Embrace
A connected future between mother and newborn, for when it matters most.
company: Johnson & Johnson (Ethicon)
timeline: 3 months, 2018
people: Benton Humphreys (designer)
The Challenge
It goes without question that having a newborn baby admitted to the Neonatal Intensive Care Unit (NICU) is a stressful experience. Life is not put on hold as you learn how to navigate an unfamiliar environment and adjust to a new routine, and all other everyday obligations still exist.

Beyond surface-level stressors, a lesser known complication is the missed opportunity for bonding between mother and newborn. The initial weeks of life are some of the most critical for the social and emotional development of a newborn, and physical contact is one of the most important elements of bonding. Unfortunately, this is the least likely means of connecting with their child.
The Solution
This concept aims to identify a solution for missed bonding between mother and newborn via a unique combination of software, hardware, and emerging technologies.

Emotion recognition technology will alert the mother when the newborn is distressed and prompt her to log in and begin speaking to the baby, sooting them. Eventually the newborn will receive care from the nurse. Given that a newborn's auditory system is fully developed, yet its eyesight still undeveloped, it will eventually begin to associate receiving care with its mother's voice, effectively simulating bonding and easing the transition from NICU to home.
Without a good initial bond, children are less likely to grow up to become happy, independent, and resilient adults.
Research
User-Interface
Industrial
Systems
A missed opportunity for bonding, a missed opportunity for connection.
Being admitted to the NICU can involve a period of isolation that lasts anywhere from a few hours to several weeks.

The first few weeks of life are critical to establishing a lasting bond between the mother and newborn. While the newborn's physical health might certainly benefit from continued isolated care, emotional development, social engagement, and overall well-being are at risk of being stunted.
Asking the right questions.
Initial research consisted of speaking with the stakeholders most involved with the NICU (the parents, the NICU nursing staff, and other associated staff), and visiting Cincinnati Children's Hospital NICU and University of Alabama NICU Sim Center in order to better understand the environment. Parents and nurses were contacted via phone and email, and were asked to describe their experiences, starting from initial admittance to the NICU and ending with the discharge process. This lead to a general understanding of the parents' plight, and, perhaps more importantly, resulted in the informed questions listed above.
1. How involved are parents during the entire experience? Are they adequately informed of what's going on?
2. What variables can be changed in the parents favor? Which are fixed, or would inhibit the nurse's job?
3. How can we create a symbiotic relationship between parents and nursing staff?
Simulating the experience of being in a NICU resulted in more informed user needs.
‍In order to better understand the role of a nursing team within the NICU, I attended a NICU Simulation training event hosted by the University of Alabama at Birmingham Hospital. This 3-hour training event was focused on preparation or recertification for NICU nurses in emergency settings that immediately follow delivery. These simulations provided valuable insight to the workings and cooperation of a nursing team in dealing with patients and parents. I opted to return for a second simulation event one week later, which reinforced the problem areas I noticed during initial research, and provided valuable stakeholder feedback that subsequently lead to a more comprehensive user journey map.
Narrowing the problem scope.
The entire experience is a stressful one, and it cannot be summarized pixels, colors, or text. However, the journey mapping exercise revealed points of convergence or conflict between parents and nurses. Whatever desire the parent may have at a point in the journey typically had an inverse desire for the nurse (e.g. a parent is envious of the nurse providing all care to baby, while the nurse would prefer the parent to stay hands-off unless directed otherwise).
The end result, while attempting to mitigate stress for parents, also mustn't inhibit the nurse's duties.
This stage offers the greatest opportunity and flexibility for getting parents involved and connected.
Parents are often encouraged to contribute to care responsibilities should the baby's state improve. Even if the parent is unable to be physically present, the care cycle runs on a schedule, which affords the parents work it into their own schedules.
Needs statement filtering.
User feedback was vital at this point in the project, and it was convenient to ask the experienced nurses from the simulation event to evaluate the user journey map, pain points, and opportunities, while contributing their own thoughts and ideas. The stakeholders were asked to prioritize the opportunity statements in order of importance, which lead to three statements being recognized as the most appropriate to focus on. The common link between all three chosen statements was communication among parents and nurses.
Communication is at the core of most issues between nurses and parents, and keeping parents at the right-level of informed can go a long way to easing their stress.
How might we promote parent-nurse communication that encourages a sense of confidence, control, and overall well-being in the moments immediately following deliver?     How might we promote parent-baby interaction in the event of absent parents?   
How might we minimize uncomfortable or jarring aesthetics?     How might we work with aesthetics in the NICU that results in a sense of confidence and comfort in the machines, equipment, and environment as a whole?     How might we mitigate feelings of helplessness for parents of babies in the NICU?     How might we minimize parental apprehension towards interaction with the baby that encourages safe and easy care by the parents?     How might we increase external stimulation (social and otherwise) for isolated babies?     How might we supplement a parent's role in the event of their absence that encourages parent-baby bonding?     How might we limit parental involvement for nurses in the NICU that decreases unwanted or unneeded parent inquiries, interaction, or otherwise distracting behavior?
Do pet owners have similar needs to new parents? Well, it turns out that they do. Somewhat.
The idea of a comprehensive system that promotes communication between two involved stakeholders is not a new idea; however, existing market options are typically concerned with client-business relationships. Gingr is but one of many pet grooming platforms that provides a channel of communication between owners and pets, and has served as a primary source of inspiration in developing a system that meets similar (but more extreme) communication requirements.

