Sound-driven design is a design practice informed by technology and listening in the multisensory dimension of interaction. An automated content analysis of 20 semi-structured interviews with sound designers, design researchers, engineers and expert users stressed the inherently embodied and situated conceptualisation of sound, and how it relates to their professional activity. The four categories of professionals bring in different designerly orientations towards sound. Listening, as a way of knowing by using sound in interaction, proves to be the red thread between the participants’ semantic models. Overall, the findings contribute to characterise the concept of sound in current design practices, and position the role of nonverbal, yet auditory representations in the design process.
Music as a low-cost sleep aid is a promising way to improve the sleep quality of people. However, most available sleep music playlists are limited to generic, soothing songs, which do not take in account personalisation. In collaboration with the Neurology Department of the Reinier de Graaf hospital (Delft, The Netherlands), we explored a profile-based personalisation approach to deliver music that fits with people’ sleep and music preferences. Through generative research, we collected people’s preference data and proposed four, evocative sleep music profiles: the Explorer, the Diver, the Hunter, and the Observer. The results of the profiling evaluation suggest that the profile experience is credible, intuitive, and easy to use. Four profiles can reflect people’s preferences, but may not be stable.
Designing alarms to address the increasing complexity of dynamic and interconnected systems in current socio-technological environments presents multi-faceted design problems that require systematic thinking and a collaborative and holistic approach. To understand the alarm design challenges better, we map out the design space for audible alarms in an applied domain, covering the alarm issues from the designers’ perspective, departing from the functional integrity of alarms, and bringing together the contribution of three major fields of expertise related to audible alarms (systems engineering, information design, and human factors). Three studies based on literature review, field observations, expert interviews, and focus groups are conducted by authors at different European Intensive Care Units. Our findings from these studies result in the definition of the components of audible alarm design, the key considerations for designing audible alarms, and a design framework for audible alarms that systematically integrates input from inter-connected disciplines that all aim for the success of a complex system that heavily relies on alarms.
Quantum Mechanics could have fundamental impact on design models and measurement. Quantum mechanics allows us to fill in the blanks of classical models of design, through its ability to explain ambiguous states of design. An ambiguous state is where design exists in between two binary states, as a superposition. Designers are most likely to be unfamiliar with quantum mechanics, as well as the subject of quantum mechanics being complex and sometimes contradictory to human scale mechanics. By discussing the opportunities of quantum mechanics for design, we are proposing a framework to model and measure ambiguous dimensions of design through quantum superpositions. The proposed framework includes the dimensions for the directionality of design (convergence or divergence), the degree of design embodiment (from low to high) and the decision-making of the designer (yes to no). Once the designer attempts the measurement of a superposition, a binary state can be distilled. For the act of designing, filling in the blanks is equal to sculpting away superposed states. In this philosophy, to design is to measure. This early stage research raises areas of opportunities and suggests further research directions for quantum mechanics and design.
This Miscellaneous is brought to you for free and open access by the DRS Conference Proceedings at DRS Digital Library. It has been accepted for inclusion in DRS Biennial Conference Series by an authorized administrator of DRS Digital Library.
Good sleep is conducive to the recovery process of hospital patients – and yet, in many wards, sleep duration and quality can often be suboptimal, in part due to modifiable hospital-related sounds and noises. At the neurological ward of the Reinier de Graaf hospital in Delft, the Netherlands, we developed and evaluated a prototype information exchange system to raise awareness of specific sounds as disturbing patients’ sleep. The system both classifies different relevant sound events and tracks sleep quality (using a Fitbit device). This information is then visualized for patients and staff to present the influence of the soundscape on patients’ sleep hygiene in a friendly and comprehensive way. We discuss the design process, including a context study and various evaluations of the technology, interface, and created affordances. Our initial findings indicate that visualizing hospital soundscapes may, indeed, support both patients and staff in their efforts towards better sleep hygiene.
Recent studies show that the well-being of patients and the performance of healthcare professionals in modern neonatal intensive care units (NICUs) are severely affected by the amount of auditory alarms and sound nuisance. This paper presents a semi-systematic review on the topic of environmental sound in the NICU, where current themes, insights, and limitations are highlighted. Furthermore, it outlines the results of an observation of the NICU environment and an interview with nurses at Erasmus Medical Center, in order to understand the users, their context, and the technology that can enable design interventions. The insights gathered from the literature and the users, together with a technology search, lead to potential design opportunities to be developed further. Based on these, we propose a technological solution towards a healthy sound environment in the NICU.
