Touch and Go: Fast Interprofessional Collaboration Relief

2.1.1 Design + nursing intense collaboration

Understanding is categorized as an “intense” collaboration phase. During this phase, design and nursing students work closely together. They conduct secondary research and limited primary research. At this point, the students understand why their problem is essential, its pathophysiological attributes, who is most affected, current condition interventions, and where the opportunity gaps are. Most importantly, they develop a list of requirements that they must adhere to, as designers and nurses, to produce a solution that will not only address the problem but also integrate into the users’ lives.

This phase is a three-week process. Students receive strict instructions on uncovering required deliverables, and the importance of delegating responsibilities is critical. Students must work outside of class to complete the phase, so group communication is also of high importance. Team dysfunctions typically emerge here, and faculty are ready to intervene. Providing intervention ensures everyone understands the process and roles. First and foremost, they know the success of the project lies in the team, not with the individual.

2.2.1 Design conceptualization (Figure 1)

Design Conceptualization is a typical ideation phase with a significant caveat. Students reflect on understanding findings and specified design requirements. They use this information as the backbone of their conceptual iterations of product, service, and system solutions. During this time, the design students update their nursing collaborators at least once a week to ensure they are meeting clinical requirements. These meetings ensure concept generation is following clinical guidelines and achieving innovative solutions.

The conceptual exercises begin with thumbnail ideations and conclude with explanatory sketches vetted with the internal D + NC team.

This system includes five thinking tools.

This method was introduced as an in-class exercise, where student teams practiced the techniques on their projects. Next, the design and nursing teams convened to evaluate the current concept directions using the SIT process. By having the design students provide internally vetted concepts, as seen in figure 1, the collaborative teams were able to iterate and find new opportunities based on initial ideas. This process was especially useful for nursing students. In many traditional collaboration scenarios, students not educated in concept development do not participate. There is not a mechanism to allow those students to contribute in an equal manner. Using SIT allows nondesigners to contribute conceptually to the process on an equal playing field and contribute through intellect, not design execution skills.

Of the five thinking tools, Subtraction has proven to be the most effective for the D + NC. The process is as follows:

This exercise made the team think in new directions. It involved everyone, and sometimes the result changed the project direction in unexpected directions.

After concluding this exercise, the teams were instructed to develop one last round of refined concepts, narrowing the total to three to five. These concepts were internally vetted, were visually understandable, and served as the primary research tool in subsequent phases. This split but integrated phase allowed focused concept production, fostered concept direction consensus, created unity in the team, and inspired team confidence that the concepts put forth were the best for gaining feedback.

2.2.2 Nursing preliminary intervention plan

The nursing students also serve as a resource to the design students, providing in-depth content on pathophysiology and feedback regarding the end user’s use of the product. Preliminary interventions, including education modules, are developed.

2.3.1 Design + nursing intense collaboration

The course only permits two weeks for Validation. This time frame includes participant recruitment, interview guide development, and summaries. Teams need organization, and tasks require delegation for proper fulfillment. This phase is an “intense collaboration” to determine whether their concepts and interventions are staying true to the requirements established in Understanding. Validation begins with a “soft” start in the last week of Conceptualization. This overlap allows teams to recruit and schedule face-to-face participant interviews early and begin interviewing at the beginning of Validation. Students quickly understand that these meetings must occur at the participants’ convincement, not theirs. Hence, during the last week of Conceptualization, students are contacting participants and scheduling interview times for the following two weeks. To gain insights teams use conceptual directions as tools for discussion, see Figure 3.

In the first week of Validation, there are lectures on proper interviewing techniques, survey targeting strategies, and question development for interview guides and surveys.

The importance of face-to-face interviews is stressed. Although it is well known that these types of meetings yield the best findings, they are also the most challenging for novice researchers. The faculty present students with documents highlighting best practices from both a question context and interview etiquette. They are taught to be aware of body language and, if lucky enough to interview at the participant’s home or work, how to observe the behavior or living environment. In addition to these benefits of conducting face-to-face interviews, Jamison et al. (2018) note that the interviewer also has the flexibility to modify the direction of conversation during the interview. Using online surveys is necessary as well. The faculty assists teams in finding online blogs and organizations to publish surveys and make sure their questions are directed toward the specific group. Online surveys also provide access to difficult-to-reach groups. Jamison et al. (2018) indicates in a recent study that both face-to-face interviews and online surveys are reliable methods to answer research questions; however, the online forum is better able to communicate participants’ viewpoints from a wide geographical area. Each project is solely a collaboration between students, and the information gained from these interviews with the end users is essential in providing students with direction for their projects.

