“I knew nurses were making because I did it myself” – Rose Hedges
Rose Hedges of UnityPoint Health in Cedar Rapids, Iowa and Anna Young of Maker Health join me to talk about how a makerspace on the first floor of a hospital has created opportunities for nurses and other medical staff to prototype solutions to problems they encounter in their jobs. Rose is a nurse and manages the makerspace called generate Lab. She is also organizing the first generate Lab Maker Faire at the hospital makerspace on May 17th. Anna and Rose provide insights into a bottom-up innovation process that is very different from the way the medical system normally works.
Rose: We have a physical space inside of the hospital where anyone in the hospital or patients can come and whether it’s prototyping an idea or maybe they just come with a problem, we are able to make it in real time. The best part about that– Anna mentioned the culture– we’ve created a culture here where we want to talk about what maybe they’re tinkering on because we have a safe place in the hospital that we can tinker on it and then create a prototype …
Dale: Welcome to Make:Cast. I’m Dale Dougherty. I’m joined here today by Anna Young of Maker Health and Rose Hedges of the Generate Lab in Cedar Rapids, Iowa. Welcome to both of you. I’m glad to talk to you today.
Anna: Thanks, Dale.
Dale: Anna, why don’t we start with you and tell us a little bit about yourself, a little bit about Maker Health.
Anna: So my name’s Anna Young, the co-founder and CEO of Maker Health, which is a company dedicated to bringing prototyping to the point of care. So wherever care is provided, we see an opportunity for people to create devices that will heal, that will make care more comfortable. And they should have the tools to do that.
We were founded out of MIT Little Devices Lab and have grown both domestically and internationally with an incredible community of clinicians both in hospitals and clinics and schools, again, anywhere where care is being provided. So we launched with makerspaces in hospitals and have grown in a couple of exciting ways, which we can dive into.
Dale: Yeah, that’s great. And Rose, could you introduce yourself?
Rose: Yeah, I’m Rose Hedges and I’m the nursing research and innovation coordinator at St. Luke’s Hospital, Unity Point in Cedar Rapids, Iowa. I’m a nurse. My background. I still work on the floor a little bit, but I also lead our makerspace that’s in the main level of our hospital.
Dale: What’s the name of the makerspace?
Dale: Generate. Okay, great. You’re organizing a Maker Fair e in your space pretty soon. We’ll we’ll come back to that.
I’ve said this in the past, that I thought the maker movement was largely a prototyping revolution rather than a manufacturing revolution. That it was really about taking your idea and be able to realize it in the form of a prototype, which you can share, which you could, get feedback on.
From the many years that I’ve known you and Jose doing Maker Health programs, it was just fascinating to think that nurses had ways to solve problems that they faced every day, and no one was asking them to solve the problem. Getting them to use these tools for prototyping is such a good idea. Tell me more about that, Anna.
Anna: We’ve had so much fun just being able to share within the Make platform and community and to be a part, like bridge that what is making look like in healthcare.
It’s fun to think of or reflect back on how that’s evolved even over, gosh, what the past 12 years or so. I feel our work really started the foundation of it was in international settings, so mostly in really austere extreme environments where we noticed that was MacGyvering moments and how yes, clinicians weren’t waiting, they were solving with the supplies they had.
We looked at that; built tools and training to support that environment and then brought it back to the us. So we really love to be able to think about how what we learned from abroad we were able to use within the US healthcare systems. And it was a similar situation
There was solving and making and there were also ideas that were sitting latent because nurses didn’t know where to start or how to start.
Dale: I remember Jose talking about this; it just not always stuck in my head that, particular in developing countries, they’d get secondhand medical equipment and it would break and they often had to tinker with it to make it work.
They wanted to almost hide that from people. That’s what I remember Jose talking about. Instead of being proud that this was something they were able to do, they’ve almost felt like: let’s not talk about that tinkering stuff that we’re expected to do.
I think this is the really interesting flip with making is no, that’s a capability you have that even, a lot of us in developed countries don’t have that ability to fix the things that are breaking.
Anna: The problem solving and even the confidence to do it. To say I can do this, then use it.
Rose is an amazing friend, collaborator who we’ve learned a lot from about what those dynamics are like in the US and why it may not necessarily be that nurses are ashamed of any making that they’re doing at the bedside, but if they don’t have the culture to support it, then it still stays in that like stealth mode.
It’s been really exciting to work on strategies to overcome that and tools to do that and and she’s a really great leader at the hospital.
Dale: Another point maybe just to add here was that there are some hospitals with makerspaces that are using that for like children’s hospitals as something to engage with kids. But the kind of spaces we’re talking about here really are for the people like nurses that work inside of hospitals and so you have one of those labs, Rose. Tell us about it.
Rose: Yeah, I was just reflecting, listening to Anna share the story is always exciting for me. But we were able to be fortunate enough that we started with a mobile innovation lab to gauge the culture here and see about– I knew nurses were making because I did it myself and how many people we could get to talk about their ideas and it quickly developed until we couldn’t keep up with all of the ideas people were bringing forward. Working with our foundation, we were able to be supported to open a space. So we have a physical space inside of the hospital where anyone in the hospital or patients can come and whether it’s prototyping an idea or maybe they just come with a problem, we are able to make it in real time. The best part about that– Anna mentioned the culture– we’ve created a culture here where we want to talk about what maybe they’re tinkering on because we have a safe place in the hospital that we can tinker on it and then create a prototype and then go back and get some feedback maybe from somebody using it on a different unit and then come back and make a change.
