Providers standing next to a negative pressure hood
From left, Rodrigo Lozano, Jingping Wang, MD, PhD, Samuel Smith, MD, MPH, and Kendrick Shaw, MD, PhD, stand next to a negative pressure hood designed by Dr. Wang.

The innovation emerging from the COVID-19 pandemic is happening at breakneck speed, as scientists continue to develop innovative solutions to keep patients and staff safe at the hospital.

Ideas, knowledge and advances are streaming from Massachusetts General Hospital's laboratories, bedsides, clinics, offices and workshops–and from a cluttered corner of Ruth Sleeper Hall.

The Prototype Staging Center–part of the Mass General Brigham Center for COVID Innovation – is a modest suite of rooms, teeming with boxes, papers, laser-cut plastic sheets and strips of foam rubber padding. It is also a launching pad of sorts for novel devices that have been–or are being–developed in the fight against COVID-19.

A small, enthusiastic team of research engineers, led by Matthew Beatty, occupies this tucked-away space. Their goal is to find something, test something, design something, develop something that will keep staff safe, help patients and improve care.

Other members of the group–Alexander Krall, Evan Sevieri, Alissa Cirio and Seth Judson–coordinate, catalogue and ponder the broad spectrum of devices, including N95 respirators, face shields, surgical masks, isolation gowns, ventilator add-ons, bed-top isolation hoods and large personal protective testing booths.

Recently the focus has been on face shields. Varying types of the devices are laid out on a desk, several from commercial companies, one sleek 3D-printed model, several high-quality shields with grayish headbands manufactured by clever students from a local school and two hybrid versions specially designed by the Ruth Sleeper team to meet the needs of staff on the COVID frontlines.

One of the Ruth Sleeper team’s designs is a more protective, more enclosed, more padded option, while the other is a lightweight, laser-cut and cost-effective model.

In the days to come, these modified face shields will be assessed for durability, visibility, comfort, fit and protection, and then will be rigorously tested by staff to get feedback about benefits, downsides and pain points.

Large-Scale Isolation Enclosures – A Safer Way to Deliver Care

On a table in the Prototype Staging Center sits a large hard-plastic bubble. Dubbed Apollo, it is the brainchild of Samuel Smith, MD, MPH, from Anesthesia, Critical Care and Pain Medicine, in collaboration with faculty from Harvard and MIT.

This Apollo patient isolation hood enables clinicians to perform aerosolized generating procedures on those with COVID-19 more safely. The lightweight portable device uses negative pressure to prevent particles from escaping out of the hood. Caregivers have ready access to the patient through sealed portals at the rear. Apollo was recently rolled out to the operating rooms, emergency departments and ICUs.

A parallel structure–this one without a name–uses PVC pipe that serves as a frame for a clear drape on a hospital bed. The cube-like device–the first negative pressure hood here at Mass General–was developed by Jingping Wang, MD, PhD, of Anesthesia, Critical Care and Pain Medicine. It features extra portals so more than one person can access the patient during procedures, protecting all caregivers from exposure to aerosolized virus.

In addition to Drs. Wang and Smith, the team responsible for developing, testing, gathering data and advancing the two isolation hoods includes Kendrick Shaw, MD, PhD, and Michele Szabo, MD, both of Anesthesia, Critical Care and Pain Medicine, Rodrigo Lozano, Biomedical Engineering, and Angela Dai, MD, Anesthesia resident.

Provider demonstrates the Edele wall
Erin Graves, RN, demonstrates the Edele Wall in the Emergency Department triage area.

Success of Hexapod Booth Leads to New Models–Introducing Oasis and Edele

One of the major device success stories in the COVID-19 pandemic has been the creation of three models of personal protection booths that provide a barrier between clinicians and patients while maximizing human connection with sight, touch and voice.

The first, called a "Hexapod," is an 8-foot-high plexiglass booth with six arm portals for high-throughput testing, using HEPA-filtered air to permit safe testing while minimizing use of personal protective equipment (PPE). These booths were inspired by a design originally used in South Korea’s Yangji Hospital and modified by members of the Full-Body Protection Working Group and the Mass General Springboard Studio.

Kristian Olson, MD, MPH, who co-leads the Whole Body Protection working group with Smith, is director of the Springboard Studio, a group focused on improving health care through ideas from those closest to the health care challenges. Paul Currier, MD, director of the Respiratory Care Unit, and Olson co-lead the team that created the booths.

The impressive devices have been used in various locations in the Partners system, including the Lunder Respiratory Illness Clinic, the Yawkey Routine Ambulatory Clinic for COVID-positive patients, Chelsea HealthCare Center and Newton-Wellesley Hospital. Two new versions of the booth have been created:

  • The Oasis, a negative-pressure system in which the patient is inside and the caregivers are outside
  • The Edele, a plexiglass wall with built-in glove portals for evaluating patients at triage (shown above)

In addition to increased patient and provider safety, all models decrease the need for personal protection equipment and make it easier to treat more patients.