Getting frontline staff to properly wear and dispose of personal protective equipment (PPE) is a persistent problem across many hospitals.
“Masks, gowns, and gloves are all really important for infection control in a hospital setting,” says Dr. Lennox Huang, Chief Medical Officer at The Hospital for Sick Children (SickKids). “It’s important that people know when to use PPE, how to put it on properly, and even how to dispose of it.”
Despite the efforts of SickKids and its partners, some frontline staff still aren’t using PPE properly. Dr. Huang says that a web of complicated factors make PPE compliance a challenge for hospitals across the country.
The complexity of this problem made it a great case for McMaster’s Innovation by Design (IBD) course. Offered by the Health Leadership Academy, IBD exposes students to design thinking — a problem-solving process that considers how different users experience a given problem. As a joint venture of the DeGroote School of Business and the Faculty of Health Sciences, the Academy is committed to nurturing bright thinkers and doers who want to work across disciplines to solve complex health challenges.
With guidance from Dr. Huang and course instructors Dr. Sean Park and Dr. Michael Hartmann, a group of five IBD students spent months applying design thinking methods to their challenge at SickKids. Alexandrea Johnston, Krish Bilimoria, Caleb Kim, David Lee, and Carolyn Ly first met with Dr. Huang in the fall of 2017.
“We felt like we were in over our heads working with SickKids,” Johnston recalls. “It was different than anything we had studied at school, and we weren’t sure what to ask or how to approach the project.”
Dr. Park says this sense of uncertainty is a key part of the learning process for students.
“A big part of design thinking is learning to work with ambiguity in the context of challenging issues that don’t have clear answers,” Dr. Park says. “The course gives them the permission and the tools to hang out in the uncertainty.”
Originally, the team had assumed the nurses’ tacit knowledge of PPE would be the best way to train incoming staff. However, after considering the problem as budding design thinkers, the students decided to focus on how users experience the process of selecting, donning, and disposing of PPE.
Johnston says the process of empathizing with patients, physicians, and other staff challenged her assumptions.
“I grew up thinking that medicine –a field based on regulations and rooted in science – is able to arrive at the best possible answer,” Johnston says. “The design thinking process showed us that there can be many right answers to a problem.”
Through many consultations with stakeholders, the team learned that distraction and confusing signage had a large impact on how well physicians were wearing PPE. In addition, they found that negative experiences in the past – such as alienating a patient by wearing a mask – could also affect compliance.
With all of this feedback, the students arrived at a potential solution: a visual approach to signage.
Their prototype uses visual prompts at each step to clarify how physicians can locate PPE, put it on, and dispose of it. The suggested signage also integrates statistical facts about the risk of cross-contamination to encourage proper usage.
The overarching goal of the prototype is to standardize PPE across the hospital, rather than relying on a few workers to share information with incoming trainee staff.
The experience of empathizing with users to develop a solution is something the IBD team will bring with them to the next phase of their careers.
Johnston plans to apply user-empathy to a future career in law, with a focus on health. Bilimoria, who starts his first year of medical school this fall, says IBD gave him another way to approach the problems he will face as a healthcare professional.
“Innovation by Design truly offers an opportunity for students to construct our own understanding of the complexity of processes, systems, and organizations that govern and deliver healthcare,” Bilimoria says. “I recommend the course to students in any discipline with any semblance of interest in health innovation.”
Meanwhile back at SickKids, Dr. Huang is already using the students’ background work as he plans safety and quality targets for the upcoming year. Going forward, he hopes to use design thinking as a complementary tool to solve problems at the hospital.
“Working with the students was inspiring to me as a healthcare leader,” says Dr. Huang. “I feel confident that the next generation coming through will be taking a bit of a different approach to some of the stickier and trickier problems in a hospital setting.”
For students entering the 2018-2019 academic year, the introductory Innovation by Design course will be offered as a 3-unit course. Enrolment is now open!