in mind, we pursued the project with the purpose of designing an app that allows for maximum nurse work efficiency while simultaneously valuing patient experience.

Challenges

In the process of working on our Nursery project, we encountered a few challenges. Starting off, once the brainstorm of our idea was complete and we were ready to get to work with coding and prototyping, we had a difficult time deciding which platform to implement our project in. We considered the value of the ultimate goal of having both an efficient and visually appealing interface and the ability to implement our algorithms. Eventually, we came to the conclusion of working on the two aspects separately, maintaining the work of our design in an app prototype using Figma to implement interactive features there, while coding the algorithm that would support the logistical abilities of the apps separately. This was the final decision due to our greater value of a more complete design with all the necessary elements to refine our user interface (UI) while being able to focus most of our coding on the algorithm itself within the short timeframe of this hackathon. However, in the future, Nursery can work as a real app with the algorithm and design from the protype compiled into the same application.

In the process of working with our app prototype, we faced a few design issues in terms of the fluidity of the interactive features within our product. The pages of the prototype were all linked to one another through a flowchart of interactions with the UI that can lead to actions, but they were not consistently working. To resolve this, we spent an extended amount of time tracing the framework and grouping of all objects to locate the issue and ensure that every feature works for its assigned purpose. Furthermore, we wanted to be able to scroll up and down on pages of additional patient information with preferences and activity reception, a feature that was difficult to implement within our prototype. We worked to solve this using the documentation of the prototyping platform along with trying numerous available features before being able to make it scroll down as we desired.

The most important challenge we overcame was making the algorithm complete the goal of matching nurses to patients in a way that is most convenient and efficient for their time availability and location. This is the most critical aspect to address as it is the functioning center of our project. The code had to weigh values and consider the different factors involved in assigning patients to nurses. In the process of navigating this challenge, we changed the method of data storage for information on the nurses and patients numerous times, making the overall process longer and more frustrating with the repeated trial and error. There were definitely times of doubt on our abilities to resolve this issue before the end of the hackathon. However, after hours of perseverance with approaching the code from different methods and perspectives, we managed to come to a solution and finish the algorithm, having the code run successfully and match nurses and pediatric patients to maximize efficiency.

Accomplishments

Our biggest accomplishment was creating an interactive prototype with elements purely from scratch without the use of templates that navigate from various pages and being able to implement common features of UI design into our application. We were able to include resources navigating out of the app for further information, implying the possibility of connecting this application to hospital resources. We were also very successful in our ability to design an app that is effective and appealing, particularly for Pediatric nurses. With the implication that the application will be used to help organize treatment for children, many elements of the design were light and created to invoke a feeling of warmth. These aesthetic elements are intended to create a comfortable relationship between the nurse and the patient, and to add personality to the patients, as activities patients are involved in are often associated with certain emotions. Overall, the design of our interactive prototype is very user-friendly, effective, and appealing to Pediatric nurses, and, when implemented in hospitals, will offer an organized space for nurses to use.

Another impactful accomplishment was successfully creating the algorithm that matches nurses to patients. This algorithm takes the master schedule of the patients, and then goes through it with each nurse. It first checks to see if the patient is in the same location as the nurse, and if so it goes through the individual patient schedule. If the nurse does not have a task during that time, then the patient's task is removed from their schedule, and put into the nurse's schedule. If the nurse either has a task during the patient's task, or is in a different location than the patient, the task will not be given to that nurse and instead given to a different nurse. This algorithm will help hospitals with the management of nurses and relieve stress on pediatric nurses in having the necessary information to do their job.

