COMMUNITY

While the team at Spectrum Health Innovations (SHI) develops innovations to solve health care problems and improve the lives of patients, we do not do so alone. We do so collaboratively with the community, and we do so with an eye to the future. Year after year, SHI encourages the youngest generations to take on leadership roles, learn new skills and think in creative ways.

Teen Entrepreneur Summer Academy youth learn about health care innovation

Since 2009, the Teen Entrepreneur Summer Academy, or TESA, has provided 148 Grand Rapids students an immersive experience in solving problems, encouraging an entrepreneurship mindset. The intensive, five-day summer program for high school students is designed and provided by the Richard M. and Helen DeVos Center for Entrepreneurship & Innovation at the Seidman College of Business.

In June 2018, a group of 46 high school students visited SHI to learn about the process of innovation—from ideation to solution. 

“Spectrum Health Innovations has been a great partner and sponsor for TESA,” says Shorouq Almallah, director, Richard M. and Helen DeVos Center for Entrepreneurship & Innovation, Grand Valley State University. “Our students go on a field trip to visit SHI, and they learn about the entire process of innovation. The program provides students with fundamental business concepts and essential entrepreneurship skills.”

Students learn about a real-world problem and explore the possibilities on how to solve it, coming up with ideas for services or products; doing market research for a targeted audience; exploring operations, financials and marketing; and finally give a 5-minute presentation to a panel of judges, competing for cash prizes totaling $5,000. For the 2018 presentation, Lori Henry, PMP, project manager, SHI, was among the panel of judges. The students worked on a project of building SMART cities, focusing on how to advance technology, and create safe and attractive urban spaces.

“Based on the data that we have collected about participating students in TESA since 2009, 13 percent have gone on to start a business, 42 percent are employed and have a career, and 54 percent are currently pursuing a higher education degree,” says Almallah. 

Kent Intermediate School District program prepares students for career readiness in health care

The Health Career Immersion Program of the Kent Intermediate School District Career Readiness Department in partnership with local health care organizations provides a job shadow experience that allows about 40 students to explore a wide variety of health careers by observing health professionals while they work. The program is available to Kent County high school seniors interested in pursuing a career in health care, and the students visited several Spectrum Health hospitals under the guidance of Spectrum Health Innovations.

“Students gain a tremendous amount of career knowledge that assists them in their decision-making process through the Health Care Immersion program,” says Krista Harmon, career exploration coordinator – health sciences, Kent Intermediate School District.

DECA prepares emerging leaders in health care

Another highly successful community collaboration takes place with the Michigan chapter of DECA. DECA prepares emerging leaders and entrepreneurs in marketing, finance, hospitality and management in high schools and colleges around the globe. Brenda Cook is a business teacher at the Center of Innovation High School, part of the Grand Rapids Public School system. 

“Spectrum Health Innovations has been one of a dozen or so organizations involved with our kids, and this year, SHI has also been a sponsor,” says Cook. “Our DECA team earned 28 medals last year in competitions.”

Approximately 60 students, mostly juniors and seniors, were involved in DECA competitions in 2018, competing against 17 schools, with about 40 proceeding to statewide competitions. Lori Henry, a member of the SHI team, is on the advisory board, offering encouragement and support to the students.

Rockford High School students experience hands-on learning

With 55 students from her advanced business management classes, Peggy Klein, business education teacher at Rockford High School, organized a field trip to Spectrum Health Innovations, providing a rare experiential, hands-on learning opportunity for her students.

“It’s an invaluable experience for them,” Klein says. “The students had an opportunity to get into surgical scrubs, worked on a medical mannequin and handled medical prototypes during various stages of the development process.”

A student response sums it up: “This is amazing!”


COLLABORATION

The excitement throughout the Spectrum Health Innovations (SHI) offices was palpable. In February 2018, SHI was awarded a $727,000 grant from the City of Grand Rapids’ SmartZoneSM Local Development Finance Authority (LDFA) to support the development of new health care solutions.

SmartZonesSM is an economic development tool that allows the capture of increased property tax dollars for investment within the SmartZoneSM to foster development and attraction of technology-based businesses and jobs by promoting collaboration between governments, universities, industries and other entities.

