By: Nicole Sweeney Etter
Last spring, 10 Penn graduate students gathered in a classroom in the School of Engineering and Applied Sciences to embark on a course unlike any they’d ever taken: Human-Centered Design for Clinical Emergency Medicine.
“It’s high stakes,” Neil Ray, MD, an assistant professor in Clinical Emergency Medicine in the Perelman School of Medicine and instructor in Bioengineering, told his students. “What you will do will potentially be implemented. So this isn’t like another class—there are real people involved.”
The course, which immerses students in clinical spaces to solve challenges for emergency departments, brings benefits for students, patients, and clinicians. It also supports Penn Medicine’s strategic goal of becoming the “most clinician-friendly health system.”
“It was a cool opportunity for the students to be immersed in this clinical environment that they otherwise wouldn’t have access to,” said Joshua Norris, MD, an Emergency Medicine resident. “This could be a way for Engineering and Design students to continue to find ways to improve operations in the hospital coming from a different perspective. This is a time-intensive process, and it’s not something that could be done by staff who are focused on our daily work.”
The power of design thinking
With a background in bioengineering, Ray embraces the concept of human-centered design. “It’s basically spending a lot of time figuring what the true problem is and coming up with an appropriate solution, rather than coming up with an idea for a solution and then trying to find the problem,” he explained.
Because the emergency department is often on the front lines of emerging issues in health care, it is well-suited for this kind of approach, he noted. “In Emergency Medicine, we know about every field so we can connect across disciplines,” he said. “And we figure out ways to do things with limited resources, so we’re natural innovators.”
In 2023, Ray launched a pilot project that brought together a handful of Penn Design and Nursing students to collaborate on improving emergency department closet spaces at the Pavilion at the Hospital of the University of Pennsylvania (HUP). It was such a success that word quickly spread, and 40 students vied for just 10 slots in the spring 2024 course. Ray selected students from a variety of academic backgrounds, including Bioengineering, Mechanical Engineering, Design, and Dental.
“We handpicked students with complementary skills so that we can learn and grow from each other,” Ray said.
Among the students selected was Shriya Boyapati from Penn’s Accelerated Master’s Program in Bioengineering.
“The opportunity to dive into the inner workings of the emergency department and solve a tangible and pressing issue was extremely enticing,” said Boyapati, who plans to attend medical school. “I hope to use the human-centered design thinking skills from this course to innovate products that will produce better clinical outcomes.”
The class was split into two teams. One was assigned to Penn Presbyterian Medical Center and the other to HUP Cedar in Southwest Philadelphia.
Norris and Zubin Hussain, MD, another Emergency Medicine resident, served as teaching assistants and liaisons between the class and the hospitals’ emergency department leaders. A third teaching assistant, Jacqueline Aquino, from the Master of Integrated Product Design program, helped students with prototyping and other hands-on design work. Ray also brought in guest speakers from across Penn’s campus and beyond to talk about everything from how to collect data in the medical environment to how to present a pitch deck to stakeholders.
“It’s a great example of bridging the gap between the university and the health system,” Norris said. “It shows how bringing together a multidisciplinary group can lead to new ideas and solutions.”
Helping staff become more efficient
At HUP Cedar, the students focused on the emergency department’s main supply closet—a source of stress for staff who couldn’t efficiently find what they needed.
“If there’s a sick patient, those minutes count,” Ray said.
In addition to interviewing staff, students toured sister hospitals to see how their supply closets were organized. Then they came in one night at 11 p.m. and worked until the wee hours of the morning to transform the space, reorganizing the equipment by type (keeping all the cardiology supplies together, for example) and adding color coding and larger labels.
“We even made sure that our colors didn’t interfere with people who were colorblind,” said Yousef Elyoussef, a student in Penn’s Accelerated Master’s Program in Bioengineering. “Our class taught us to go that extra mile to think all about the people using it.”
During the students’ post-project testing, the average time it took staffers to find supplies fell from 51 seconds to 43 seconds, “which adds up over the course of every day,” Ray said. Staff satisfaction scores with the space skyrocketed from 2.9 on a 10-point scale to 8.
For Elyoussef, the most gratifying part was the big smiles and thanks his team received at the end. “Sometimes we don’t stop to think about health care staff burnout,” said Elyoussef, who plans to pursue a career in medicine or research. “And for them, just having one small detail fixed in their work lives can add so much relief to their day.”
Enhancing patient privacy and comfort
At Penn Presbyterian Medical Center, the students concentrated on how to improve the experience for patients in hallways. During busy periods in emergency departments nationwide, it’s common for patients to wait in a hallway bed until a room is available.
The students’ solution: “Privanopy,” a retractable canopy that attaches to the head of a patient’s bed to block out light and noise. In the early testing, patients preferred the canopy and the hospital’s portable screens together for maximum privacy.
“Following a concept from ideation to prototype development to testing was a grueling but extremely meaningful experience—hundreds of cumulative shadowing hours, 50-plus stakeholder interviews, and meticulous data analysis,” Boyapati said. “Seeing the final prototype deployed and watching different stakeholders interact with it was my favorite part.”
The prototype still needs more refinement before it could be implemented. “But I do think it’s something that would have the potential to be adopted more widely,” Norris said.
In the meantime, Ray is already gearing up for next spring’s class. He hopes to eventually run it during the fall and spring semesters and expand to other medical disciplines beyond Emergency Medicine.
“Most of the time we think about health care innovation in terms of quality and safety improvements, and that’s very rigid and structured,” he said. “But I think there’s a lot of benefit that can happen with this new way of thinking, and it’s how you get disruptive technologies rather than incremental changes. At least moving the needle a little bit is a win.”