Psychological needs of users as a basis for design are at the core of design practice, yet the importance of fundamental human needs when designing soundscapes has not been studied specifically. This paper investigates the relationship between nine fundamental human needs and the affective qualities and categories of soundscapes. In a free-labeling survey study, we collected descriptions of imagined sound environments for the fulfilment of the needs, as well as ratings of the perceived affective quality of these environments. We found that needs were associated with pleasant soundscapes, while their eventfulness varied. ‘Human’ sounds were a common category for each of the nine needs considered in this study, but systematic variations of the categories were found dependent on the need. Results suggest that designing categorically different soundscapes dependent on the users’ needs will have beneficial effects.
Sound-driven design is an emerging, human-centered design practice informed by technology and listening in the multisensory dimension of interaction. In this paper we present a discourse analysis approach aimed at qualitatively understanding the constituent concepts of such a practice, by means of semi-structured interviews with sound designers, design researchers, engineers and expert users in the context of critical care. Preliminary results show that sound-driven design is inherently embodied, situated, and participatory, that the four categories of interviewees equally contribute to the definition of the design problem, and yet that a clear, shared arena is still missing.
This paper presents CareTunes as a concept to explore musical sonification of patient vitals and the role of music in Intensive Care Units (ICU). In this paper, we first describe the design specifications for the sonification of data in a musical fashion. Secondly, we present two applications for CareTunes in prototype stage and user evaluation studies. The first application regards the ICU nurses’ need to monitor patients from a distance (CareTunes as musical updates for nurses) and second application regards families’ need to connect with their loved in the ICU (CareTunes as musical messages for families). We conclude that music has the potential to represent changes in patient vitals for nurses and emotionally regulate families’ anxieties regarding ICU patient’s condition. Music offers a platform for reutilizing patient data for human-centered solutions.
Conceptual design and communication of sonic ideas are critical, and still unresolved aspects of current sound design practices, especially when teamwork is involved. Design cognition studies in the visual domain represent a valuable resource to look at, to better comprehend the reasoning of designers when they approach a sound-based project. A design exercise involving a team of professional sound designers is analyzed, and discussed in the framework of the Function-Behavior-Structure ontology of design. The use of embodied sound representations of concepts fosters team-building and a more effective communication, in terms of shared mental models.
As operation theatres produce excessive noise, the listeners are in great risk of physiological as well as psychological discomfort. It is crucial to take action and develop sensitivity and awareness to clinicians? sonic needs in operation theatres. The purpose of this observational study in orthopedic surgery was to understand how professionals and patients listen in complex sonic environments by virtue of their role. In our opinion, a distinction has to be made between hearing and listening when sound is part of a workflow. While everyone ?hears? during the surgery, as it is a physiological process, everyone pays attention to sound in their own way. Truax?s (2001) distinguished the listening attention in three categories: ?listening-in-search? (sound users), ?listening-in-readiness? (active listeners), ?background listening? (passive listeners). We augmented this framework by two additional ?listeners? considering the roles of the patient (the exposed) and the surgeon (sound producer). The sedated patient is the exposed with ?no-listening-attention?. The passive listeners are either scrub nurses or anesthetist assistants with ?background-listening?, while active listeners are scrub nurses who are ?listening-in-readiness? waiting inter alia for the surgeon, to give orders. The sound user and sound producer are the surgeons that either use sound as feedback during surgical events, but also produces sounds by using surgical tools on the patient or guiding the surgery through speech. Depending on the moments of the surgical procedure, listeners can move in-between those listening types, but mainly stay in their role. Identifying the different listening types is crucial to understand the individual concerns and needs depending on their roles.
Our paper focuses on understanding the experience of medical alarms from the perspective of critical care nurses. Critical care nurses are the backbone of intensive care units and they have first-hand information about how environmental factors affect the quality of patient care and patient experience of ICU stay. In this paper, with an observational study and interview with nurses, we aim to qualify the experience of nurses with sound sources, especially medical alarms. Based on our findings we propose quick fixes and long-term strategies to tackle sound-induced problems originating from patient monitoring technology, in the clinical setting.
The current socio-technological context encourages the increase of products with increasingly complex and advanced interfaces. Sound is a valuable resource capable of facilitating interaction between product and user, and conveying information about events of different nature and criticality.However, design engineering lacks unified knowledge and a consensus methodology that facilitates the characterization of sound during product development processes. This article presents a retrospective, critical and systematic review of the most relevant theoretical and practical contributions applied in design engineering, from different scientific perspectives. The result is a map of publications classified in 6 large blocks, ranging from initial psychoacoustic studies, through observations on sound semantics, to the most up-to-date approaches supported by communication theories. In this way, researchers and developers in design engineering are provided with a guide and introduction to the main key aspects of sound study and in its application to product design domain. The article collects the main bibliographical references indicating whether they are theoretical or experimental studies, the scientific field with which they relate, their chronological location, and highlighting their main contributions.