We have these micro-feedback loops. So we’ve really just ironed out a really great process of having a space to create things and then get feedback and create a fine tuning loop. It’s pretty awesome.
Dale: Feedback is such an important piece, isn’t it? That’s why I say like the prototyping process is really a means to get feedback about this original idea you had.
Anna: It’s flipping the medical device development kind of cycle on its head, R & D’s process. Whereas typically clinicians would receive a very close to finished version of a device, maybe to give feedback on, where at this stage they can drive the process based off of what the idea is. They’re so close to the challenge that it’s really neat to see how they can build in features that an engineer may not think about if you’re not living these experiences day in and day out.
Dale: It reminds me a bit of what we saw during covid of some of the makerspaces that got involved in making face masks and other devices. It was just such a beautiful realization of this maker idea that designs could go anywhere in the world, but they had to be made somewhere. When you make them locally, you can customize them locally and you could get feedback from a doctor that says, that just doesn’t work for me. Can you make it longer? Or whatever the feedback was, and people working on it say, yeah, certainly we can do that.
One question though. Medical devices are highly regulated. There was even concerns with makers making stuff that they didn’t understand what the regulatory requirements were around things. How do you deal with regulations and restrictions?
Rose: A great question and a common question. We quickly realized as we were preparing to open our makerspace in the hospital, that we needed to have whatever those measures were in place.
We created an innovation safety council, which really talks through all of the things inside of a hospital, whether it’s something that comes from the makerspace or not. So something like adapting an automated bed turner, right? Who do I need to talk to? So we have people on this council from biomed, risk, compliance, infection prevention, all of the things that hit those core things of, what are the fail proofs before we would touch a patient with something? So we have a process ironed out pretty well. We also have an IRB that if we’re doing any kind of research with it, that we would go through. And then we have support from the system level if it was something we needed to go further with.
But a lot of our projects are single patient impact projects.
Dale: That’s a solution customized for a single patient.
Anna: Yeah. I feel that what’s exciting when you hear about Unity Point is it’s like the right level of just procedures and reviews. It’s not new to make things inside of a hospital– hospitals have been making devices that they use, but being able to put those reviews in place so that it meets different risks and safety requirements. But still fosters again that culture of okay, you can make something new. Because sometimes even just the act of making it even is really exciting for a clinician.
Dale: I actually wanted to get back an automated bed turner? I don’t know what that means. So what’s an automated bed turner?
Rose: Patients who are bedridden have devices that inflate certain areas of the mattress.
Dale: Oh, okay.
Rose: So it’s almost like you’re turning the patient. But it’s an air device.
Dale: There’s no grappling involved. What are some of the other innovations you’ve seen come out?
Rose: We’re preparing for Maker Fair, so we’re getting a lot of projects either recreating or getting ready. We do a lot of devices or creations that help us with education, with things we might not be able to simulate in real life. I’m looking at one right now and I’ll share with you cause I just happen to have a stack of them here.
It looks awful, but there’s just some silicone, right? It’s just a silicone overlay that we then have kinda like a vinyl sheet that goes underneath it, but we attach these to a mannequin and then we have a blood filled sac in the middle. So we’re able to simulate the escharotomy process when a patient has a burn really badly if they’re in the field.
We’re using this specifically with our flight helicopter paramedics and nurses. But we’re able to use this as an educational process of how do I even do that technique and what does it feel like to cut through skin and to be able to know I’ve hit the right depth. So doing educational tools like that, creating our own, these products that are on the market are so very expensive.
So is it something we can make here if it’s something simple like, I need to be able to learn that skill or practice that skill? We do things like that. We do a lot of 3D printing. We have several 3D printers that they’re constantly running, whether we’re fixing a face plate for an IV holder, one that broke. And we don’t need to replace the whole device. We just need a little piece of it. The possibilities are endless. There’s just lots of things.
Dale: I bet it’s true, is that once you get people solving problems, they start to see lots of more problems they can solve, right?
And it isn’t always about devices. It could be process oriented solutions, right? People feel like they can talk about making changes to things that have been done a certain way sometimes for a long time.
Rose: Absolutely. Sometimes it’s a process just as you had mentioned. And sometimes after you have somebody that comes in, learns a new skill, because that’s how we function. We help you do the project. They will then bring a friend over. Hey, I learned how to run the laser cutter and actually let me show you. Now they’re teaching other people. The thing that really helps me just feel even more pride– I love the work that I do –is every time people come in and they’re really engaged in their work and the pride that they have in their work, it’s a different way to care. It’s a different way that we provide care and are enabling people to do that.
Dale: How do nurses get time to do this? Time must be a challenge for, it’s a challenge for anybody, but especially in a hospital.
