The Problem
During my graduate program, one of the last courses I took was Healthcare Design of the Future. The premise was to form multidisciplinary teams to tackle a problem space in the healthcare industry. We partnered with Children's Healthcare of Atlanta (CHOA), specifically the Cardiac ICU. The class began by researching the history of ICUs, followed by forming our teams, and then writing a paper on our team topic.
Hand hygiene was the problem space my team picked, and it certainly proved challenging. During research, I found that compliance has been a big program in the industry for as long as it has been tracked, and of the many attempted solutions, none found success. One interesting piece of research was that compliance education for nurses had no long-term effect on compliance, despite being the default choice of many hospitals to combat compliance dips.
The Stumble
We had to go through a lengthy process before we were allowed to go to the hospital itself. Unfortunately, the certification process took over a month, so in the meantime our team started brainstorming solutions without the opportunity to complete user research. By the time we were able to talk to CHOA employees, we had started designing a compliance monitoring system that would detect when employees were supposed to clean their hands and alert them if they did not. Our goal was a sort of Fitbit-style tracker that, instead of reminding you to move, would remind you to wash your hands at the right moment.
When we were finally able to meet with CHOA representatives, we hit a brick wall. They weren't interested in an expensive monitoring system at all! In fact, they weren't even interested in improving their compliance monitoring. They wanted a solution that would address the root problem of compliance itself. We were back to square one.
The good news was we could finally do user research and interviews. Taking turns, we observed the Cardiac ICU as nurses completed their tasks; as nurses went off their shifts, we pulled them aside to get quick in person interviews. After that, we had a much clearer picture of the issues they faced. The key issue we teased from our user research was accessibility. Much of the rest of the hospital had a more traditional setup, with a room for each patient and hand hygiene stations outside and inside each room. The Cardiac ICU is set up as an "open bay," or a series of beds separated only by hanging curtains. Hygiene stations are on the outside edges of the room.
The Solution
Given this new information, we went back to brainstorming. After several rounds, we had a new idea: what if nurses had access to hand hygiene devices from their computer carts? The carts are glued to their side as they chart patients' progress. We took this idea to CHOA to get feedback and they loved it. Their main question for us was, when can they buy them? Encouraged by this, we went through several physical prototypes, using cardboard models and finally, 3D printing.
The Reflections
We received positive feedback at our research showcase at the end of the semester. The most frequent comment was, "I can't believe this idea is so simple, but it works!" That was a key lesson for me during this project. A simple idea with strong execution can be more impactful than a complex and costly technical idea. Keeping your eyes open to the root problem can lead to a radically different solution.