Excessive noise has become one of the most publicly debated issues in critical care over the last 10 years. Beeping alarms, conversations, droning support devices and the care giving activities that clatter, buzz and ping turn intensive care units into an acoustically hostile environment in which neither can patients recover comfortably nor can medical staff operate safely and efficiently. Keeping the patient alive and stable with the help of advanced technology comes at a price: health conditions such as anxiety, post-traumatic stress, noise fatigue and possibly delirium are linked to excessive noise. It is our plea to foster medical innovation that focuses not only on patients’ medical and safety needs, but also on human needs/values such as pleasure, dignity, sense of achievement.
In this paper, we discuss some uncommon settings and roles for music, demonstrating how music can aid in the design and implementation of socially responsible healthcare products that are encouraging, inclusive, and sensitive to critical contexts. We review three music-inspired design cases (CareTunes: Musical Alarms for Critical Care, Music and Senior Exercise, and We Are All Musicians and the Adaptive Use Musical Instrument) in which the authors took part. The literature review and the analysis of the case studies provide us with the following insights: music enhances sensory experiences, facilitates physical engagement with the world, music can guide medical professionals in critical contexts, and music creates social cohesion. All of these projects demonstrate the importance of involving participants (users or performers) in the process to address their life experiences. Thus, the use of music in design applications is experienced as a positive influence that can facilitate wellbeing for community members, persons with disabilities, medical patients, and healthcare professionals in the workplace.
Clinicians who are exposed to noisy environments are more likely to suffer from alarm fatigue, stress or sleep deprivation, and can finally become inefficient in the moment to respond to a critical situation. In other words, a lack of compliance or an inappropriate response to alarms is constantly observed in clinicians operating in critical care. In this paper, we introduce the issue of lack of compliance with medical alarms in critical care by contrasting the mandatory approaches stemming from safety and efficiency purposes (i.e., study of (cognitive) ergonomics) with a motivational approach (i.e., a user-centred study focusing on contextual inquiry). Based on in-situ observations carried out in intensive care units and the relevant literature review we define the obstacles for compliance deriving from psychological and contextual constraints and provide relevant insights to help designers and clinicians to fight with. Our aim is to initiate discussions regarding the main purpose of medical alarms and how to integrate them better in clinician workflow.
Intensive care units are technologically advanced environments that are designed to safeguard the patient while their vitals are stabilized for further treatment. Audible and visual alarms are part of the healthcare ecology. However, these alarms are so many that clinicians suffer from a syndrome called ‘alarm fatigue’ and often do not comply with the task alarm is conveying. Measuring compliance with rules in the workspace and determining the success of a system belongs to the field of ergonomics and is based on data collected through task observations and scoring. In this paper, we will explore compliance with critical alarms by not only from their potential success or failure perspective but also from the perspectives of the clinician capacity, needs, and motivations to comply with alarms in critical environments. We will finally, reflect on further possible design strategies to increase compliance in critical care that are beyond following rules per se but through intrinsic motivation.
In this chapter, we present a sound design study for a commercial brand (Toyota Motor Europe) based on our expertise and theoretical knowledge underlying auditory display design, (auditory) icon perception, usability of interactive systems and tools and methods for conceptual design (e.g. poetry and metaphors). As a result, we show that given a certain brand identity it is possible to design sounds that enable users to take proper behavioral actions. This chapter aims to introduce a conceptual design methodology using poetry as input for auditory display design that incorporates brand, hedonic and ergonomic qualities. With this new method, companies can create functional but pleasant sounds that also carry brand values.
Interface sounds (beeps) in passenger cars are most commonly used to draw the attention of the user to a graphical information display, but they are underused for the purpose of implicitly informing users about an ongoing system event (eg low oil levels, door not well closed, safety belt not buckled). In general, sounds in the automotive industry are considered complementary to the visual displays in the dashboard design but not as a stand-alone information display (ie auditory display) the function of which is to communicate dashboard messages to drivers (Bazilinsky and De Winter 2015). For car manufacturers, the brand identity should provide the tonal quality (ie timbre) with which sounds should be designed. Currently, design is based on drawing attention without considering the brand values and does not have a natural causal relationship with the event it signals. The design of (functional) sounds for passenger cars comes with great responsibility to ensure passenger and road safety as well as stylistic concerns over conveying brand values through sound. While focusing on safety through functionality enables drivers to take the right action, styling (expressiveness of the sounds) can increase the hedonic value of the sounds, making them easily acceptable and even pleasant.
