When illness or injury prevents an individual from the simple task of breathing, death is only a few moments away. A medical respiratory ventilator is the essential device that takes over for the patient’s breathing functions making its availability, convenience and functionality critical to survival. Whether at an accident or the hospital, ventilators must integrate into environment without complication. Hamilton Medical collaborated with our teams to develop a new line of ventilators that provide life-saving support in a rugged, ergonomically refined and intuitive package to allow caregivers focus more on the patient and less on the machine.

The challenge was to identify unmet needs and critical touch points for life-critical situations in need of a new era portfolio of medical ventilators. To address this, the team took a comprehensive approach to conducting ethnographic research. While it is typical to focus mainly on the product and how it’s used by people, the emphasis for this challenge was to concentrate on life critical scenarios in which ventilators are used. The research team took a holistic approach to combine needs and pain points from the different types of environments and transportation scenarios considering all possible situations. Our research ultimately led to the creation of an entirely new category of portable medical ventilators. Together, the Hamilton Medial Ventilators have built a platform that fits various situations and enables patient ventilation anytime, anywhere.

The intent of this project was to design a caregiver-centric solution that optimizes patient outcomes while incorporating the best features of full-sized, static ventilators into more compact, mobile units. In order to achieve this it was essential to conduct research in critical, dynamic and often highly-charged environments to identify the essential needs, aspirations and pain points of hospital staff. The team explored ICUs, hospital transportation, MRI treatments and interviewed various staff member such as first attenders, respiratory therapists, nurses and hospital administrators. The geographical scope of this research initiative included Europe and the United States. The results were used to build a foundation for further research in Latin America and the Emerging Markets.

Research initially explored environments in which ventilators are used as well as uncovering latent needs and pain points of users of the ventilators in intensive care and emergency situations. These additional insights were translated into specific design criteria, guiding the project to build and shortlist configuration prototypes. Configurations were put into four mock-up prototypes and then evaluated by users. Their feedback gave much-needed first-hand insight to optimize and finalize the design.

Contextual Activity shadowing and Inquiry: The team followed various caregivers and hospital staff members throughout their shifts to better understand their workflow, protocols, obstacles and abrasion points. Conducted by one ethnographic researcher and one designer as well as several client representatives, In-depth interviews with first attenders, nurses, respiratory therapists and ICU division managers presented a better understanding of the needs, motivations and challenges as well as the landscape of competitive devices used and available on the market. Video and photo cameras, voice recorders, journals, and visual stimuli were used during primary research.

Field Observations and Secondary Research: The team observed transport scenarios in different environments, ranging from intra-hospital procedures to emergency airlifts. From convenience to portability, the team observed critical requirements for the attributes of the ventilator. Researching the, then current, ventilator models and relevant competition was also conducted in order to add to the understanding of the medical ventilator market and benchmark key features and user experience. Online resources and digital databases were used for secondary research.

Research Synthesis, Prototyping and Testing: The activity patterns of various staff interacting with the ventilators and patients during transportation were identified and then mapped visually. The research team collaborated with the strategy team to translate the research insights into design criteria and two rounds of prototype evaluations were conducted. In round one, configuration prototypes were evaluated and shortlisted. The second round was a user reaction study containing foam mock-ups that were used to evaluate and optimize the final ventilator design. Engineers and designers developed the prototypes for both the configuration evaluation study and the user reactions study. Post-its, white boards, conference rooms and excel spreadsheets were used during research analysis.

For this research program, a comprehensive approach was required that enabled the team to identify hidden user needs, desires and aspirations as well as to test concept configurations across environments and emergency scenarios. The team conducted research expeditions at four medical facilities and immersed themselves in the hospital and transport settings. By doing so they witnessed first-hand the needs and challenges of caregivers developing a deeper understanding of the first respondents’ needs and circumstances. The team worked closely with the attenders who rely on ventilators to keep patients alive after trauma or during transport.

These attenders were comprised of:
• Three (3) respiratory therapists
• Two (2) managers of respiratory care department
• Three (3) ICU nurses
• Two (2) hospital administrators
• Four (4) transport respiratory therapist
• Five (5) emergency medical technicians (EMTs) and transportation service providers

Less focus on the machine and more on the patient: Requiring less interaction with the equipment for monitoring patients or responding to alarms transformed the clinician’s experience. Carefully considered display layout and data, intelligent knob and control design and adaptable alert parameters allowed the caregiver to focus more on the patient and less on the machine.

Minimal disconnections to improve patient outcomes: Based on our observations on-the-go patient care is essential, with minimal disruption. Interviews with first attenders and caregivers uncovered a need for ventilators that include built-in long-run batteries that can also be “hot-swapped”, integrated chargers, power source adaptability and auto-switching between power sources for international travel.

Portability for all situations: On-site analysis exposed the challenges of navigating tight quarters such as entrances, elevators, ambulances, ICUs, and operating rooms. The ventilator’s light weight and minimalist footprint allowed the machine to get to where it was needed most quickly and easily. Mobility was further optimized through the battery design, cord/hose management and integrated universal attachments that are able to be used in various locations such as helicopter mounts, bedside attachment, etc.

Our resulting ventilator designs enhanced performance, operational safety, intuitive usability, and refined ergonomics that serve the caregivers well by serving their patients. Designed-in adaptability allows the multi-functional units to meet the varying needs of all ICU patients as well as those en route. With cost-effectiveness, efficiency, ease-of-use, as well as the ruggedness essential to mobile medical equipment, the design breathes new life into the world of the emergency caregiver.

New Development Process: The first major research undertaking in years for Hamilton Medical, this was the first collaboration with a design firm, resulting in initiating a new product development process. Our thoughtful and comprehensive approach to this research and its critical insights resulted in a sound strategic foundation for subsequent creation of the ideal product experience. The success of our process prompted Hamilton to ensure their future projects do not rush through the research phase, but spend considerable time to thoroughly understand the user needs, aspirations, pain points and ecosystem dynamics. Similarly inspired by our work process, Hamilton’s next stage of development focuses on creative brainstorming of potential product and service solutions. Supportive technology is then developed and prototyped to support the refined solution. This is a rather unconventional approach compared to the tendency of many corporations to create the technology first and then find the right users who will adopt it.

Design Flexibility: Our exploration of ventilator environments revealed a level of diversity that could not be addressed by the creation of a single ventilator. Unit requirements varied from bedside use to helicopters to emergency vehicles to MRI tunnels. Research showed that the basic design would need to be both flexible for a variety of applications and lend itself to alternative configurations for specialized use.