At the end of two weeks, students present their findings (Figure 3). They review significant insights, potential concept refinements, and a determination of their one final direction.

2.4.1 Design

In this phase, design students start the process of honing the selected concept by developing final Computer Aided Designs (CAD), explanatory imagery, animations, model making, and so forth, that bring together the vision of this well-vetted solution. As in Conceptualization, nursing students were kept aware of developments as the refinements proceeded. This is where trust in the process is critical. Students may need guidance to ensure they are staying true to the voice of the user, but from an executional perspective, they were expected to complete this independently (Figure 4).

2.4.2 Nursing

In this phase, the nursing students carefully review the final selected concept and collaborate to develop necessary support interventions. These interventions generally include patient education materials, instructions for staff training on the final concept, and any other education essential to support the safe use of this concept. For some of our concepts, the design and nursing students have collaborated on the development of a simulation or a video demonstrating correct use of the concept, as well as training modules for end users .

2.5.1 Design + nursing intense collaboration

To finalize, the project teams prepare for the end-of-semester presentation. Designers and nurses review their semester’s work and develop a story that encompasses breakthroughs, drawbacks, and final results. Avoiding the typical critique, the D + NC embraces a participatory review. This review brings together experts from area commercialization centers and shares innovation with the community. Representatives from those entities participate in the final evaluation. The goal is to move our ideas past the portfolio or résumé and into partnerships that could directly benefit from the solution.

The end-of-semester format has taken several shapes, but the most successful was a speed-dating format (Figure 5). Students teams developed a comprehensive 10-minute presentation to share with invited reviewers, who are experts in the fields of design, nursing, and entrepreneurialism. The faculty selected a representative from design and nursing to give an overview of the project and semester goals. Faculty divided critics into review teams and the students presented, allowing productive presentation time and maximizing exposure. Every 15 minutes, guests were asked to rotate. At the conclusion, reviewers approached the project teams and asked more detailed questions. During this time, reviewers voted on their favorite projects. The winning team received a gift, and there was a big celebration. But what is more important than the winner and the ceremony was the fact that an expert evaluated each team. These experts could fund an aspect of the student project or the entire project.

3.1.1 Topic significance

In 2012–2013, several academic medical faculty within the University of Cincinnati’s College of Medicine (COM) developed a Sports Neuroscience Initiative with the goal of bringing innovative, collaborative university research teams together to work toward one goal—to improve the health of student–athletes and enhance their safe participation in high-level athletic programs without risk of lifelong repercussions. The D + NC participated in this initiative by developing conceptual innovation for several sporting activities susceptible to concussion. One area of focus was American youth football (AF). Youth football was selected because American tackle football reports the highest injury rate for all contact sports (Gilbert and Johnson, 2011).

This sport exposes young people to violent collisions with equipment designed for much older players. Also, concussions received when the brain is still developing can have catastrophic effects on long-term development, causing several disorders, including learning disabilities, and increase the individual’s susceptibility to future concussions. One phenomenon that has been revealed through postmortem research on the brains of football players is that of chronic traumatic encephalopathy (CTE), which is a degenerative brain disease resulting from repeated trauma to the head (Gilbert and Johnson, 2011). Tsushima et al. (2016) noted that athletes in high-contact sports, such as football, experienced more subconcussive impacts, thereby negatively affecting speed and reaction time. Also, youth participation in high-contact sports could lead to persisting neurocognitive and developmental deficiencies, often resulting in impaired behavioral functioning and reduced academic performance (Gilbert and Johnson, 2011; Tsushima et al., 2016). This collaborative team chose to address primary preventative solutions to youth football by not only addressing head protection but also designing a system that fits and prevents upper body movements that cause a concussion.

