ABSTRACT
Purpose of Study In March of 2020, the World Health Organization declared the coronavirus (COVID-19) a global pandemic. As the number of cases increased worldwide, existing hospital infrastructure struggled to keep up with the demand for equipment and supplies.This exposed healthcare workers to contracting the disease. The purpose of this study is to demonstrate an emergency innovation response in overcoming shortages of personal protective equipment within a university hospital setting, with a special focus on powered air purifying respirators (PAPRs). Methods Used The Center for Medical Innovation (CMI)-a center designed to promote research and development of high-impact healthcare products at the University of Utah (UofU)-enlisted university engineers to develop an open source PAPR system made from readily available commercial materials. Parts were selected to meet filtration, airflow, and protection specifications as outlined by industry standards. Commercially available parts consistent with these specifications were assembled into a novel PAPR system which utilized 3D printed pieces on demand to achieve compatibility. Once assembled, each PAPR went through protection testing to demonstrate health worker safety. A fit factor of 200 is the minimum requirement needed as defined by NIOSH. Testing procedures were carried out with industry standard equipment. Summary of Results A human centered design approach was utilized in iterating versions of the product based on repeated fit testing. Failures were addressed in subsequent models. All PAPRs passed fit testing with a score of > 1000. Following the lean processing standard of just in time inventory, materials to fabricate 1000 PAPRs were procured and assembled on demand. PAPRs are now being used by the UofU Hospital as well as other affiliate entities globally and are filling the gap needed for PPE. Approximately 200 units have been donated to Navajo Nations hospitals in the state of Utah and others have been donated to university sister entities in India, Nepal, and Kenya. Conclusions The Center for Medical Innovation at the University of Utah has facilitated a rapid emergency innovative response in filling the PPE needs locally and abroad by creating this open source accessible PAPR system.
ABSTRACT
Purpose of Study In the spring of 2020, the coronavirus pandemic brought new challenges to healthcare systems as the rising demand for protective equipment led to product and resource inequalities around the globe. The inability to safeguard workers led to increased infection rates and deaths of healthcare professionals worldwide. The purpose of this study is to evaluate the response of an in-house innovation committee to meet the unforeseen needs faced by healthcare systems during an acute medical crisis. Methods Used Housed directly within the University of Utah's health system (U Health), The Center for Medical Innovation (CMI) teamed up with the hospital's administration, BME, COVID task force, and occupational health to create an innovative think-tank to tackle the challenges brought in by the coronavirus pandemic, with the purpose of stratifying clinical needs based upon acuity, frequency, and urgency. While prioritizing equipment needs, CMI used human-centered design to analyze common industry practices, engineer comparable solutions from commercially available materials, test reimagined products against known gold-standards, and create open-source assembly guides that allowed others facing similar shortages to do the same. Summary of Results The close-working relationship between CMI and U Health allowed for the rapid identification, innovation, and engineering of products that met the needs of healthcare workers during the months following the COVID pandemic. Many of these were directly adopted in clinical settings, including aerosol containment tents, powered air-purifying respirators, and self-testing stations. Additionally, CMI identified and engineered 20 additional readily producible, rapid-response products in anticipation of future needs, such as a bubble CPAP, containment boxes, and re-usable PPE. From these, dozens of open source, 'Improvised Personal Protective Equipment' manuals were shared with global partners to address the inequality of medical equipment in lowresource settings. Conclusions The rapid development of easily-producible, lowcost solutions for acute clinical needs-especially those faced by the equipment shortages seen during a pandemic-is improved via the partnership between health systems and a center for medical innovation.