In 2017, the City of Grand Rapids LDFA issued a request for proposals to identify opportunities to invest in projects or services that support high-technology businesses and entrepreneurs. They sought candidates who were strong in the areas of inspiration, mentoring and access to resources; infrastructure and physical resources; connection and awareness; and talent. SHI brought together long-time partners Grand Valley State University (GVSU) and Kendall College of Art and Design of Ferris State University (KCAD) to submit a winning proposal.

“The three of us have a uniquely developed collaboration,” says Brent Mulder, PhD, MBA, president, Spectrum Health Innovations. “We have been working together for five years recruiting the talented faculty and students of our local universities and colleges to create novel technologies that solve existing health care problems. This award will help to expand upon this already successful platform.”

The LDFA grant will bring together students from GVSU’s engineering program, KCAD’s industrial design program, and Spectrum Health clinicians to work on solving real-world health care problems.

John Farris, PhD, professor of engineering, will bring the GVSU engineering students to the collaboration. “We will work as a team to develop three projects per year for three years, beginning fall of 2018. We’ll meet regularly to discuss ideas for projects with a quick path to commercialization. That’s what the LDFA wants to see.”

“John and I will co-teach a class of industrial design and engineering students,” says Jonathan Moroney, chair of the industrial design department at KCAD. “We’ll begin with four students this fall, six in spring, then six students per project each year. When choosing students to participate, we’ll look for those with a passion for health care, self-driven, and primarily those with senior status. All 12 students will work on one of three projects.”

Another part of the collaboration will include entrepreneurs-in-residence (EIR). Linda Chamberlain, PhD, director, GVSU technology commercialization, will oversee the EIR positions. “The EIRs will be responsible for creating the business model as the projects progress through the development pipeline. This includes commercialization road-mapping, market assessment and financial analysis. The EIR could also be asked to support development of the foundational issues of a business start-up, such as corporate form, licensing and obtaining seed funding.”

“Our classes will feel like an internship,” Moroney says. “They will have more of a professional experience, as if they were part of a company preparing to launch a new product. But whereas many students might have a challenge in gaining access to context and experts, by working with SHI, we won’t have that problem. That’s the strength of this program—the students will be able to work directly with technicians, managers, charge nurses, therapists and other staff around the hospital.”

The experience will open pathways to medical careers for students while developing innovative medical devices to solve real-world health care problems that will benefit many. 

The Grand Rapids SmartZoneSM LDFA was established in 2002 by the City of Grand Rapids, Grand Valley State University, Van Andel Research Institute, Grand Rapids Community College and The Right Place, Inc.


THE EXTERNAL URINARY DEVICE

One of the most common hospital-acquired infections is the catheter-associated urinary tract infection, or CAUTI. The Centers for Disease Control and Prevention estimates that more than 560,000 urinary tract infections per year have resulted in 13,000 deaths nationwide. Patients with a CAUTI on average have a 2- to 4-day longer hospital stay.

As health care facilities strive to reduce CAUTIs, a growing demand has emerged for external urinary collection devices that are safer and more comfortable than catheters.

Mary Tibbe, MSN, RN, CCRN-K, AGCNS-BC, cardiothoracic services clinical nurse specialist, Spectrum Health, noticed that when CAUTIs occurred in her patients, the infections were overwhelmingly showing up in females.

“We didn’t really have anything specifically suited for women,” Tibbe says. “Our only option was to prescribe antibiotics, which added to patient discomfort.”

Kris Emery, BSN, RN, clinical specialist, Spectrum Health Innovations (SHI), met with Tibbe to talk through the problem. Students from Grand Valley State University (GVSU) design and engineering classes worked on the design of an external urinary device, or EUD. 

“Ideally, the device should keep moisture and fluids away from the skin,” Emery says. “And it shouldn’t cause any pressure against the patient’s body or cause any kind of skin breakdown or irritation. We wanted something that would be comfortable to wear, whether the person is lying down, sitting, or standing. It would have to support different sizes, connect to a drainage bag, be easy to apply, and not be difficult or painful to remove.”

Three classes of GVSU students were involved in the project. They found that the adhesive that fit a device securely to a woman’s body was the most challenging part of the project. Wicking, or pulling liquid away from the body, was another.

