19 Jun Tomorrow’s Smart Operating Room
Post Written by Sumi Hansen
Can you imagine a Smart Operating Room that assists hospital staff by mapping out equipment placement on an illuminated floor? Or an Operating Table Platform that snaps into multiple configurations? Or a Smart Wall that displays the status of an operation to family members waiting outside?
These are all early stage prototypes designed by graduate students at IIT Institute of Design (ID) in collaboration with the University of Chicago's new Center for Care and Discovery, itself a masterpiece of innovative design.
Over the past year, students in Martin Thaler's advanced product design class have been developing prototypes at this $250 million facility under the guidance of Dr. Alexander Langerman, Director of OPRI (the Operative Performance Research Institute), a think tank and research unit at the University of Chicago. It’s a powerful collaboration: both ID and OPRI foster interdisciplinary encounters to meet the needs of a rapidly changing healthcare industry.
“One of our key missions is to open up the doors of the OR to disciplines that traditionally haven’t been involved in making surgery safer and more efficient,” says Langerman. "Our collaboration with ID has been one of the most fruitful that we’ve conducted."
Day One starts with an open-ended challenge from Dr. Langerman: "Innovate in the operating room." Over the next five weeks the designers spend over 100 hours in the operating room of this ultra-modern teaching and research facility. Their mission: to examine the day-to-day functioning of a modern surgical OR and develop plausible, cutting-edge solutions to any lingering design inefficiencies.
"Working in a cutting-edge facility is especially exciting," Thaler observes. "If we were at an older institution, we might be looking at legacy issues that had already been solved. But in a state-of-the-art hospital, we know that anything we find is really important."
Immersing themselves in the daily activities of the operating room, the designers observe surgeries in action; analyze the lifecycle and physical layout of the OR; and probe for possible points of disruption in the workflow. Back at IIT Institute of Design they participate in regular sessions with Thaler to discuss their observations, analyze the data they've captured, and develop design prototypes.
As newcomers to the OR, the design students notice things that medical professionals might take for granted—precisely the reason that the students have been invited in. “The students came in with probably the freshest eyes of any collaborators we’ve had," Langerman says. “They walked in and started asking questions that no one had ever thought of asking before. They really thought about the OR in a very new way.”
Taking a uniquely people-centered approach, the design team examined not just the hospital space (and the tools and equipment used within it), but the way that doctors, nurses, technicians, and medical students interact in a complex, ever-changing environment. Thinking in a radically new way about the role that the physical environment plays in an operation, they adopted the metaphor of the OR as an active partner in the surgical team.
How could the OR make things easier for the surgical team? Could the OR set up its own furniture? Lay out its own tools? Or handle its own communications, so that the surgeons and nurses can focus on the task at hand?
The result was six forward-looking design prototypes that incorporate new, still under-utilized technology to manage complexity, increase efficiency, and reduce cognitive overload for the surgical team.
The students envisioned the operating room of the future as a Bright Vision Room with a Smart Floor that changes colors to map out furniture placement according to layouts indicated by surgeons. An illuminated Smart Wall announces the status of the operation to people inside and outside the room.
Floating above the operating table, a Central Information Station uses lights, cameras, and data-imaging screens to record the operation, allowing medical students to see what a surgeon is pointing to during a teaching moment. A customizable OR Table Platform features a sliding smart panel that facilitates communications. Nearby, an expandable PlusCart reduces cognitive overload by keeping generic tool sets in the foreground, unfolding to reveal specialized tools only when needed. In the background, an innovative storage unit uses visual hierarchies to organize waste and personal belongings.
One of the most exciting prototypes, an illuminated Smart Table, assists scrub nurses in laying out surgical tools. The designers observed that the instrument table was a key “pain point” that could interfere with the effortless functioning of the OR. Surgeons needed different tool sets for different procedures, and each surgeon wanted to have his or her tools arranged in a particular way. Only a nurse who had extensive experience with a particular surgeon would know all of his or her idiosyncratic layouts by heart; the others needed guidance.
To facilitate the process of tool layout, two of the students designed a Smart Table that uses RFID (radio-frequency identification device) technology to project ideal instrument layouts on its illuminated surface. "The Smart Table is a refinement of a basic concept we had hoped for," says Langerman. "We had imagined using a flat screen video monitor as a table to project the layouts, but the students came up with an even more elegant solution."
In addition to indicating each surgeon’s preferred tool layout, the Smart Table also tracks changes to the layouts and catalogues the surgeons’ preferences in a database.
“It’s exciting to see how certain products can really be ‘enabled,’” says Hank, one of last semester’s designers. “Taking a basic object and giving it the right interface and digital capacities can really change the way people work.”
Thaler observes that all of the students brought experienced insights to the design process, thanks to their extensive prior experience with user interaction. Fascinated by the power of grids to organize workflows and objects, one of the designers, Beth, introduced grids into several objects to manage complexity while enabling flexibility. Another student, Lee, had exciting design ideas involving modularization.
"Every idea was very well thought out and inspired,” Langerman remarks. The students also sought to develop prototypes that would work well together, in keeping with the medical equipment industry’s growing interest in holistic design. "Because we started developing prototypes early in the process, and because we worked so well as a team, we developed a very solid ecosystem of products," says Beth. "The big ‘aha’ moment for me was realizing that we never design alone.”
The final show
At the end of the semester, the designers turned Langerman’s research lab at the Center for Care and Discovery into a mock operating room. Here, at the high point of the course, they spent the day receiving feedback on the prototypes from over fifty surgeons, nurses, technicians and administrators. “When we started showing the prototypes to the doctors and nurses, they got really excited,” says Hank. “The scrub nurses were especially happy to see that some of the stuff was being geared towards them—they were very quick and ready to give suggestions.”
“It was remarkable,” Beth observes. “Here we are as designers, bringing our fairly fictional concepts in front of the users, the absolute subject matter experts. It was just fascinating to have all the people who would really use these objects, from head surgeons to scrub nurses to medical students, talking about the designs—what appealed to them, how they could be refined.” “It was a really fun, final show that created tremendous excitement about what we were doing," says Langerman.
Thaler’s product design classes at ID have a track record of success. Two students in his Kickstarter Design class recently designed a much smaller but equally innovative product, the Tidy Tilt, a novel iPhone stand that was immediately snatched up by Logitech—along with the two students who designed it. Logitech has since expanded the original product as its top selling Case+ system and won multiple Edison Awards for design.
Although the medical design prototypes may never be seen outside the mock operating room, Thaler's students are already carrying their excitement and experience out into the real world, where their design contributions will shape the future for the rest of us.
"I’m pretty sure this class helped me get my internship last summer as a design strategist at FUSE Project in San Francisco," says Evan, a third designer in the class.
“There’s lots of opportunity in the hybrid space between product design and interaction design,” Hank agrees. And who knows? Last semester’s collaboration between ID and UC’s Center for Care and Discovery was so successful that at this very moment a second cohort of design students is working with Dr. Langerman exploring OR information systems.
With this kind of momentum, the Smart Operating Room of the future may be closer than we think.
Read the paper on the Smart Operating Room here!