Rose: That is a big question. So some of it is, some people are so excited about their project that they make the time and they come. They come. Sometimes it’s associated to a specific project for their units, and then they’re allotted a certain amount of time to be able to work on it. Sometimes it’s associated with our nurse residency program where they have a project they’ve been working on all year, and then they do the work here in the lab.
We also have an intern in our lab who helps facilitate projects from the frontline to the lab and back. Sometimes they can’t get away and that is a challenge I think that most healthcare professionals will say that. We have a shortage of healthcare workers.
Anna: One of my favorite strategies is when Rose messages and says we’re taking the sewing machine to the unit. The ICU needs it. So it’s part of, is fitting, fitting the makerspace into the realities of the work in the hospital and those schedules.
Dale: If they had to go to a university or somewhere to do this even, it would be a lot more time consuming. Having it right in the building must make a difference.
Anna: Yeah, it’s right next to the coffee shop, first floor of the hospital. Amazing.
Dale: Can you give me a story of a sort of someone that’s been surprised at what they were able to do and solve, someone that didn’t think they could solve a problem?
Rose: A great one from two weeks ago. You said somebody that was surprised and I was like, oh, he’s gonna ask me my favorite story. But this one was a surprise story. This nurse had been a nurse, she’s probably been a nurse for 30 years, and after she came and worked with us, she then shared when her project was done, she said, I was very curious when you opened this space, what are they actually gonna do?
Which I was like, oh, that’s some interesting feedback. But she came down and shared that when they do cosmetic surgeries, they have to put little rubber bands in the hair that helps adjust where the skin lies during this procedure. The rubber bands are very small, almost the size of what you would use on braces.
She wanted to create like a fancy tweezer almost, that you could load up, but then put it around the hair and it would deploy a rubber band. Something very simple. We can CAD that, we can get that printing today. We worked with her on this process. We got it printing. We even put her name on the side of it and she was just so excited.
She said, I had no idea I could come in here and tell you roughly what my idea was and you’d help me do it. Yeah, that’s what we do. And I found a lot of pride that day because I knew she came in skeptical. I know her from working on the floor and she came in skeptical, but was willing to just be curious enough to try it out.
Then she walked out that same day with something we could go get feedback from her peers.
Dale: Was that a 3D printed thing?
Rose: Just a 3D printed fancy tweezers.
Dale: That’s great.
You probably have more of the context of how does the medical world look at this? Or even if they’re looking at it. But people must come visit the Generate space and see why can’t we do this in our hospital?
Rose: We do.
Anna: No, and it’s amazing. I love when Rose talks about like the visitors that they have and when they’re surprised that it is a community hospital that is able to produce and use this portfolio of technologies that are made in-house and designed in-house. I feel really proud to be able to just to see it happening.
Dale: One of the ways people could see what’s happening there is a Maker Faire that’s coming. Tell us about that Rose.
Rose: So we are getting ready for it’s nurses week rolling into, and so we wanted to celebrate really just the frontline ingenuity and creativity of our people here at the hospital.
We’d planned this. We opened in the fall of 2019, and then the pandemic came. So we put a pause on it. Pause. And. And we’re ready. We’re ready to start sharing some of our celebrations. We’re having an open house here, Maker Faire, where we’re gonna spotlight some of our projects from the last four years.
Dale: I wish you the best of luck on that. It’s such a dream. The 30-year career nurse that comes in doesn’t have any of these skills, comes in with an idea, be able to walk out with a product and say that that’s something I made. That’s the dream of the maker movement right there, right?
This can transform how people think about themselves. That I’m a creator, I’m a maker. It doesn’t matter how complex these tools are. People can help you, you can get better at them, but you were the one that came in with the idea and you were able to walk out with something real that addressed it, solved the problem.
Sometimes there are people out there that are skeptical and they have to see it for themselves and that’s what the Maker Faire can accomplish. Anna, are you gonna be out there for it?
Anna: We’ll be there supporting Rose and anything — I’ll get the coffee. You just tell me, we’ll support you with that. But we’ll also be live streaming just conversations with some of the makers who are exhibiting throughout the day. So on our Instagram account.
Dale: Let us know more about it as it happens. It’ll catch that. I think it’s important for others that may care about this, is it doesn’t really matter what the size or in what context a Maker Faire happens. It’s really, it’s just really about bringing a community together. And sharing. People are proud to talk about the things that they do, and it opens the door to other people thinking I could do that. That’s possible for me.
Anna: It’s amazing. I think there’s so many lessons from Maker Faire that healthcare benefits from and being able to see Rose build this culture and it happening in other places like that.
The exhibits, right? They’re your project, but they’re also the process. Like my favorite Maker Faire exhibits are the ones where people have the four prototypes that didn’t work. And then they also show you what they learned along the way. So that just like exchange of learning and open.
Dale: So that’s pretty amazing. I wish you both well on, on your event and it sounds wonderful. Rose, particularly, thank you for what you’re doing both as a maker and a nurse.
Rose: I’m very lucky that I was able to connect with Anna and get to do the work I do.
Dale: Anna, thank you for connecting to people like Rose and spreading this.
Anna: She’s why we do it. It’s great.
Learn more about generate Lab Maker Faire.