Their inability to communicate effectively whilst he had a tracheostomy on the Intensive Care Unit (ICU), had such a profound impact on Duncan Buckley and his wife, Lisa-Marie, that they developed a concept for a novel interactive communication device, called ICU CHAT. Together, they have been embedded within the multidisciplinary ICU research team at the Queen Elizabeth Hospital Birmingham (QEHB), supported by the Human Interface Technologies team from the University of Birmingham, and funded by the National Institute of Health Research Surgical Reconstruction and Microbiology Research Centre, to further develop their prototype for clinical trial.The team followed a human centered design process (1), with the following stages:1. Literature review of Augmentative and Alternative Communication (AAC) devices for patients with a tracheostomy on the ICU. 2. Bench testing with ICU survivors, family members and staff. 3. Multidisciplinary development of a clinical trial protocol.The review determined that although there are a range of AAC devices available on the market, there are practical limitations to their use. The current literature does not explore factors relating to device requirements and patient usability in the ICU.Bench testing established the safety and appropriateness of system components by combining usability assessment with qualitative appraisal. Testing determined that both patients and staff preferred to use a tablet/ laptop sized screen as visual display attached to a mobile stand. The interface with the best usability ratings was the camera mouse; laptop software allowing tracking of facial gestures to control an on-screen cursor.The clinical trial protocol ''Feasibility of the use of a novel interactive communication device, ICU-CHAT, for patients with tracheostomy on the ICU'' has secured Health Research Authority permissions and is open to recruitment at QEHB.This early translational research demonstrates the ability of clinical and academic teams to support potential patient innovators, whose reflections on experiences during their ICU stay enable technology development to be truly patient-centered. The structured process used by the research group optimises usability engineering process (2) and facilitates regulatory approval prior to rigorous evaluation via clinical trial. Bibliography BSI (2010) Ergonomics of human-system interaction -Part 210: Human-centred design for interactive systems (ISO 9241-210:2010 Abstract Early oliguria (EO) during the first 24 h of intensive care unit (ICU) admission is more likely to be related to the reason for admission than to subsequent complications or therapeutic intervention, and so may be a more accurate predictor of outcome than later estimates of urine output (UO). Moreover, the accumulation of a number of discontinuous hours of EO may offer an earlier indication of renal dysfunction than the fixed periods common to modern definitions of acute kidney injury (AKI). We used electronic patient record data, including hourly fluid balance information, to ...

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