Neonatal Intensive Care Units (NICU) are environments with a high level of sensory stress. Medical advances and technology have contributed to increase the ratio of survival of premature infants but some devices and practices expose these babies to excessive noise and toxic sensory stimuli for which they are not prepared. This is related to an increase of neonatal morbidities, that are considered as minor sequelae, but that can greatly alter the life of the child and the family. Those responsible for hospital management and caregivers who want to take a step forward, need standards to guarantee the benefit of neonatal health and a proper physical and cognitive development of these babies. Design activity, from a Human-Centered Design approach (HCD), together with Developmental Centered Care (DC) contribute to identify and reduce adverse environmental conditions for newborns and premature infants. The purpose of this paper is to establish a method to provide design recommendations and good practice guidelines from evidence and especially from in-situ observations carried out in neonatal units by a multidisciplinary team (i.e., nurses, NICU supervisors and designers). Thus, we identify proposals to reduce stress situations and obtain potential benefits in the development of the hospitalized infant through adaptation of the NICU macroenvironment (i.e. the reduction of light and noise).
In this paper, the sleep phenomenon is considered in relation to critical care soundscapes with the intention to inform hospital management, medical device producers and policy makers regarding the complexity of the issue and possible modes of design interventions. We propose a comprehensive strategy based on soundscape design approach that facilitates a systematic way of tackling the auditory quality of critical care settings in favor of better patient sleep experience. Future research directions are presented to tackle the knowledge deficits in designing for critical care soundscapes that cater for patient sleep. The need for scientifically-informed design interventions for improving patient sleep experience in critical care is highlighted. The value of the soundscape design approach for resolving other sound-induced problems in critical care and how the approach allows for patient-centred innovation that is beyond the immediate sound issue are further discussed.
Today’s intensive care units (ICUs) pose a design dilemma considering the use of technology and its psychological effects on the inhabitants of the ICU. While the ICUs are designed to be technologically advanced in order to ensure patient safe recovery, the very technology that ICUs rely on threatens patients’ as well as clinicians’ wellbeing. Especially the system behind patient monitoring and the consequent alarm management needs to be reconsidered from the human perspective to prevent any occurrences of clinician alarm fatigue and post-traumatic stress syndrome observed in patients as well as their visitors. Moreover, advancements in patient monitoring technology, medical informatics, and societal developments offer new possibilities to give patient data a central role specifically in alarm management and clinician workflow in the ICUs in general. In this chapter, we envision a data-driven product-service system for patient monitoring in the future critical care context. Our design ideas and future vision are based on a critical review of the literature in patient monitoring, trend analysis, and technological developments in medical care, followed by a stakeholder analysis, the design of a future vision concept and scenario that we validated with expert interviews.
The value of sound design is increasing in the field of product development, and even more so in critical contexts such as healthcare. A well-designed sound can have an impact over job satisfaction, efficiency in work environment, user experience and well-being of healthcare staff and users as a whole. On the other hand, service design is a particular domain within design engineering focused on how the relationship between service providers and users can be improved. An emerging community highlights the utility of the tools and techniques to effectively include system stakeholders in the design and implementation of health technology and healthcare service design. Service design has been applied successfully in several projects to improve patient experience as well as in other areas of public sector. This paper states the potential contribution of service design to sound design, as another methodological approach in order to improve audible alarm design for product development in healthcare environment. Likewise, the paper offers designers and engineers possibilities to implement together both the tools and methods of service design and product sound design deriving from the review of existing literature and empirical conclusions compiled from observation and analysis of oncological treatment rooms at different hospitals.
Audible clinical alarms have been an indispensable component of patient monitoring since the 1950s.1,2 During the previous 15 years, and particularly since the clinical alarms summit in 2011,3 several initiatives by regulatory agencies, hospital management, and medical equipment producers have sought to optimize the use of alarms and audible alarm signals in an effort to overcome their negative effects (e.g., alarm fatigue, delirium, postintensive care syndrome) on clinicians, patients, and visitors. Although the field of alarm and alarm signal design is gaining momentum in creating more human-centered alarms, current technological advances (e.g., biosensors, smart wearables, remote monitoring) and the ways in which society is engaged with technological solutions (e.g., continuous tracking of heart rate, sleep, or healthy behavior) bring new challenges and opportunities for monitoring health data and warning users regarding out-of-limit values and other conditions for which alarms might be appropriate.