The device the students designed uses a shallow drainage basin that holds and drains urine down to a drainage bag. The bag is attached around the patient’s leg or near the patient’s side. It accommodates a female pelvis. A hydrogel adhesive wafer attaches to the patient and connects to a urinary cup. The cup attaches to the adhesive wafer. Finally, tubing connects the cup to the urine collection bag.

Tracy Hosford, MSN, RN, AGCNS-BC, clinical nurse specialist – burn/trauma, was one of about a dozen nurses who volunteered to test the new device.

“We had to wear the EUD for a 24-hour period,” Hosford says. “Being in health care gave me a better understanding of what a patient might need.”

Once the trial was over, Hosford and the other volunteers suggested improvements to SHI. The SHI gave their suggestions careful consideration, improving application and sizing.

Next came more testing, this time with 128 patients at two Spectrum Health facilities.

“SHI has been a recipient of 2 grants—funded through the Michigan Economic Development Corporation (MEDC)—to help develop the EUD for patient use,” says Brent Mulder, PhD, MBA, president, Spectrum Health Innovations.

The award is granted in order to enhance the commercial potential of a technology owned by any Michigan-based nonprofit.

“The external urinary device has enormous potential to decrease catheter-associated urinary tract infections,” says Christopher Chambers, MD, PhD, FACS, vice president, Spectrum Health Research, and vascular surgeon, Spectrum Health Medical Group. “Developing clinical evidence is necessary for widespread adoption, and, as it transitions from product development to investigation, the collaboration between the research and innovations teams to obtain grant funding and design the clinical research project has been outstanding and very productive.”

The EUD could help as many as 5 million patients in any given year.


COVER MAX

More than a year of work by hundreds of Spectrum Health staffers has resulted in an improved surgical skull cap.

Sharp eyes and some brainstorming by Spectrum Health staffer Karen Duncan and former staffer Ann Shupe yielded a prototype for an improved skull cap worn during surgical procedures.

But that was the easy part. Getting the product to market was a whole new story.

That’s where Spectrum Health Innovations stepped in.

While Duncan and Shupe crafted the idea, the Innovations team made it a reality through more than a year of intensive collaboration, research and testing. It was truly a team effort.

The result: a new skull cap that meets Spectrum Health’s surgical attire policy and ultimately improves patient care.

Duncan, an RN and senior accreditation specialist, said she and Shupe performed an audit to see how Spectrum Health complied with its attire policy.

“(We realized) the skull cap being used was not designed to adequately meet the requirement for covering all of the hair,” she said. “We concluded we needed to innovate a product that would meet the standard.”

Why is a proper hair covering important?

“We’re keeping everything covered and keeping the surgical areas free of any particles,” explained Kris Emery, BSN, RN, clinical specialist, Spectrum Health Innovations. “It’s all about the patient and maintaining a safe environment for surgical procedures that supports patient safety.”

Duncan created a combination skull cap with a bouffant cap to the back bottom section of the skull cap. She said skull caps and bouffant caps are not new, but putting the two together into one piece took some ingenuity and skill.

She said she used her husband as a model to determine where to add the bouffant cap to the surgical cap to capture the span correctly from ear to ear.

“It didn’t take that long to pin and sew, about 10 to 15 minutes,” Duncan said.

Next, she turned the one-size-fits-all prototype over to Emery.

Research and testing

“My role as a clinical innovation specialist is to work with clinicians across the (Spectrum Health) system to bring their ideas to life,” Emery said.

She said the team had to confirm that there was a problem and then obtain considerable feedback from surgeons, operating room staff members, nurses, scrub technicians, anesthesiologists and so forth.

“It was a lengthy process that engaged hundreds of people to get their direction,” Emery said.

The team worked closely with Halyard Health, based in Atlanta, which owns the patent to the skull cap and is marketing the product.

“We extensively tested the prototype to make sure everything was what we were looking for and for support staff satisfaction as well,” she said.

The new non-bouffant version of the skull cap went on the market Aug. 20, with the bouffant version expected to be available in November.

Although the list of those who helped make the new skull cap a reality is a long one, Emery gave special credit to product specialist Andrew Heuerman, MTE, and Anthony Lazarro, MHI, from the Innovations team and also Amanda Yang, MD, who served as executive sponsor of the project.

Duncan couldn’t say enough about the cooperation and collaboration among the Innovations team members, Spectrum Health staff and those from Halyard Health.

