ICU Chat – first stage of trials now complete

16 August 2018

The first stage of trials for a new communications system for people recovering and being treated in Critical Care Unit (CCU), has now come to an end.

The system, called ICU Chat, was inspired and developed by ex-patient Duncan Buckley, who woke in the CCU at UHB after a six week long coma following a serious traffic accident.  Speaking about the frustrations for both himself and wife Lisa, during his recovery, Duncan said: “Through our own experiences of not being able to communicate whilst in the first two months of a long term hospital stay, we decided something was needed to rectify this problem and so ICU Chat was born.”

Duncan had worked in IT before his accident, but the time out of work meant he had to retrain.  Adding this to his patient experience, his involvement with Patient and Public Involvement and Engagement (PPIE) Groups and with researchers at the Trust, he has gone on to establish himself in a new role as a Portfolio Facilitator with the National Institute for Health Research (NIHR), which is one of the funders of the research trial.

ICU Chat is a laptop-based system which allows patients to communicate their basic needs and ask and answer simple questions, like “Are you hungry?” or “I am thirsty / in pain.”  Unlike other systems being used on a more long term basis though, ICU Chat is cheap, simple to install and use and requires minimal training for the patients, staff or carers. It doesn’t require hand movements or even eye movements, which weak, tired or heavily medicated patients may struggle with, but the simple movement of any part of the face allows communication.

Fiona Howroyd, Senior Physiotherapist and team leader in the ICU at UHB, who has been working on ICU Chat as part of her Masters in Clinical Research, said: “Working on this project has been a fantastic experience. It’s been a great opportunity to learn a lot about the research process and ultimately it’s very exciting to know that the patient’s voice can be heard in so many forms.”

Fiona has worked alongside Duncan and Lisa, together with Dr Charlotte Small, a PhD Research Fellow in anaesthesia and critical care and Ruth Capewell, a speech and language therapist.

The first stage of the small scale trial has closed after recruiting eleven patients in five months. All participants were tracheostomy patients, so were awake and able to participate, but had basic communication issues.

After demonstrating the ICU Chat programme at the Research Showcase earlier this year, Duncan said: “ICU-CHAT has been a great experience for both Lisa and I. It has been a long, emotional and eventful journey for us but now we get to see the ‘fruits’ of our invention.  The showcase event at the QEHB was very satisfying and thrilling for us to meet not only other patients and relatives, but staff who were very interested and amazed by our device and supportive for the future.  We have come up with something wonderful that we hope will make a big difference for many people.”

While Fiona explained that the information gathered during the first stage is now under analysis, Duncan added: “As non-clinical PPIE ‘innovators’, Lisa and I have both really enjoyed working alongside the team and being involved from the very conception of the study to the closure. There have been adaptations needed along the way with regard to setting up the device for patients to utilise, but we have received some useful feedback to help develop the system into the next phase of development.

“The feedback itself will now help drive the evolution to get the device more widely utilised for patient benefit, so the patients and relatives that took part can really feel like they’ve contributed to helping others who may find themselves in similar circumstances.”

The involvement of a commercial organisation is the hoped for next step, as Duncan would like to meet with experts in the area of constructing a standalone unit. Currently his software has been adapted for use by the University of Birmingham’s Human Interface Technology team.

Fiona points out that while ultimately the device is all about improving patient care and communication, it does provide many benefits for staff too.  Knowing how your patient is feeling and their reaction to a particular treatment, only makes medical care even clearer. She said:  “Questionnaires have been distributed to staff, relatives and patients and there have also been interview follow ups, when a patient’s voice has returned. We wanted to keep the input of patients and their feedback central to the trial as this will help to decide what the next steps are.”

The next stage for ICU Chat is a vital one, and perhaps with the right funding and collaboration, the team could be demonstrating a complete and commercially ready unit at next year’s showcase.

Caption: Left to right Duncan and Lisa Buckley, Dr Charlotte Small, PhD Research Fellow Anaesthesia and Critical Care, Ruth Capewell, Speech and Language Therapist and Fiona Howroyd, Senior Physiotherapist and team leader in the ICU.