Efficiently Creating Solutions in Health Care Simulation

“If at first you don’t succeed, try, try again” is a common phrase that we all learned as young kids, the idea being that you need to learn through mistakes. While this may seem like a simplistic idea, biomedical engineers around the world utilize this exact same notion when developing their products for the health care industry.

However, we don’t simply create a product, use it on a patient and then see if it works; that is obviously incredibly dangerous in a world where life and death can be on the line for patients using our products.

Instead, we utilize a process called biodesign, which focuses on iterating prototypes very early in the design process using our customers as our guides. At the Jump Trading Simulation & Education Center, biodesign processes are used every day to create the great simulation products you use and see.

The Biodesign Process

Here’s how it works: we start by identifying a clinical gap in a discipline of health care—a skill or area where patient outcomes could potentially be affected by an engineering solution. Before we even start building anything, we go through a rigorous process determining the most viable solution, as well as classic upstream marketing metrics such as total addressable market and target segments.

As we begin prototyping, we are in constant contact with the end-users of the product—the ones who will actually be interacting with the product once completed. In Jump Simulation’s case, this is generally nurses, doctors and EMT’s, but we have worked with nearly every discipline within OSF HealthCare over the past several years. This clinical exposure is the key to our success; without adequate clinician interaction, products are doomed to fail from the beginning.

As each prototype or feature is generated, the end-users are brought in to assess the usability of the design. The goal of this engagement is to make sure we have the most efficient design in the simplest form. By interacting with the engineers at this stage, clinicians can help engineers understand where some functions may be superfluous, and others may be lacking and need improvement.

This is incredibly important to determine early in the design process. Imagine creating a device with no clinician interaction early on, based only on what you can read and your previous knowledge. The device would work no doubt because our engineers are excellent, but the value in our effort comes from creating a product we know will produce results because our clinicians and have tested and approved it.

How Biodesign Has Been Useful at Jump

Two products Jump utilized this process are the CAUTI trainer and the Bubbler. The CAUTI trainer was developed to help properly train nurses in the technique of inserting a female catheter to avoid causing any catheter associated urinary tract infections (CAUTI). Traditional methods for teaching this technique either relied on experience in the clinics, and training on mannequins already on the market.

These mannequins seemed to be a good training medium, but there were two issues: they were very expensive, and the anatomy was very unrealistic compared to the patients who generally needed to receive urinary catheters. Thus, we were tasked with generating an inexpensive and anatomically accurate model to teach catheter placement.

After discussing how these procedures are performed with seasoned nurses, we determined the trainer should include a way for nurses to learn how to maintain proper sterile technique, the correct manipulation of a difficult to access anatomy and a urine flashback to indicate proper placement. We iterated through about 15 different designs of both the anatomy and the flashback mechanisms, discussing with the nurses every step of the way.

“What angle should it be placed at? Does this material feel accurate enough? What volume of urine will be necessary?” These and numerous other questions were asked and answered until we came to a finished prototype that met the minimum viable product requirements and the goals nurses wanted to accomplish. The trainer has been used by hundreds of nurses now to practice the procedure.

The Bubbler is a device we designed for the control of a chest tube drain. Through our Clinical Immersion Program, our engineers determined nurses were not being adequately trained in the identification of problems with their patients who had chest tubes. Generally, a patient has a chest tube put in to maintain the pressure in their chest after a cardiothoracic surgery or a traumatic event; this maintenance prevents their lungs from collapsing.

To monitor the integrity of the tube, a chest drain is attached. By troubleshooting issues in the chest drain, a nurse can determine what is wrong with the patient’s tube if there is a problem. We were tasked with creating an add-on product to commercial chest drains to control the movement and functionality of the drain as if it were connected to a patient who had a problem with their tube.

By interacting with nurses and doctors, we determined exactly what each of the incidence states needed to look like for the different types of troubleshooting that would need to take place. We also ruled out needing to use some additional expensive equipment because it was not necessary for the minimum viable product. A story that really exemplifies why this process works so well came from the development of the Bubbler’s pumping system.

After several weeks of sourcing parts to get the pump working correctly on the device, we finally had a functioning system. When we showed it to the nurses, they were not as ecstatic as we were hoping. “The pumping looks perfect, but the noise that the pump makes will draw attention to the device during a simulation, and that defeats the purpose of having the device in the first place,” they said. We had completely overlooked that feature of the device, and without that input, we may have moved much further in development before we determined that there was an issue. The purpose-built environment of Jump, a part of OSF Innovation, allows us to easily collaborate with our clinicians on these important projects.

Quickly Generating Solutions

Jump uses its biodesign principles to a great extent when developing products. By rapidly iterating prototypes with the health care professionals within OSF HealthCare, we efficiently generate solutions to help improve patient outcomes. This clinician-engineer interaction is unique, and allows Jump to continue to be at the forefront of innovation in health care.
Categories: Bioengineering, Clinical Simulation, Clinicians, Collaboration, Engineering, Innovation, OSF Innovation, Task Trainer, University of Illinois (U of I)