What came before Each year hundreds of patients have to be returned to the Netherlands from all over the world. These medical transports are also referred to as repatriations. Due to the expensive and difficult circumstances of existing medical transport services, an innovative design was required that would enable a secure, flexible and more affordable alternative. It was up to Medness, a team compromising of six students including the author of this report, to design such a medical unit. Their final result is called the Guardian. The Guardian is an Intensive Care environment for repatriation purposes on long-haul flights. It consists of a small, modular cabin with three walls and a diagonal entrance. The dimensions of the cabin allow installation in airplanes such as an Airbus A330-300 and a Boeing 777-300. In order to carry the patient in- and outside more easily, a diagonal entrance was chosen. The interior consists of a medical stretcher, a variety of medical equipment and two seats for an intensivist and a nurse. The medical team is specially trained for these repatriations and continuously remains close to the patient, in order to enable a secure transport. The exterior of the Guardian The Joint Master Project ended with a conceptual design for the construction of the cabin walls and a business model. However, the impact of the Guardian on its surrounding environment was not yet fully considered. The goal of this project is to create optimal conditions for those directly and indirectly interacting with the cabin. Optimisation can be achieved by detailing all communication possibilities, the exterior appearance of the cabin and the overall protocol for those involved, henceforth referred to as users. This report recognises five different user groups: Family members Key challenge: Even though they sit nearby the cabin, they are not informed on what to expect from the flight. Regular passengers Key challenge: They are unfamiliar with this new medical unit and have no way to receive additional information. Cabin crew Key challenge: Their assistance could be necessary during emergency situations inside the Guardian, yet they have not been briefed and do not know what to expect. The medical team Key challenge: They have had no chance to prepare their repatriation properly. Therefore, they are not entirely aware of the Guardian's possibilities. Also, they receive no guidelines on how to interact and communicate with family members and cabin crew. The patient Key challenge: Although in most cases heavily sedated and unconscious, he/she does not benefit from a medical team working under suboptimal conditions. Repatriation analysis By interviewing four intensivists, all experienced with repatriation, a complete overview was formed of the steps all of the users go through during a repatriation on board of an airplane. This user journey helped to form three different scenario's: Scenario 1 | First impressions The moment where each different user group experiences the Guardian for the first time. Scenario 2 | A quiet flight In most cases, repatriation involves an uneventful flight with no serious problems for the patient. Scenario 3 | Emergency Despite the secure environment of the Guardian, emergencies concerning the patient are possible and the Guardian has to accommodate accordingly. The scenarios were necessary to compile an overview of remaining issues. These can be summarized in three main problems: Main problem 1 Users are not properly informed on the purpose of the Guardian. Main problem 2 Users experience problems with communication between different user groups. Main problem 3 Current forms of repatriation revolve around the cabin and do not fully accommodate users' interactions. Instead of producing a universal design to fit all users, a holistic approach was taken by considering the relationship between a few separate designs and the Guardian concept as a whole. The designs should function on their own for each user they are meant for, but a combination of them is supposed to optimise Guardian repatriation in its entirety. Separate user studies with different participants, such as regular passengers, cabin crew or intensivists, were required in order to form four final designs. Final design 1 | Information for Family / Passengers By providing family members and passengers with two brochures, they can be fully informed of what the Guardian entails and what they can expect. Final design 2 | The Guardian Guide The guide is meant to support the medical team during three stages: before, during and after the flight. By providing an overview of all the on-board equipment and medications they can prepare the repatriation beforehand. It also informs them in what ways they can brief the cabin crew and how to keep the family informed during the flight. Lastly, the guide advices them to prepare the transfer of the patient in a pre-specified document. Final design 3 | The Guardian Wearable During an emergency, situations might occur where the medical team requires assistance from a cabin assistant. The Guardian Wearable helps them to instantly contact someone without having to leave the cabin. A small, wireless device, worn by a cabin assistant, enables this form of contact. Final design 4 | The cabin walls The walls enable passengers to immediately get some notion of the purpose of the cabin. On each side the Guardian logo is featured, along with the words: Secure Patient Transport. This only has to communicate the utmost basic essence of the cabin, since further information can be found in the Information for Passengers brochure.