In researching this topic, students found equipment worn by adults was retrofitted for children, making the concussion protective effectiveness much less than optimal. Also, at the age when young people are introduced to AF, their growth is anything but uniform. Some players are fully grown by 13, and others have yet to hit their full size (Figure 6).

3.1.2 Area of team excellence

In the initial research phase, the team gained a deep understanding of the pathophysiological aspects of youth concussions. This understanding enabled the designers to get early conceptual visions of how to address these facts. The team also completed significant work in identifying varying body characteristics. This proved to be a substantial factor when addressing equipment adjustability while maintaining safety requirements.

3.1.3 Collaborative innovation results

After gaining a complete understanding of the issues surrounding concussions in youth football, the team began to look past the helmet. The nursing students found that concussions occur not only from a blunt force contact but also a whiplash motion. With this knowledge, designers conceptualized an upper torso and head garment. This garment connected the large muscles and bone structures of the torso to the head and neck, taking the structural responsibility off the underdeveloped neck muscles and dispersing it to other body areas (Figures 7,8 and 9).

3.2.1 Topic significance

In researching the topic of allergies and EpiPens, this team found statistics indicating the number of those suffering from allergies was on the rise, and the supply of this vital medication was in high demand but difficult to obtain. The research found traditional EpiPens often expired before use, and there was no affordance to reuse. The team also found this delivery system was not easy to obtain.(Figure 11)

3.2.2 Area of team excellence

In the Validation phase, this team discovered a dual-dose refillable system was highly desirable. They presented several concepts that include aesthetic, functional, and clinical features and benefits. They found that EpiPen users are supposed to carry two pens but typically do not, it is not illegal for users to replace cartridges (but it is for pharmacists), and many try to hide their pens because they are unattractive and do not make them feel empowered. This collaborative activity allowed the team to gather product and process insights and was effective in providing them with a final direction. (Figure 12)

3.2.3 Collaborative innovation results

The final result was a dual-use refillable system whose instructional method guided users through the process using both audio and written instruction. The internal component configuration ensured sterilization through a single use, double use, and refilling. The aesthetic was sophisticated, honest, and nonthreatening. This system allowed the primary injection system to remain for several applications, with only the medication cartridge needing replacement. An easy-to-follow instruction pamphlet accompanied the packaging. This, combined with the audio instructions, made using this system very intuitive. Making the main housing robust and designed to last several iterations of use and replacement made only the medicine cartridge disposable and significantly reduced the amount of plastic use over long periods. This product was sustainable on several levels. (Figure 13)

3.3.1 Topic significance

Although functional, it is more challenging to receive a proper medication dose with an inhaler versus a nebulizer. Nebulizers are aerosol drug delivery devices that help administer medication to the lungs. (Figure 14) Nebulizers typically treat respiratory illnesses and break down medical solutions into a mist that the user can inhale. While nebulizers are a useful tool to help treat people with respiratory issues such as asthma, many fail to maintain their machines properly, resulting in less effective treatments. Specifically, most users fail to sanitize nebulizer components properly. The team’s goal was to redesign the nebulizer in a way that naturally addressed this issue and enhanced homecare experience by using UV light technology.

3.3.2 Area of team excellence

This team was very efficient in determining the actual aspects of nebulizer sanitation and discovering what technology could assist. They found users rarely sanitized their machines. And if they did, it was not to manufacturers’ recommendations. The research also discovered that nebulizer pieces were not always dishwasher safe. (Figure 15)

They found the most common nebulizer issue was a failure to adhere to proper sanitation techniques. Inadequate cleaning and maintenance were imperative to optimize machine performance. Failure to adhere to recommended standards would not only hinder medication delivery but also heighten the risk of infection. Improperly maintained parts also housed dangerous pathogens such as Pseudomonas spp. As a result, many users could experience a worsening of their respiratory symptoms using their nebulizer rather than obtain the expected signs of relief.

3.3.3 Collaborative innovation results

With these sanitary considerations as a backdrop, the team developed a nebulizer system that integrated the medication aerosolization with a storage/sanitizing system. The storage/sanitizing system engulfed each component with ultraviolet light, thus sanitizing it while not in use. By combining the delivery, storage, and sanitizing systems into one device, they developed a safe, convenient, and useful product. (Figure 16)