Triage Nurse Lainé tries the Pelican prototype designed by students from MIT-RISD Product Design and Development. Getting tangible prototypes into the hands of real users right away yields vital feedback like this comment from Lainé: “I usually only need two minutes to check vitals on each patient during the admissions process; five minutes at the longest. A device that takes two minutes to give a reading would take much too long.”
The Design that Matters team just returned from an incredibly productive field research trip bringing our Pelican Newborn Pulse Oximeter prototypes to Haiti. Our two gracious hosts for the trip were Partners In Health and the Saint Boniface Haiti Foundation.
With Partners In Health, we had the pleasure of visiting three sites: a primary healthcare center in Boucan Carré, secondary referral facility L'Hôpital Sainte-Thérèse de Hinche, and the brand new Mirebalais University Hospital. Together we discovered major opportunities for a partnership designing global health technology that can impact the interconnected Partners In Health hospital system where it can help the most.
We were very lucky to travel with pediatricians Jack Long and Delight Wing who have been working in Haiti for decades and with Partners In Health for the last three years. The combination of interviews about pediatrics in Haiti and leveraging their introductions to hospital staff at all three sites made all the difference. Reflecting on Pelican’s possible uses in Haiti, Dr. Wing said, “Using the Pelican during an intervention could make sense. For instance, putting it on the foot, then altering oxygen level, or unblocking an airway, then watching the Pelican readout until oxygen levels to stabilize and move on to the next patient.”
Left: Nurse Bien-Aime Iphonise shows how she uses the adult fingertip pulse oximeter to get blood oxygen readings from newborn feet. Right: Nurse Lelia Dorcin displays a disposable pulse oximeter probe and the alcohol wipes she uses to clean it before reuse
We felt extremely lucky to see how pulse oximeters were currently being used at L'Hôpital Sainte-Thérèse de Hinche. Monica Terez is leading the Ohio State University Greif Neonatal Survival Program to build newborn services at Hinche beginning with a new neonatal ICU that opened only months earlier.
Monica introduced us to Lelia Dorcin, the Nurse Manager of the new unit. Before the OSU project, Lelia said, “I sometimes used the adult fingertip pulse oximeters to read blood oxygen levels on newborns. They work ok, but you have to put two fingers inside to get a reading from a newborn. Now we have both Masimo and Nellcor pulse oximeters in the newborn unit. We use the disposable sensors that wrap around the foot with tape. The sensors last 1-2 months even though they are disposable. We clean them between use on each baby.”
Healthcare providers at all three hospitals loved the familiar and friendly aesthetic of the shoe pulse oximeter prototype.
At L'Hôpital Sainte-Thérèse de Hinche, we also met Bien-Aime Iphonise, Nurse Manager for Pediatric Emergency Department. We showed her the shoe prototype and she responded the same way so many other responded: “I smiled when I saw that prototype because it’s so cute!” Dr. Jean Louis Judson, Medical Director of Boucan Carré Health Center elaborated; “The shoe is the best idea for children because it’s a shoe, which is familiar. The other prototypes can look strange and bizarre, but the shoe will make everyone, especially children, more comfortable.”
Chief Nursing Officer Marc Julmisse considers how to best represent blood oxygen level and heart rate so the broadest audience will understand it.
We had a tremendous meeting at Mirebalais University Hospital with Deputy Medical Director Dr. Pierre Marie Cherenfant, Chief of Pediatrics Dr. Romain Jean Louis, and Chief Nursing Officer Marc Julmisse. Looking at the Pelican electronic display, Marc commented, “We need a way to know whether the signal is good. We are used to seeing the waveform showing the heartbeat, but perhaps the waveform won’t be long enough on this small screen.” We also interviewed Director of Biomedical Engineering Monette Valliere to better understand the trials and tribulations of selecting and maintaining equipment throughout the hospital.
Deputy Medical Director Michelle Morse shows us her favorite piece of lab equipment, the ISTAT. It can complete multiple vital lab tests completed at the bedside. Unfortunately it shuts down after 15 minutes outside of an air conditioned room and they do not have the cable to allow them to update the software every six months.
Dr. Michelle Morse, Deputy Medical Director for Haiti, joined us for dinner on Thursday night. She invited us to see the lab at Mirebalais University Hospital the next morning. We discussed some of the challenges in finding lab equipment that is appropriate to the environment in Mirebalais. We also reviewed how the lab affects the patient throughput and healthcare outcomes for the entire hospital.
We want to thank Maggie Smith for her amazing tour of the road to Mirebalais as well as her efforts managing all arrangements for the Design that Matters team during our first ever trip to Haiti.
Overall, the Partners In Health system in Haiti is truly impressive. Seeing a network of 12 sites working together is truly powerful. Gaining access to hospital staff is one of the biggest challenges we face in our work, so it was a real pleasure to work with a team who values and gives voice to all the different healthcare providers. We are now synthesizing what we learned and looking forward to creating the next version of the Pelican pulse oximeter.
Partners In Health is a Boston-based global health organization relentlessly committed to improving the health of poor & marginalized people. Partners In Health establishes long-term relationships with sister organization like Zanmi Lasante in Haiti to bring the benefits of modern medical science to those most in need of them.
This international field research for Project Pelican was made possible with support from the following: An Anonymous Donor of Dietel Partners, Suzanne and Michael Graves; The Ansara Family Fund at The Boston Foundation; Jonathan Moulton; Ben Vigoda; Emily Vanderbilt Wade; Premier Platinum Sponsors Dassault Systèmes and SOLIDWORKS; Philippe Villers; Dr. Steven Ringer; Gold Sponsors Boston Design Solutions and Optikos; Silver Sponsor Supporting Strategies; Eastern Bank Charitable Foundation; Jack Oldham and Virginia Mulkern; Dr. Ralph and Christina Sweetland; and the 130 donors from our Indiegogo crowdfunding campaign.