88 Chapter 4 4 Ethical considerations Informed consent from all participants was given prior to study activities. Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent to participate in this study was provided by all participations prior to study activities. In the case of children, informed consent was provided by the participants’ legal guardian/next of kin. Results Phase 1: discover The experience journey mapping session (identifying the process steps and experience touchpoints) resulted in a visual representation of the experience journey with ten distinct steps: (1) At home; (2) to the hospital; (3) at hospital registration; (4) at the outpatient registration desk; (5) In the big waiting room; (6) weighing and measuring; (7); in the consultation room; (8) blood drawing; (9) leaving the hospital; (10) back home. There were multiple (potential) stress and anxiety experience touchpoints, although it became apparent that touchpoints differed strongly between children, possibly due to character traits or prior experience. In general most prominent stress and anxiety experience touchpoints were when entering the building, in the waiting room, taking of the clothes for weighing or physical examination, “giving” their arm for blood drawing, and seeing the needle or attributes (e.g., arm cuff) associated with prior (painful) experiences. Healthcare professionals also noted that caregivers might unwillingly project their stress on the child. As blood drawing is the most common invasive procedure, it was decided to focus on reducing stress and anxiety surrounding blood drawing visits. Finally, the most important experience qualities (e.g., child should be distracted during waiting, app should be engaging during multiple visits, child should be in charge) were identified and resulted in a description of the ideal hospital journey for children with the desired experience qualities (see Figure 2). Phase 2: iteration 1 The Hospital Hero concept The desired experience qualities, such as children are distracted with searching, were translated into the Hospital Hero concept. The Hospital Hero concept is based on three core elements: (1) preparation, (2) distraction and (3) supporting caregivers in supporting their children. The Hospital Hero app supports and guides children in their journey through the hospital using a “discovery map” in the app. The map visualizes the different rooms in the outpatient clinic (waiting room, weigh and measure room, consultation room, blood drawing room). It also includes the steps at home, going to and leaving the hospital. Children can download the app already at home and watch short videos in the different steps together with their caregiver, such that they become informed about the different procedures (preparation and parental
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