Proof of Value of Gamified Projection System for ICH Trial Ward

Year Submitted: 2024
Published Date: 31 December 2024

Tags: Technology, Automation, Robotics

About this Content

Aims

The project aims to incorporate an innovative delivery of care by including gamification element into the delivery of therapy to make therapy engaging and interactive for patients without need for additional manpower and space resources. Also, to identify a solution that can be operated by providers safely and with ease.

Background

Gamification in the elderly is an upcoming area to motivate and encourage participation. The gaming elements encourages the elderly in actively participating in therapeutic activities. Besides traditional forms of engaging patients, gamifying activities allows for increased opportunities for patients to be engaged, and in turn increase their out-of-bed hours. Current gaming interventions are increasingly popular and recent systematic review have found that within the health domain, specifically the physiological, mental and cognitive functions, results have been positive and hold potential for older adults. Within a rehabilitation setting, recreational games such as bowling, “bingo”, table hockey would require 2 persons to support the logistics. Throughout the duration of the game, 1 person would conduct the game with another to assist patients to ensure safety. A typical seated group size would comprise 6-8 patients. One staff would be the game master to conduct the game and the other staff would need to ensure that the other patients are participating and engaging in the group appropriately. If a patient needs to leave the group for instances such as toileting/unwell, group therapy has stop until the accompanying staff returns back to the group. For commercial console games such as Sony PlayStation/Nintendo Switch, the appeal varies, depending on the digitisation exposure of elderly patients. Console game set ups would require the use of handheld devices and enabling patients adequate hand eye coordination. With an ageing workforce, staff may not be technologically savvy in operating console or digital games. As such, the ease of setting up such games, operating and maneuvering between applications have to be taken into consideration so that staff are able to operate with confidence and ease during the session of game.

Methods

From the findings of the POC, the project team would like to embark on a Proof-Of Value implementation of the omiVista Mobii system to have further insight into the following areas:
a) Therapist led group sessions for both physical and cognitive domains for general
patients in subacute and rehab wards.
b) Therapist led groups for patients with dementia or cognitive impairment.
c) Nurse led recreational therapeutic groups for patients with dementia or cognitive
impairment.
d) Nurse led recreational therapeutic groups for general patients in acute wards.
e) Volunteer led recreational therapeutic groups.
For the POV trial, 1 unit each would be assigned to the ICH@RC8 ward where patients are transferred for further optimisation of function and general rehabilitation. The other unit would be assigned to TTSH Ward 9 @ Ren Ci which was designed for piloting ICH frailty care model and patients with dementia, behavioural and psychological symptoms. Further exploration and consults would be carried out and the extensive library of games will be curated accordingly for the multi-disciplinary teams such as Nursing, Allied Health professional groups and volunteers.

Results

Therapists were able to train therapy assistants to conduct sessions for patients on an individual and group basis for both physiotherapy and occupational therapy interventions. The omiVista sets are currently sited within the Dementia/Frailty Wards and Deconditioning ward in ICH. The sets are used daily to engage patients cognitively and physically. Volunteers have been trained to use the omiVista sets and this is deployed bi-weekly during volunteer sessions. Volunteers have been observed to conduct the sessions out competently and safely. Therapists have an additional adjunct tool to engage patients during interventions. This is a portable system that is set up with ease, easy to clean and requiring a small physical footprint. The applications comprise of localized quizzes, photographs and sounds of our local settings. With the various applications and its aims, it caters to patients with varying needs and difficulty levels. Volunteers who are pre-tertiary students have found the system easy to learn, set up and conduct the applications with training and guidance. The main aim of the SIP was to have gamification integrated into patient’s rehabilitation. Besides therapeutic use, the recreational component has been wellreceived by patients who join in the volunteer led groups. Based on our clinical outcome measure of the Pittsburg Rehabilitation Participation Scale, patients usually score 5 and above in their participation and taking interest in the activities.

Conclusion

omiVista has found to be a useful adjunct for integrating gamification elements for patients within the therapeutic and recreational setting. It is easy to set up and navigate the applications from the therapist, therapy assistant and volunteer perspective.

Lessons Learnt

omiVista comes with over 150 applications that had to be shortlisted to about 100 for purchase. Therapists had to run through all the applications and categorise them into
their different themes and work with the vendor for the layout. Although a manual and guidebook was written up, training had to be conducted for therapists and volunteers to explain how to integrate the applications into therapy interventions or conversation starters for the volunteers. The usage of the machine in the initial stages had to be tracked manually. The software has no tracking mechanism of how the time the machine is utilized and what are the commonly used applications. There are limited applications that are catered for our local population. Further costs would be incurred if new applications are purchased/refreshed or customized to our local context. To operationalize the omiVista, there were structured trainings for the utilization for both the therapists and therapy assistants. There were sharing to ensure that staff were aware of the machines and how to integrate them into therapy sessions. There were regular check ins in the initial purchase phase to ensure staff were competent with the use of the machine. As the machines are portable and easy to set up, omiVista was easy to use within the ward activity areas and gym.

Keywords

Physiotherapy, gamification element, participation

Innovators' Details

Connect with this contributor!

Ms Lynn Chua - Ying_Lynn_CHUA@ttsh.com.sg

Project Attachment