What we learned

Our project focused heavily on UI design and components, and while designing the app, our team learned a lot about how to make features more accessible and easier to navigate. Some elements that we implemented include a navigation bar, buttons to transition pages, and containers that contain information that expands. Through these elements, our team learned how to simplify the design of our application, while still displaying all relevant information. We also learned how to prototype apps by linking elements to others in the most optimal way. This involved decisions on which buttons logically would flow to other pages, and in doing so led to the creation of a “flow chart” system that involves arrows pointing between elements. We examined standard app structure and uses, specifically positioning our elements in such a way that leans towards user familiarity with trending visual familiarities in icons and navigation techniques.

flowchart

In addition, our group learned how to create algorithms to sort through patient data, and how to weigh variables over others to decide which ones to prioritize when matching nurses to patients. As seen below, heavier weight was put on location, and then a loop was run to decide if the activity should be added to the nurse’s schedule based on availability of the nurse.

for i in range(num_nurses):
  schedule = ["", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""]  # 24 empty time slots
  for j in range(len(all_patient_schedules2)): # gets individual patient schedules
    nurse = nurse_stations[i]
    patient_schedule = all_patient_schedules2[j]

    room = rooms[j]
    if room[:2] in nurse: # if the patient is in the nurses area
      for w in range(len(patient_schedule)): 
        if (patient_schedule[w] != "") and (schedule[w] == ""): # if patient has an activity and nurse schedule is empty
          schedule[w] = f"{patient_schedule[w]} with patient {patient_names[j]}" 
          patient_schedule[w] = "" 


  all_nurse_schedules.append(schedule)

In the future, the techniques and lessons learned from this project can be applied to designing more UIs and optimizing accessibility of elements in apps. These applications can include other data storage for hospitals, such as expanding this system from nurses and pediatric care to other parts of the hospital, or matching remote patients to telehealth providers to place patients with the best care providers.

Overall, our team has learned a lot about the technical innovation process and how to build a project that is meaningful. We have gone through a process of developing ideas, which often took brainstorming and discussion with mentors during office hours, to gain as many opinions as possible to further our project. Additionally, we learned that creating a project means starting with a basic plan and then adding details as we move further, implementing new ideas. Lastly, we learned how to complete a project with many deliverables, working hard to describe and pitch our product in many forms to share our passion for solving problems we care about to contribute towards societal progress.

What’s next for Nursery

Although the goals for Nursery are to expand our prototype and build an application that can be used at hospitals, there are a few ideas we want to implement into our prototype. First, we want to add creative, interactive, and graphic explanations of the process a nurse will administer to the patients so that the child can watch and prepare for the administration of treatment. This will ensure that children experience their administrations at lower stress levels and with more context than they would if they went into procedure blindly. These explanations would be in video or animated format, and could potentially be personalized based on a child’s preferences, especially for patients who will be staying at the hospital for a longer time. This personalization could be accomplished using Artificial Intelligence. This way, the given familiarity with equipment allows for prior desensitization of the scary treatment process, relieving patient stress in the experience.

Another idea to implement into our prototype is that we want to improve our algorithm to take more arguments than location and nurse schedule. Potentially, our algorithm could also take into account factors such as patient-nurse relationship, familiarity, and comfortability; as well as nurse skills and specialties along with the ability to follow certain patient preferences. This idea could be implemented when Nursery is introduced to hospitals and can be specified to fit the skills of nurses at particular institutions.

We, at Nursery, hope to expand our prototype and create an iOS or Android app, as we have the CSS files for our design available to be translated and implemented into a mobile platform. Additionally, as we have the python algorithm as a backend, we can import it into our application based on the completed prototype. This, along with a potential user input feature in the app, such as hospitals or nurses being able to continuously feed in data directly from their system, will make Nursery an app that has the potential to launch and be implemented within pediatric facilities at hospitals. We hope to expand the impacts of our project and put it into action, improving the quality of life through technological innovations.

Works Cited

“Pulse on the Nation's Nurses COVID-19 Survey Series: Mental Health and Wellness Survey #3, September 2021.” ANA, 22 Oct. 2021, https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/pulse-on-the-nations-nurses-covid-19-survey-series-mental-health-and-wellness-survey-3-september-2021/.

Bates, David W., et al. “The Safety of Inpatient Health Care.” New England Journal of Medicine, vol. 388, no. 2, 2023, pp. 142–153., https://doi.org/10.1056/nejmsa2206117.