“If you have an idea, don’t hesitate to bring it to the Innovations team,” Duncan said. “They are great and will help you every step of the way so that your idea actually does build and grow and become a product or a process or a solution to a problem that can make our care for our patients better.”

This story originally appeared in Spectrum Health Beat on Sept. 12,2018. Written by Allan Adler. 

Photos by: Chris Clark | Health Beat


AUTO SLIDER

Every single day in any one hospital—in this case, Spectrum Health Butterworth Hospital—patients are moved as many as 900 times. Over a year, that adds up to 100 million times that hospital staff lifts and moves patients from stretcher to bed, from bed to operating table, from one bed to another.

Kirk Rykse, supervisor, patient transport, Spectrum Health Butterworth Hospital, brought the problem to Spectrum Health Innovations (SHI), where Eric Van Middendorp, MSE, biomedical engineer, took the project on and brought it to a team of engineering students at Grand Valley State University (GVSU) as well as his colleague at SHI, Andrew Heuerman, MTE, product development specialist. Rykse saw a need for a lateral transfer device that could be operated by one person at a time.

“A lot of injuries happen during those transfers, sometimes to patients but often to hospital staff,” Van Middendorp says. “Often four or more staff are required to safely move a patient, which takes away valuable time from other patients.”

Although many hospital rooms are already equipped with ceiling lifts, the engineering student team found that many nurses and transporters are reluctant to use these lifts.

“When the students asked nurses and transporters why they don’t use the lifts, they were told the hoists just took too long,” says John Farris, professor of engineering, GVSU. “They also require more than one person to operate.

According to the National Institute for Occupational Safety and Health, or NIOSH, rates of musculoskeletal injuries from overexertion in health care occupations are among the highest of all U.S. industries. The overexertion injury rate for hospital workers is twice the average rate—68 injuries per 10,000 workers—and five times the average among paramedics. The single greatest injury risk is manual lifting, moving and repositioning of patients.

“Due to the physical demands of our jobs, patient transport staff are susceptible to injuries, and every year we see many lower back–related injuries. This can lead to staff missing work time, but, most importantly, we do not want to have the staff getting injured,” says Rykse. “We discussed the need with GVSU engineering students for a device that could be safely operated by one person and is easily accessible.”

The students set to work, with four working on the initial design during the fall 2016 semester and handing off their work to six students in the winter semester. Meanwhile, Heuerman became their business lead, doing the market research and writing grants to fund the project.

“The team started off with three initial concepts, then a cardboard mock-up using a car battery, metal posts and winches,” Farris says. “Now, the auto slider is on casters, so it can easily be moved in any direction, stored in a closet for easy access, but then grips the floor when in use.”

From concept to design to prototype, the auto slider is now in the capable hands of Jim Medsker, president; Jason Barr, product development manager; and their team at Keystone Solutions Group in Grand Rapids and Kalamazoo. A Mi-Kickstart grant, awarded by the state, has funded the development process and partnership. When Keystone received the prototype concept from SHI, the Keystone team was challenged to refine the concept for manufacturing: improving the user interface and portability, increasing to 500-pounds-plus pull capacity and adding electrical controls. During early development work, Keystone tested the prototype on a weekly basis with SHI, using bags of rock salt to resemble the density of the human body, until all could agree on design and calculations.

“We are preparing to do some product testing—consumer feedback will be a part of that,” Barr says. “We want to make sure all components are reliable, safe and comfortable for any height or weight.”

“Testing is very rigorous,” Medsker says. “We make sure everything about a product is FDA-compliant before we take it to the market. We plan to reach that point within a year.”

Eric Van Middendorp adds: “This device is a simple and effective solution to a complex problem that affects many of the employees and patients at Spectrum Health. At this point, we’ve filed for a provisional utility patent. We are looking forward to continuing the partnership with GVSU and Keystone to bring this device to market and make a positive impact in hospitals.”


LAB SPECIMEN DROP BOX

We’ve all been there—a nurse or clinician sends us into the restroom to leave a urine sample. We are given a small container, labeled with our name, date of birth, sometimes even the name of the test designated for the sample. We are then instructed to leave the sample on, typically, either a steel shelf in or outside of the restroom or inside a pass-through door that opens on both sides.

