# Developing an App for Real-Time Daily Life Observations in a Nursing Home Setting: Qualitative User-Centered Co-Design Approach

## TL;DR

This paper describes the development of a user-friendly app to replace a time-consuming Excel tool for observing daily life in nursing homes.

## Contribution

The study introduces a co-designed app version of the MEDLO tool, emphasizing user-centered design and iterative improvements.

## Key findings

- User feedback led to key improvements like automated data handling and an intuitive tablet interface.
- Early and continuous user involvement significantly enhanced the app's usability and functionality.
- The iterative process resulted in an app that better meets the needs of researchers and care professionals.

## Abstract

Assessing the daily lives of older adults, including their activities, social interactions, and well-being is essential, particularly in nursing homes, as it gains insights into their quality of life. Methods such as the Microsoft Excel-based Maastricht Electronic Daily Life Observation (MEDLO) tool are time-consuming and require extensive manual input, making them difficult to use.

This study aimed to develop an app-based version of the MEDLO using a user-centered design (UCD) and co-design approach to enhance efficiency and usability. We looked to actively involve researchers and care professionals who have used the MEDLO before, throughout the development process.

Participants included a diverse group of researchers and care professionals experienced in using the MEDLO tool. The UCD approach involved multiple iterative phases including semistructured interviews, user research sessions, and application development. Data were analyzed using a qualitative (thematic) approach of UCD and user research sessions. The app, which was preferred to the traditional Excel-based MEDLO, underwent multiple iterations. This method primed the continuous iterative development of the app, aimed for a minimum viable product (MVP).

This study included 14 participants, primarily female, from diverse professional backgrounds. Their feedback highlighted the need for efficiency improvements in tool preparation and data management. Key improvements included automated data handling, an intuitive tablet interface, and functionalities such as randomization and offline data syncing.

The iterative development process led to an app that aligns with end-user needs, indicating potential for improved usability. Early and continuous user involvement was key in enhancing the application’s usability, demonstrating the importance of user feedback in the development process.