A temporary tracheostomy—an opening created in the neck to facilitate placing a tube into a person's windpipe—can be essential for allowing a critically ill patient to come off a ventilator.
As the COVID-19 pandemic continues to evolve, hospitals and health care organizations have continuously adapted their practices to overcome new hurdles and keep the focus on safe testing, treatment and triage option.
To meet these needs, innovators from Massachusetts General Hospital and Partners HealthCare have joined with industry experts to design, test and deploy Personal Protective Booths (PPBs), aimed at reducing the risk of COVID-19 exposure for both patients and providers. They also are hoped to help with personal protective equipment (PPE) conservation efforts, and to help increase the number of patients tested for coronavirus.
The first testing booth was installed last week and began testing at Newton-Wellesley Hospital on Thursday.
Paul Currier, MD
The fact that the team was testing a prototype in nine days and has a device in use within weeks really speaks to the process and the group we’ve been fortunate to work with.”
Mass General Respiratory Care Unit director, Harvard Medical School assistant professor and project co-leader
The booth concept—based upon testing “phone booths” that were developed in South Korea—allows a clinician to stand inside, apart from the patient and administer a swab test from gloved external hand ports, which are featured on three sides of the booth to increase throughput. Because the individual inside the booth is not in direct contact with the patient, they do not use additional PPE beyond standard exam gloves and surgical masks which saves vital supply of items, including N95 masks, face shields and gowns.
“This project is really a product of design thinking and end-user feedback,” says Kristian Olson, MD, director of the Mass General Springboard Studio, a group supported by the Massachusetts General Physicians Organization to engage patients, providers and staff in human-centered design to make healthcare more user-friendly. “We’ve worked to combine the skills and talents of engineers, designers and care providers with the feedback and experience of actual users—like our colleagues in South Korea and here at home—to develop a device that works well for both patients and caregivers.”
The project, Olson says, was born from a request from Anne Klibanski, MD, president and CEO of Partners HealthCare and Gregg Meyer, MD, chief clinical officer at Partners HealthCare, who became aware of a similar device deployed by health care workers abroad.
The PPBs’ ability to switch from positive to negative air pressure means it can be used both as a place for health care workers to provide tests and also a vehicle in which to provide patients with oxygen and nebulizer treatments while decreasing risk to caregivers. Other features include a hands-free intercom system and safety dividers to ensure proper distance between patients.
“It’s really useful to be engaged in the early stages of design as a frontline provider. One piece of feedback we provided for the testing booth was to increase the glove ports from one wall to three walls. Our walk-up testing clinic already has very high throughput and I wanted to maintain or increase that. I’m excited to use it. I don’t think it will slow me down one bit,” said Amy Israelian, NP, lead advanced practice provider at Newton-Wellesley Hospital.
The team, which has worked closely with the Partners Center for COVID Innovation, is in the process of developing another seven units to deploy across Partners institutions. The next testing booth is prioritized for MGH Chelsea HealthCare Center as that clinic expands testing capabilities for the community.
“The fact that the team was testing a prototype in nine days and has a device in use within weeks really speaks to the process and the group we’ve been fortunate to work with, “ says Paul Currier, MD, director of the Respiratory Care Unit at Mass General, assistant professor of Medicine at Harvard Medical School and co-leader of the project. “We knew we couldn’t just approach this from a clinical perspective, we needed business, regulatory and process-oriented minds to help us overcome some key obstacles.”
The process, as Currier outlines, involved working with an external design firm, Eleven LLC, to essentially create an entirely new, small, nimble company to specifically tackle the safe testing, treatment and triage challenges. The entity, called Healthcare Innovation Partners (HIP) exists solely, Currier and Olson say, to harness the resources of health care and private sector entities and move quickly through various processes involved in getting medical devices into the hands of providers and patients. Both have a minority interest in the company.
“We believe people closest to the challenges—patients and providers—know their needs best. Working with a range of disciplines, like designers, we can co-develop practical solutions rapidly with the intimate knowledge of what matters most to the people who will actually be using them,” said Olson.
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