Spectrum Health has 35 lab sites. Twenty-six of these are inpatient sites, and 10 are outpatient sites. In our system alone, more than 500,000 lab patients are processed per year.

“We’ve never had a problem with this yet,” says Nick Rambow, MLS (ASCP), MS, lab manager, Spectrum Health. “But I’ve always thought there has to be a better way to do this. All our facilities are a little different. In some, patients have to actually bring their specimen out into the waiting room to place on a shelf there. It makes patients uncomfortable, and it can be a privacy concern.”

Rambow thought about how to make a container for lab specimens that is HIPAA-compliant and tamper-proof, and can keep the specimens secure until picked up by a staff member. He noticed the lockboxes that couriers used when taking specimens to the laboratory, and it occurred to him that something similar could be installed in restrooms with a PVC pipe at the top into which a specimen could be dropped.

“I went to the hardware store and bought some PVC pipe,” Rambow says. “I attached it to the top and the bottom of a lockbox and welded it to the wall at Spectrum Health Butterworth Hospital.”

The idea had merit, but Rambow wanted to make more improvements. He took his concept to Spectrum Health Innovations, meeting with Kris Emery, RN, clinical specialist, and Alissa Smith, engineering intern.

“Alissa was ready and onboard,” Rambow says. “She took that initial conversation and ran with it. She came up with an innovative concept, made a prototype, SHI helped with the licensing, and now it is a product for sale in MarketLab’s catalog.”

MarketLab, a marketing business that sells laboratory and medical supplies, agreed to add the new stainless- steel, locking drop box to their line.

“Last I checked, they had sold nearly 50 of the boxes,” Smith says.

“What I love most about this is that Nick came up with a proactive solution,” says Leah Voigt, JD, MPH, chief privacy and research integrity officer, Spectrum Health System. “So many solutions are reactive, but Nick was thinking forward. Patient privacy is always a concern, and it can sometimes seem like an obstacle, something to work around, but this drop box was an elegant solution.”

The new drop boxes have already been placed in four sites. Voigt says plans are in the works to place the drop boxes in hospitals, physician offices, clinics, and other facilities.


LEARNING BY DOING

When Alissa Smith began her college studies, she wasn’t sure what kind of career she wanted to pursue. Now a graduate student in biomedical engineering at Grand Valley State University (GVSU), she no longer has any doubts. Since joining the Spectrum Health Innovations team as an intern in May 2017, her path ahead is clear.

“I first learned about the internship opportunity from my engineering professor and adviser at GVSU, Professor John Farris,” Smith says. “After having a medical device project in Dr. Farris’ product design course, I knew that I wanted to pursue biomedical engineering. Working at Innovations has been extremely beneficial to get the hands-on experience while finishing my master’s degree.”

“I knew Alissa was right for this internship,” Farris says. “She was an undergrad in product design at that point, so she had a lot of the skills Spectrum Health Innovations wanted—she knew a lot more than just the technical part.”

Shabbir Choudhuri, director of the graduate program at GVSU, agrees. “When SHI described what kind of student they wanted for this internship—versatile, can cross boundaries, creative, has ideation capability, can work with little direction—I thought of Alissa. She was pursuing a combined degree in a 5-year program, so I knew her attributes made her a strong candidate.”

Spectrum Health Innovations agreed and put Smith to work on several projects. One of those projects became her thesis project, titled “Design and Testing of a Sheath Device to Secure Rotator Cuff Anchors in Osteoporotic Bone.”

Smith has been working with Kendall Hamilton, MD, orthopedic and sports medicine, Spectrum Health Medical Group, to design a device, called a gauntlet, bone sleeve, or sheath. Dr. Hamilton was the originator of the idea, and Smith became the designer and engineer.

“Rotator cuff disease is a common problem in the 40- to 60-year age group,” Dr. Hamilton says. “About 40 percent of people in that age group get a rotator cuff tear. A tear like that can cause pain when reaching, extending or lifting an arm, or just carrying things. It can cause significant pain at night, too, disturbing sleep.”

Repairing such a tear is a common surgery, with the surgeon sewing the torn tendon back to the bone, then using a suture anchor to keep it in place.  Seems simple enough, but that same age group often suffers from another condition—osteoporosis or osteopenia.

