User-centered design of an integrated, hybrid personalised digital prehabilitation intervention in the lung volume reduction surgical pathway (‘Fit4Surgery’): A case study of the double diamond method

Lung Volume Reduction Surgery (LVRS) requires pulmonary rehabilitation(PR). COVID disrupted rehabilitation services, and several UK hospitals have 2-year PR waiting lists. The LVRS waiting list is long, and even if patients went through PR, they might finish before surgery and lose rehabilitation benefits. A digital PR initiative could improve PR access and enable patients to continue their programme till surgery. The double diamond (DD) methodology (figure 1) will be used to alter fit4surgery (F4S) software for COPD patients to improve LVRS eligibility and surgery success. <bold>Methods:</bold> The DD process involved 'discovering' various insights into the problem, 'identifying' areas to focus on, 'creating' broad prospective solutions, and choosing 'deliverable' ideas to implement. These were achieved through workshops involving patient groups (n=5), healthcare professionals (HCP) (n=9), and the main study team of academic researchers and software designers (n=8). <bold>Results:</bold> Incorporated summary changes into the F4S LVRS: 1- Sit-to-stand test, EQ5D, HADS, and CAT questionnaires. 2- Symptom-specific health videos. 3- Improving exercise programmes with progression guidelines. 4- PG-SGA questionnaire-based nutritional intervention. 5- Tracking other physical activities such as cycling and gardening. Patients and HCPs liked the app (Figure 2); Fit4surgery.uk has further information. <bold>Conclusion:</bold> Fit4Surgery, an acceptable app, was developed using DD user-centered design to complement face-to-face prehabilitation in the LVRS pathway. Fit4Surgery LVRS feasibility study results will be presented during the meeting.