The only remote platform that exists for the NICU is the NicView camera system. Though it claims to be "the next best thing to being there," it lacks any avenue of direct communication between parents and nurses, and parents to newborn. If anything, the simple one-way portal system has the potential to dehumanize the newborn into a collection of pixels on a screen. The parent misses out on the opportunity for bonding with a newborn in the form of physical contact, auditory communication, and limits any chance for interfacing with the nurse.

Initial concept generation used these two services as a starting point before developing into a more refined solution.
Now, let's brainstorm!
Promoting communication between all stakeholders is the integral part of the system. Everything else follows..




An opportunity to simulate bonding.
With feedback from the stakeholders, I felt comfortable pursuing a final direction for Embrace. Ideally, parents will be given an information packet upon arrival to the NICU that details what to expect, how to use Embrace, and other associated contact information for the hospital. Before it is provided to the parents, an administrator will provide the initial login information on the packet - there is no setup required for the parent, they can simply log in. This is beneficial in the event that the mother is still bedridden, as she can now immediately log in and view her baby remotely.
Mapping the interactions.
From the concept generation session, I decided to purse an online web portal as the center point of all communication components of the system. Below is a broad overview of the portal and its specific components. From here, I generated several layouts for web and app, and presented these to the stakeholders for further feedback and refinement.
All stake holders are connected at a single point of contact.
Remote feedback session with those most directly affected.
Before pursuing any final concept direction, I found it necessary to receive feedback on several concepts from those affected. Upon reaching out to the March of Dimes, I was put in touch with 2 NICU mothers that agreed to participate in a feedback session centered around refined concepts. Being that the 2 mothers were located in different parts of North Carolina, and myself in Alabama, I opted to host a virtual feedback session. This consisted of screen-sharing a template that helped guide conversation, which was populated with their own experiences, thoughts, and wants throughout the conversation.

This proved to be an experiment in and of itself, but ultimately affirmed the direction of several design concepts.
The participants were asked to describe their experiences in the NICU and how their experience could have been better. Ideas were categorized in 3 areas: 

1. "What happened"
2. "How things could have been better," and
3. "What might be"
Following the interview, the participants were shown 2 different concepts (shown below). They were informed that all information was consistent across each concept, even if one didn't show it on the home page.
  Online Portal Concept 1
  Online Portal Concept 2
Concept 2 was the clear favorite among the participants.

While knowing the newborn's vital and health information was important to them, it was described as being too distracting from the most important part of the system - their child. Further, the participants found knowing that the nurse was reachable via chat box, even if not entirely visible was reassuring.
Connecting the dots.
Based on stakeholder feedback, I developed the final wireframe of the online portal. Its intent remains a simple, yet intuitive and informative user experience.

Below is the final wireframe and concept video overview.
The newborn's livestream is presented upon login and takes visual precedence over all other elements on the page. This focuses the user's attention on what is important, and leaves any distractions hidden.
The nurse chat box remains hidden within a popup window, and is with the user on every page they visit. From this chat box, the user can leave messages or request a video call with the nurse. The nurse has the ability to respond to the parent at their discretion.
The health page displays daily updates about the newborn's weight, growth, age, and any changes (like improved sleep quality) that might happen.

On the right side of the page are the newborn's vitals, which are live streamed to the portal. The decision to include this information stems from trying to simulate the in-person experience as closely as possible, as parents are typically taught to read the monitors by the nurse when they are there in person.

Colored gauges represent a range from "normal" (green) to "attention required" (red).
User can adjust preferences and settings and more information is available for parents to better understand the system, its privacy policy, and methods of contact in case of issues or further questions.
FAQ is available for parents to better understand the system, its privacy policy, and methods of contact in case of issues or further questions.
Click to watch concept tutorial.
Embrace the connection.
Embrace attempts to simulate a bonding experience between mother and newborn. Upon birth, a newborn's auditory system is fully developed and research shows a preference for their mother's voice. However, their eyesight is underdeveloped to the point of being unable to recognize faces or distinct shapes. Embrace takes advantage of this and will alert the mother when their newborn is in distress. Eventually, a nurse will come to relive the newborn of its stress, but in the meantime, Embrace prompts the mother to soothe and comfort the newborn with her voice. The newborn does not know who is giving it care, but will recognize its mother's voice and, given enough repetition, will eventually associate the care it receives with its mothers voice - effectively simulating bonding between the two.
Made with love by Benton Humphreys, 2020.