The PPP (Patient Partnership for Prevention) Study: Preventing non-ventilator hospital-acquired pneumonia (nvHAP) by engaging patients and families – a human-centered co-design approach

Non-ventilator hospital-acquired pneumonia (nvHAP), a pulmonary infection, is one of the most common, expensive, and serious infections acquired in the hospital [1-4]. Effective prevention measures like oral care, mobilization, or dysphagia (swallowing difficulties) screening exist but are not systematically implemented in the busy hospital routines. As a particularity of the nvHAP prevention measures oral care and mobilization, patients and families could well contribute to prevention. But, although often capable and willing to self-engage, patients and families are only very rarely addressed and enabled to engage. Furthermore, although a patient-centered development of ‘solutions’ to engage patients would likely best support prevention efforts, scientific literature about the development and the performance of such solutions is very scarce (or even absent).

Thus, this project aims to 1) design and 2) evaluate ‘solutions’ (with the definition of “solutions” intentionally kept open, e.g. videos, posters, leaflets, small products) that engage patients and families in nvHAP prevention. This happens by a) investigating the needs of patients and families to self-engage, b) collaboratively (patients, families, designers, healthcare workers) creating prototypes for solutions that address these needs, and c) finalizing and evaluating the solutions regarding patient relevant aspects (e.g. anticipated effectiveness, usability).

We will apply a human-centered design (HCD) approach, including a) a mixed-methods needs assessment based on interviews, observations, surveys, and literature review, and b) conduction of human-centered design workshops with stakeholders (e.g. patients, families, nurses). To evaluate the solutions, we will 1) collaboratively define relevant outcome measures based on the designed solution, and 2) conduct a mixed methods evaluation of solutions by established questionnaires and interviews.

We aim to develop and evaluate solutions that are cost-effective and timely deployable and can concretely be used in nvHAP prevention projects. The ‘solutions’ hopefully will help to decrease nvHAP infection rates and lower morbidity and mortality attributed to nvHAP. They will be designed to engage and enable patients and families to contribute to nvHAP prevention, increase patient self-efficacy without increasing the workload of healthcare professionals.

Additionally, we will hopefully provide a proof of concept for co-designing solutions that engage and enable patients and families. If successful, the HCD-approach could later be used for the design of ‘solutions’ for other healthcare-associated infections (HAI) like surgical site infections or urinary tract infections.