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Usability and acceptability of mixed reality to support emergency clinicians during community outreaches: A quality
Amy J Spooner1, Daniel Best2, Elizabeth J Marsden3
1Older Persons Emergency Network, Metro North Hospital Health, Caboolture Hospital, McKean Street, Caboolture 4510, Australia.
Background And Problem Statement:
The global population is ageing, and Australia's older population continues to experience the highest growth in emergency department (ED) presentations. Older adults have a higher level of vulnerability and are at greater risk of hospital acquired complications.
Local Problem:
The Older Persons Emergency Network Acute Outreach Service (OPEN AOS) provides ED substitution and ambulance co-response to older persons in their home to avoid unnecessary transfers to ED. Since establishment, service demand has grown and cost-effective initiatives to increase service capacity and capability are required to sustain service delivery.
Methods:
A quality improvement project was undertaken to trial and assess mixed reality (MR) goggles in conjunction with video calling software over 90 days, to increase service capacity and capability. Usability, acceptability, enablers, and barriers related to MR use was assessed using the System Usability Scale and open-ended questions. Descriptive statistics summarised the data and content analysis further explained the results.
Intervention:
The intervention involved Registered Nurses or Advanced Practice Nurses performing solo outreaches wearing the MR goggles to liaise remotely with OPEN AOS senior clinicians (Senior Medical Officers or Nurse Practitioners) for medical governance.
Results:
Thirty-two clinicians interacted with MR and completed the survey. Most patients were treated in Residential Aged Care Homes (RACHs) (66%, 21/32) for minor injuries or fractures (25%, 9/32), lacerations (25%, 8/32) or wounds (19%, 6/32). Good usability and acceptability were reported. Nurses found MR easy to use and obtained clear advice from senior clinicians. Senior clinicians found the image quality to be the biggest strength of MR. Half of the staff experienced technical issues mainly due to internet connectivity in RACHs causing call disconnections and distorted images.
Discussion:
These findings provide valuable insight into MR use in the OPEN AOS, enabling service directors to make informed decisions regarding future investment in MR technology. This was a quality improvement project with a small sample size and caution should be exercised when generalising these findings to other healthcare settings.
Conclusion:
MR shows great potential to increase capacity and capability within the OPEN AOS, enabling nurses to carry out solo outreaches safely and competently. Further research is necessary to evaluate clinical and cost effectiveness of MR to support broader adoption in other healthcare settings.