Safetouch and Behavioural Design

A few years ago when I was studying Industrial Design at Rhode Island School of Design, I took a class that — unbeknownst to me at the time — would define my interest in design for behaviour change. It was a joint studio class between RISD and Brown University, which afforded students of both schools the opportunity to work together to solve some kind of social problem.

Taught by RISD Industrial Design Prof. Michael Lye, and Brown Engineering Prof. Chris Bull, the prompt was to design solutions to the crisis of HAIs (hospital acquired infections) in the US. The statistics we were issued, based on research at the time, will stay with me forever — “approximately 100,000 people die from HAIs in the US every year. This is the equivalent of a jumbo jet crashing every single day”. I wondered, if things were that bad in the US, what were they like at home? The answer, perhaps even more disconcertingly was that we didn’t even know; no such data even existed.

The class was endorsed by hospital administrators from Rhode Island General Hospital, so we had access to their research and connections, and were encouraged to do on site primary research ourselves. This was probably one of the most exciting aspects of the design process for me. It was an anthropological approach to design, one which brought things out of the sometimes insular realm of aesthetics, and closer to the objective ideals of science and technology.

Of course, I had zero knowledge of practical engineering or medicine, but that’s why it was a ‘joint studio class’. My classmate Yena Ahn, and I were partnered with Brown engineering students Alice Leung, Zahid Karim, and Mehves Tangun, and together we spent the semester researching, ideating, prototyping and of course, presenting.

Archival photo of a mid-term presentation.

The data (as explained by our hospital admin and public health experts) suggested that the main agent for HAIs was another acronym — HCWs (healthcare workers). This means doctors, nurses, and anyone else charged with providing care within the hospital environment. This wasn’t accusatory of course, rather it was just a reality. The ridiculously long hours and stressful situations foisted upon hospital staff created an inhuman burden that couldn’t simply be “willed” away, or ignored. And the issue wasn’t just the availability of Purell dispensers or sinks within the hospital. There were more than enough of those in the halls and rooms of these North American hospitals already. It was an issue of memory and cognitive load. In other words it was a behavioural design problem.

We became convinced then that the best way to tackle this was to issue realtime reminders to hospital staff while they saw their patients. We imagined a system of sensors that could track doctors’ or nurses’ hand hygiene habits and issue a reminder in the form of an alarm or vibration that would bring the issue to their attention. Here’s how it would work —

• There are three types of sensors. The doctors and nurses wear one type in their hospital badge, the patients wear the second on their patient bracelet, and the Purell dispensers and sinks are fitted with the third, which is wall mounted.

• When a doctor or nurse cleans their hands, the two sensors ‘ping’ one another, logging a time stamp in their onboard computers.

• When the doctor or nurse goes over to their patient, their sensors do the same, logging another time stamp.

• If the time passed between the two time stamps is greater than a few minutes, it will be assumed that the HCW has either touched their face (which humans do on average 15.7 times per hour) or dirtied their hands some other way, and an alert or buzzer will sound to inform the HCW that they need to clean their hands.

That was our basic model. We called it “Safetouch”. Rhode Island General’s admin loved it, and our professors encouraged us to start a business! It was really exciting. Unfortunately, we were five international students who were all graduating and had no idea what our next steps in life were. And so we went our separate ways. A few years later we saw similar products being developed. It was initially somewhat depressing, but we soon realised it was the ultimate form of vindication; if someone else had come up with a similar idea and it worked, it meant we had been on the right track.

That was the project that sparked my interest in behavioural design, and in the field of healthcare. And even though the industry does not yet exist in Trinidad and Tobago, we’re convinced that these are the kinds of solutions needed to address our wicked problems. This is the kind of work that Vessel will be doing.

Sketching the Patient Bracelet Sensor