A Perioperative Nurses Innovation Journey
I’ve always considered myself a creative person when it comes to problem solving, but it wasn’t until I started working as a Unit Educator (UE) in the OR at The University of Kansas Health System (TUKHS) that this skill became invaluable.
Lorie Hassel-Chuang, BSN, RN
I’ve always considered myself a creative person when it comes to problem solving, but it wasn’t until I started working as a Unit Educator (UE) in the OR at The University of Kansas Health System (TUKHS) that this skill became invaluable.
As a UE, I was part of a team performing a root cause analysis of an RSI event involving a sponge. An RSI is a retained surgical item that is unintentionally left in a patient during surgery. To prevent an RSI, staff must conduct a surgical count of all countable items (instruments, needles, sponges, blades, etc.) used during surgery with zero errors. I was tasked to find a commercial product that would improve visualization of sponges to reduce the likelihood of a miscount.
The current sponge counting process is both time consuming and messy as it requires staff to lift sponge bags that are stacked on top of one another to count the sponges. It is a bloody mess! I researched sponge accounting systems (SAS) currently on the market and spoke to a product specialist within TUKHS. It turns out that there wasn’t anything available that provided the visibility that was needed. Out of necessity, I came up with the idea of a SAS with telescopic arms that can be expanded to increase visibility of sponges used during surgery.
At the next root cause analysis meeting, I spoke about the limitations of current products and how stacking sponge bags not only reduced visibility (increasing the potential of an RSI), but also created biohazard exposure for nurses that must lift each bag to perform a count. I presented my SAS concept and a drawing depicting the telescopic arms as a possible solution. At the end of my presentation the Director of Perioperative asked me whether I had created a new product. This was my eureka moment! I hadn’t thought of it that way, but it dawned on me that maybe I had created something new!
I submitted my idea to the Department of Innovation at TUKHS. Shortly after my submission, I met with John Rochelle who is the System Director for Digital Strategy and Innovation. John was intrigued with the new SAS concept, and thought it had potential. He said something to me that I will never forget, “sometimes the most simplistic of ideas are the most elegant.”
I was thrilled when John wanted to move forward with developing the idea. More importantly, he thought my idea was innovative, practical and had commercial potential. I’m not an engineer; so, I assembled a committee of nurses to help refine my idea and the Department of Innovations hired an engineering firm to help create schematic drawings. John warned me this was going to be a long process that included filing for patent, market research, user surveys, product development, and testing. He made sure that I understood the amount of work that was required of me to help develop the SAS.
And Johns was correct, it a lot of work! I developed a survey tool to solicit feedback on current products. A non-working prototype was delivered and was evaluated by me and a colleague to further refine the design. Seven working prototypes were delivered in February 2022 for use and testing. I solicited staff feedback during the trial and the evaluations have been overwhelmingly positive. It has been gratifying to receive feedback on how much staff really liked using the new SAS and how it was a big improvement from current products. I’ve even had calls from staff looking for available units when they can’t locate one that is available.
The next steps are to provide enough of the new SAS to all of the OR’s within the TUKHS, investigate the commercial potential, and to find a partner that can manufacture at scale. I am grateful that there may be commercial potential that can benefit the TUKHS and am fortunate that TUKHS shares that success with staff that came up with the idea. The thing that I am most proud of and humbled by is that my idea has the potential to contribute to the safety of surgical patients and OR staff worldwide. I am fortunate to have all the support and help I have received from colleagues and leadership. The vision of TUKHS to tap into ideas such as mine by housing their own innovations department has been instrumental in helping my idea come as far as it has.
In closing, I want to implore you to not only be passionate and creative in improving healthcare but to take those creative moments and truly innovate. You never know where it will end up as my simplistic idea has been a ride of a lifetime.
https://www.facebook.com/lorie.hasselchuang
The first video is pre unusable prototype
https://www.youtube.com/watch?v=ofRRburfx4E
The prototype shown in the first video was never used in the Operating rooms, as it was the initial prototype
The 2nd video is actual usage of the prototype in the ORs