The reserved set of audible alarm signals embodied within the global medical device safety standard, IEC 60601-1-8, is known to be problematic and in need of updating. The current alarm signals are not only suboptimal, but there is also little evidence beyond learnability (which is known to be poor) that demonstrates their performance in realistic and representative clinical environments. In this article, we describe the process of first designing and then testing potential replacement audible alarm signals for IEC 60601-1-8, starting with the design of several sets of candidate sounds and initial tests on learnability and localizability, followed by testing in simulated clinical environments. We demonstrate that in all tests, the alarm signals selected for further development significantly outperform the current alarm signals. We describe the process of collecting considerably more data on the performance of the new sounds than exists for the current sounds, which ultimately will be of use to end users. We also reflect on the process and practice of working with the relevant committees and other practical issues beyond the science, which also need constant attention if the alarms we have developed are to be included successfully in an updated version of the standard.
The reserved set of audible alarm signals embodied within the global medical alarm system standard, IEC 60601-1-8, are known to be problematic and in need of updating. The current alarm signals are not only suboptimal, there is also little evidence beyond learnability (which is known to be poor) demonstrating their performance in realistic and representative clinical environments. In this paper we describe the process of first designing, and then testing, potential replacement audible alarm signals for IEC 60601-1-8, starting with the design of several sets of candidate sounds, initial tests on learnability and localizability, followed by testing in simulated clinical environments. We demonstrate that in all tests the alarm signals selected for further development outperform the current alarm signals (by a long way), and we describe the process of collecting considerably more data on the performance of the new sounds than we have for the current sounds, which will ultimately be of use to end-users. We also reflect on the process and practice of working with the relevant committees and other practical issues beyond the science which also need constant attention if the alarms we have developed are to be included successfully in an updated version of the standard.
Satellite monitoring and control systems provide the possibility for audible alarms to signal system events that require operators to pay attention and eventually to take action. The audible alarms that are currently in use at ESA control areas are very basic and unfortunately non-discriminating with respect to the events they are signalling. These audible alarms consist of sound files often arbitrarily fished out from the Internet; thus, when they sound they convey no added information about the event that caused it. No considerations whatsoever are made concerning their suitability, ergonomic aspects, or effects of such alarms on operators working on long shifts. Because sounds are prompting a much faster reaction from operators than visual cues, when used efficiently they can also be made to establish criticality, urgency, origin or expected action (think for example on your car alarm that tells you to buckle up or that you are about to bump the car behind you). This paper describes the work performed together with Delft University of Technology and the University of Plymouth to analyse the satellite monitoring problem, to define a sound alarm philosophy that foresees different levels of urgency/criticality associated with typical operator actions based on contextual enquiry in the field, and the corresponding implementation of a library of coherent sounds that include 3 themes of 5 sounds each that map to the levels defined. It will also describe the evaluation of the sounds with operators and how the Cluster mission is implementing a solution to deploy this alarm philosophy and sounds in its dedicated control area, making sure to analyse evolution of operator behaviour before and after the deployment.
This article addresses the need of including acoustical perspectives in the debate on alarm fatigue within the healthcare domain. We show how conceptualisations and proposed solutions to alarm fatigue are unequally distributed across what could be called the ‘alarm chain’: a generic model of the core structural elements and dynamic relations that constitute any alarm scenario. A focal point in the alarm chain – the ‘alarm mediation cleft’ – seems to divide the alarm fatigue literature from the segment of the alarm literature that deals with auditory alarm design. The current healthcare discourse on alarm fatigue is centred around the ‘premediated alarm phase’, which has the consequence of an unfortunate dichotomous approach to the functionality of sound. We address some shortcomings of this approach and outline some methodological implications and potentials of searching for signs of alarm fatigue in the ‘post-mediated alarm phase’.
In the old days, spacecraft alarming notifications to operators were directed, upon arrival to ground, to one of those needle printers. Trained operators could tell, from the length and rhythm of the printer noise, what kind of alarm it was and therefore infer the criticality or the subject. Today, in monitoring and control systems (MCS) currently in use at the European Space Agency (ESA), there is no care to convey information in the sounds, and these alarm sounds have not been systematically designed to indicate the type of system failure and further elicit the desired and accurate operator response. Operators depend heavily on the graphical interfaces in order to pinpoint the source of alarm sounds (see Fig. 1) which further creates cognitive load. Similarly, switching cost from auditory perception to visual perception while finding the source of the information is undesirable when time can be a precious commodity for operators when monitoring valuable spacecraft. Therefore, ESA teamed up with Delft University of Technology and Plymouth University in order to investigate and design a new auditory display for the control rooms located in the European Space Operations Centre (ESOC), in Darmstadt, Germany.