Redesigning Neonatal Healthcare
Experts agree that premature infants fare better in neonatal intensive care units (NICUs) when they’re periodically removed from isolettes so that parents can hold them against their chests (a practice known as kangaroo care). But this simple procedure is often overlooked due to the many cords attaching preemies to monitors and other devices, along with lack of space in “open bay” NICU settings.
Students in Redesigning the Neonatal ICU – an interdisciplinary class at Stanford’s d.school co-taught by Dr. William Rhine and industrial designer Jules Sherman 94 ID – are working on empathy-based solutions to this and other NICU design problems. Their ideas include cord organizers that can be used to alleviate parent anxiety while providing kangaroo care, a knock-down chair specifically designed for kangaroo care in space-challenged NICUs, privacy screens that attach to headwall systems (for encouraging breastfeeding in the NICU), and NICU-to-home transitional training programs and informational mobile apps for parents bombarded by clinical information during their stay in a NICU.
“There’s a lot of resistance to change in the healthcare industry,” says Sherman, who holds a master’s degree in design from Stanford. “And the big medical device and supply companies have left problems like this largely unsolved because the market in pediatrics is usually too small.”
With about 500,000 premature babies born in the US each year, this “small” market might actually amount to revenues in the low millions for a specific device or product designed for the pediatric community, Sherman explains. The biggest issue for small pediatric medical device companies is finding grants or investors to help pay for expenses like running clinician/patient focus groups for feedback on prototypes, creating molds, producing products for testing, developing a quality system and 510K (FDA) and IP development/management. “Luckily for passionate entrepreneurs in this space,” Sherman says, “pediatric medical device consortiums around the country are now required by the NIH [National Institutes of Health] to give part of their funding to innovators developing devices that improve patient outcomes and/or clinician work-flow but have a smaller financial return.”
Inspired by personal experience
Her own hospital birthing experience in 2010 inspired Sherman to launch her company Maternal Life in 2012 – at about the same time she began developing d.school classes for healthcare design. “It was one issue after another,” she says about giving birth in a small hospital in California. “The whole time I was there I was analyzing the hospital experience – from the products that interface with the body to the communication style of the nurses to the legalities surrounding a high-risk birth scenario. For me the entire experience fell short on many levels.”
While a new mom at Stanford, Sherman got to work designing Primo-Lacto: A Closed System for Colostrum Collection & Feeding. Based on the research done by her advisors, Dr. William Rhine and Dr. Jane Morton, Primo-Lacto is the first product dedicated to colostrum collection and administering from a single container (a syringe), which eliminates contamination after expression.
“If you’re separated from your infant and don’t express your colostrum, lactogenesis is put on hold and sometimes never happens,” Sherman explains. “It’s so important for the baby to get the colostrum, which is filled with antibodies and immunoglobulins. When a baby is fed their mother’s colostrum it is as if the mother is giving her neonate a first vaccination.”
With the prototype for Primo-Lacto currently in its 14th iteration, the device could get to market by late 2015, if funding efforts are successful. “This fall the New England Pediatric Device Consortium offered our team a $10K pre-seed grant,” Sherman says. “We are grateful to have this support, but in order to complete development and testing, we will need close to $100K more in funding.”
A designer’s perspective
In addition to teaching and designing her own products, Sherman is also helping teams of clinicians to write NIH and internal university grant proposals that benefit from her perspective as a designer. One such proposal involves helping adolescent cancer survivors resume a more normal life after treatment. A second one recently funded by the NIH is entitled Optimizing safety of mother and neonate in a mixed methods learning laboratory. Sherman will be working on the second proposal with the Center for Pediatric and Perinatal Education (CAPE), “an amazing medical simulation lab founded by Dr. Louis Halamek,” for the next few years.
“I tell my students that you don’t need a medical background to be a designer in the healthcare space,” says Sherman. “In fact, I believe it can be powerful to observe as an outsider who hasn’t been brainwashed by a standard western medical education and is able to ask the questions clinicians might be too jaded or busy to ask.”
Sherman says that her RISD education and approach to critical making play into all of the work she now does. “If you’re doing it right,” she explains, “your users are designing the product and you’re executing its design at the appropriate resolution to get the feedback that’s needed. You can’t fall in love with your product. You have to be willing to go through as many iterations as it takes to get it right.”
Sherman also values the “real appreciation for the touch, feel and look of things” she took from RISD. After all, it’s not just about whether the design works, she points out, because “if the product looks clinical, ugly or scary, people won’t want to use it.”
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