The Impact of Design Factors on User Behavior in a Virtual Hospital Room to Explore Fall Prevention Strategies

Abstract

Objectives: Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk.

Background: Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes. This study introduces an innovative approach using AR technology to advance methods for healthcare facility design efficiently.

Methods: Ten healthy participants enrolled in this study to examine different hospital room designs in AR. Factors of interest included room configuration, door type, exit side of the bed, toilet placement, and the presence of IV equipment. AR trackers captured trajectories of the body as participants navigated through these AR hospital layouts, providing insights into user behavior and preferences.

Results: Door type influenced the degree of backward and sideways movement, with the presence of an IV pole intensifying the interaction between door and room type, leading to increased sideways and backward motion. Participants displayed varying patterns of backward and sideways travel depending on the specific room configurations they encountered.

Conclusions: AR can be an efficient and cost-effective method to modify room configurations to identify important design factors before conducting physical testing. The results of this study provide valuable insights into the effect of environmental factors on movement patterns in simulated hospital rooms. These results highlight the importance of considering environmental factors, such as the type of door and bathroom location, when designing healthcare facilities.

Keywords: augmented reality; built environment; evidence-based design; fall prevention; patient room; risk.

Figure 1.

Immersive virtual reality screenshots of a footwall room configuration (left) and headwall room configuration (right). used in this study. The headwall room configuration features the bathroom positioned at the head (top) end of the bed, while the footwall room configuration (left) places the bathroom at the foot (bottom) end of the bed. The yellow rectangles serve to highlight and emphasize the notable differences between these rooms, allowing for a clearer visual understanding of the distinct Immersive virtual reality screenshots of a footwall room configuration (left) and headwall room configuration (right). used in this study. The headwall room configuration features the bathroom positioned at the head (top) end of the bed, while the footwall room configuration (left) places the bathroom at the foot (bottom) end of the bed. The yellow rectangles serve to highlight and emphasize the notable differences between these rooms, allowing for a clearer visual understanding of the distinct configurations.

Figure 2.

Spatial arrangement of inside (left) and outside (right) toilets. The inside toilet is positioned closer to the bed within the bathroom space, while the outside toilet is further away from the bed. The yellow circles specify the locations of the toilets, highlighting their positions in relation to the surrounding elements. Additionally, the inside and outside walls of the bathroom are tagged.

Figure 3.

Bathroom Door Types. The figure showcases the two different door types implemented for the bathroom within the headwall and footwall room configurations. The sliding door smoothly glides along a track, allowing lateral opening and closing of the bathroom entrance. In contrast, the swinging door features an outward opening mechanism, swinging away from the bathroom space. The yellow arrows help to visually distinguish between the two door types.

Figure 4.

Differentiating far (left panel) and close (right panel) sides. By incorporating the yellow arrows, we effectively draw attention to the starting point of participants.

Figure 5.

Visual representation of participant perspectives in physical and virtual environments. (a) Depicts the participant’s view in the virtual room, featuring a clear shot of the bed and the participant walking toward it. (b) Represents the participant’s presence in the physical room, highlighting the physical bed and toilet. (c) Illustrates the participant’s perspective of the virtual bathroom. (d) Displays the participant’s movement toward the physical bathroom in the physical room. Panels (a) and (c) showcase views corresponding to panels (b) and (d), respectively.

Figure 6.

Visualization of Angles θ and Motion Areas. The plot depicts the angles θ between the instantaneous orientation and velocity of the lumbar tracker, showcasing the forward (− π/4 < θ < π/4), sideways (π/4 < |θ| < 3 π/4), and backward (3 π/4 < |θ| < π) motion areas. This graphical representation offers insights into participants’ movement patterns within the virtual environment.

Figure 7.

Box and jitter plots for total trial time for each set of factors. Different factors (e.g., door type) are illustrated in different colors, with shading indicating different levels within a factor (e.g., sliding verses swinging door). Total trial time was influenced by Door type, IV pole presence, bed side, and set number, which exerted significant influence on the results, as indicated by the p-values and brackets. Each dot on the box plots represents one trial.

Figure 8.

Box and jitter plots depict total path length across various sets of factors. Distinct factors, such as door type, are visually distinguished by unique colors, while different shading patterns within a factor group, like sliding versus swinging doors, indicate various levels. The factors including toilet position, door type, IV pole presence, side of the bed, and set number were all associated with increased total path length. Significant factors are indicated with p-values and brackets. Each dot represents a single trial.

Figure 9.

Total time in the bathroom for each combination of factors are presented in box and jitter plots. Each factor, like door type, is represented by a different color, while within-factor variations, such as sliding and swinging door options, are highlighted with varying shading. The door type, IV pole presence, and set number all had a significant impact on the time spent in the bathroom, as indicated by the p-values and brackets. Each dot represents a single trial.

Figure 10.

Box and jitter plots were generated to illustrate the distribution of distance backwards across distinct sets of factors. Each factor, such as door type, is assigned a unique color for visual differentiation, and shading is utilized to indicate specific factor levels, such as sliding and swinging doors. The room configuration, door type, IV pole presence increase the distance traveling backwards, as indicated by the p-values and brackets. Also, the interaction between IV pole and door type can push participants to move more backwards, with each dot representing an individual trial.

Figure 11.

These box and jitter plots serve as visual representations of distance sideways distributions across multiple factor combinations. Each factor, such as door type, is allocated a unique color for clear differentiation, with shading employed to denote specific factor levels, such as sliding and swinging doors. The room configuration, door type, IV pole presence and set number exhibited increased sideways motions, as highlighted by the p-values and brackets. The interaction between room configuration and door type affected sideways traveling, with each dot representing an individual trial.