“That means the bone has become soft,” Smith explains. “It can disintegrate during surgery, or it’s just too soft to hold the anchor in place.”

The result, Dr. Hamilton says, is that repairs to the rotator cuff fail 20 to 60 percent of the time. The tendon may not heal, or it tears again, or the suture anchor doesn’t hold in the too-soft bone. Surgeon and intern put their heads together to design a solution.

“I designed a sheath that changes configuration to provide fixation in soft bone. For patients that need a revision surgery, the sheath will also serve as a solution.”

“The sheath will decrease re-tears and cuff failure,” Dr. Hamilton says. “We will be testing it on bone models with suture anchors, with a plan for filing for a patent.”

If the intern has learned a lot with her hands-on work alongside the surgeon, the surgeon says he has learned from the intern. “She taught me how to think outside the box,” Dr. Hamilton says. “Alissa helped me see in three dimensions and to think through how we would test it. She brought energy to our team and kept us motivated.”

The rotator cuff sheath was not Smith’s only project at SHI. She has also worked on a drop box for lab specimens that will ensure patient privacy and resists tampering. On that, she partnered with Nick Rambow, MLS (ASCP), MS, lab manager, Spectrum Health.

“Alissa was ready and onboard with our project,” Rambow says. “We had an initial conversation, and from that, she came up with an innovative concept. It’s being marketed now.”

“Working at Spectrum Health Innovations has given me such valuable experience working with clinicians, physicians, surgeons, engineers, and in business roles,” Alissa says. “I’ve really enjoyed being part of a team that takes ideas from clinicians and makes them into real health care products.” 


CAROL

The family called him Bud. Bud was 98 years old, and he lived at home until his passing. For most elderly people, staying independent and living in their own homes is a most fervent wish.

“Bud was my grandfather-in-law,” says Mike Czechowskyj, MSN, RN, CNML, CHP, clinical innovation specialist, Spectrum Health Innovations (SHI). “Family cared for him, and we called in help for hygiene and errands such as grocery shopping, but sometimes Bud needed the care of a nurse. His wish to live his life out at home inspired me to come up with a solution.”

Watching the family’s struggles and listening to caregivers’ concerns, Czechowskyj realized he was witness to a problem millions of families face: keeping loved ones home as long as possible and doing so safely.

Czechowskyj approached a colleague at SHI, Anthony Lazzaro, MHI, product development specialist, to discuss an idea he had for improving home care: an on-demand, easy-to-use web platform for health care. Czechowskyj and Lazzaro became business partners, working together to develop a program they would call Carol.

Carol, Czechowskyj says, was a name chosen both because it incorporates, in part, the phrase “care for all” but is also a common name associated with a friendly presence.

“Carol gives people the ability to request on-demand service for patients living at home and seeking basic nursing care from licensed and insured registered nurses,” Lazzaro says. “The patient, a family member, or a caregiver, can call or log in to Carol’s app or website and request a registered nurse visit, pick the service needed, and a registered nurse will arrive at your door.”

Patients and caregivers will be able to receive updates throughout the entire process of care. The service costs $35 for a half hour and is pro-rated after the first hour. If the patient requires a physician’s care, Carol will make the connection through the recommendation of a primary care physician to a service such as MedNow.

Tara Ter Vree, BSN, RN, is a float nurse with Spectrum Health. She signed up with Carol when the pilot began in January 2018. “I heard about Carol when Mike did a presentation at a staff meeting. I signed up—it was a clear-cut, simple application, and I was soon on my way, answering patient requests for care. Most of my patients have been 70 years of age or older, and the person requesting care is a son or daughter who may not always be able to visit their parent for everyday medical needs.”

Ter Vree says that most of the calls are for basic hygiene needs, skin breakdowns, colostomy changes, or simply to clarify a change in prescribed medicines. “Most of these needs I can take care of in 45 minutes or less. Anything beyond my scope as a nurse, and I can connect the patient with their primary care physician.”

Ter Vree says she enjoys the more personal relationship she develops with repeat patients that goes beyond the hospital setting and the flexibility in scheduling.

Czechowskyj says, “The initial pilot is in Grand Rapids and the Holland area, but then we will expand our territory—and eventually we hope to go nationwide.”

Learn more about Carol at www.carolhealth.com.