Using the Focus Mapping technique to identify activities to promote sleep in hospitalised patients in Hospital Clinic

Abstract

Sleep during a period of hospitalisation is an essential element for recovery in admitted patients. Hospital Clínic de Barcelona has developed the ClíNit project with the aim of promoting patients' sleep to identify elements that affect the quality of sleep and implement actions to improve rest at night. To prioritise specific actions in a collaborative way with nurses from Clinic Hospital we have been use two techniques from the Fogg Model: Swarm of behaviors Focus Mapping. This study aims to provide results on two levels: firstly, in relation to the usefulness of the Fogg methodology itself. Secondly, showing the results of the techniques used with a sample of healthcare professionals in a real-life situation. Our hypothesis was that The Fogg model could be a useful methodology applicable in the clinical setting for process prioritization. Those actions proposed and prioritized by the clinical staff themselves who must execute them would be more realistic and adjusted to the actual possibilities of implementing them. METHODS: We organized two focus group & design sessions. At these sessions the common aspiration to start the design process was: How to promote good sleep for hospitalized patients during admission nights to the Clinic Hospital. Sessions: 2 behavioral design sessions (one per unit). 60 min each Participants: Pulmonology (8) and Neurosurgery (6) units night shift nurses (nurses, nurse assistants). Mean age: 49 years. 11 females, 3 males. Average professional experience: 22 years. Location: Patient Experience Unit of the Clinical Hospital Sessions Guided: Led by a senior expert on the Fogg model and a junior expert to document the session. Two observers Reports: photo-documented sessions and memorandum to CliNit project staff.4-5 proposed actions was proposed per participant in SoB and we start to create the Focus Mapping (FM) following the Fogg Technique. We ask nurses to classify the previous actions identified in SoB, putting it in FM Vertical axis (higher-lower impact), no discussion Vertical axis adjustments, no discussion Horizontal axis (feasible-not feasible), no discussion Horizontal axis adjustments, no discussion position changes, justifying and voting completion when no further changes are proposed and identification of Golden Behaviors (yellow area). Analysis: Classification of actions in according to impact-difficulty axes. Identification of repeated actions. Assignment of those responsible for the implementation of the actions: Nursing Hospital address Medical Equipment Disclosure Hospital management ClíNit team meeting to select actions, prioritizing Golden Behaviors (yellow area) and specifically that nurses consider that has high impact and depends of themselves.RESULTS: Prioritized Actions (GOLDEN BEHAVIORS) Explain the ClíNit project at entry Ensure patient has light device on hand Change the standard of waking patients at 6 am In the medication protocols, indicate “Do not administer during the night” Action Owner: 44% Nursing (14/32) 41% Hospital management (12/32) 9% Medical equipment (4/32) 6% Communication (2/32) Conclusions: Fogg's behavior design methodology and specifically swarm of behaviours and focus mapping techniques helped to efficiently identify the actions that the nurses considered relevant and that the ClíNit project managers considered easier and more effective to carry out. We recommend the use of these types of techniques in the field of Health due to their ease, potential for co-creation of solutions and identification of viable and positively impacting actions on the objective.