Hand in Hand: Unique Collaboration Between Tulane Engineering and Medical Students Helps Improve Hospitals

Spring 2015 | Article by Nicole Escarra

Hand in Hand: Unique Collaboration Between Tulane Engineering and Medical Students Helps Improve Hospitals

Last month, engineering undergraduates Gregory Michaelson and Zachary Resnick joined a group of medical students at the National Forum on Quality Improvement in Health Care, hosted by the Institute for Healthcare Improvement (IHI). Led by Dr. Frank Rosinia, Chairman of the Anesthesiology Department at Tulane Medical School, the team presented on their efforts to improve hand hygiene at the Tulane Medical Center.

Michaelson (’15) and Resnick (’15) collaborated with Dr. Rosinia and Tulane medical students over the summer of 2014, studying hand hygiene practices in the transplant unit at the Tulane Medical Center. Specifically, the team set out to determine how much hand sanitizer should be used, given the existing traffic patterns of nurses and doctors on the unit. The project required twenty-four hour surveillance of the transplant unit over a period of time, and students took shifts to observe and record compliance and traffic patterns.

In addition to calculating how much sanitizer the transplant unit should use in a given period, Michaelson and Resnick also needed to determine how much of the liquid was actually being dispensed. In order to do this, the two students designed two modifications to the standard Steris soap dispenser. First, they developed a sticker that allowed them to quickly measure the volume of soap in each dispenser. The sticker adheres directly to the dispenser and was designed to align with a reference point on the container itself, thereby reducing the risk of installation error. Previously, the only method used to measure the rate at which hand sanitizer was consumed was to note how frequently the 1,000-milliliter unit was replaced over a period of time. To provide greater accuracy, the students designed the sticker to measure usage in 50-milliliter intervals, which allowed them to measure changes in volume in between the installation and replacement of the soap container.

The second modification made to the Steris soap dispenser was the installation of a tally counter clip. The tally counter clip is made up of two components: a pre-fabricated tally counter and a clip designed by Michaelson and Resnick. The tally counter was inserted into the clip and attached to a hand sanitizer unit. Located underneath the tab used to release sanitizer, the tally counter clip is hidden from sight and records the number of times the hand sanitizer pump is actually pressed. Michaelson and Resnick designed the prototype for the clip using SolidWorks CAD software and an Ultimaker 3D printer, both of which were available to them at the Tulane Engineering Physics Design Laboratory.

Rosinia, Chairman of the Anesthesiology department at Tulane Medical School, shared that the volumetric sticker and tally counter clip were a resounding success.

“Steris, the company that supplies the Tulane Medical Center with the soap dispensers, liked the volumetric sticker so much that they paid for them to be made and installed throughout the transplant unit. They are also interested in further development of the clip prototype for other clients,” said Rosinia.

The undergraduate engineering students joined the team as part of their Summer Internship engineering course, taught by Norman Horwitz, a senior professor of practice in the School of Science and Engineering.

The seeds of collaboration between Tulane medical and engineering students were planted when Rosinia and Horwitz met years ago, through a mutual acquaintance. Both men felt that there could be more projects that cut across standard medical and engineering lines, and they encouraged their students to undertake joint research. This initial interdisciplinary effort resulted in a paper, published in the American Society of Anesthesiologist Practice Management (ASAPM), which focused on the use of industrial engineering techniques to study key metrics of operating room management.

Horwitz, whose professional background is industrial and mechanical engineering, knows from experience how engineering skills can benefit healthcare settings. Before coming to Tulane University, Horwitz taught industrial and mechanical engineering at Southern Illinois University for twenty-six years, and consulted for hospitals and automotive companies.

“How we think about quality has really changed over the years, and hospitals have started to come on board with ways of thinking developed in industry,” said Horwitz.

“Both the auto industry and the military use statistical techniques to predict when products go out of specification. Using engineering techniques is really about improving the productivity and quality of an organization.”

“The skills and techniques used in industry and manufacturing are well-suited for examining hospital health care,” added Horwitz.

For many, it seems logical that engineering techniques can be used to streamline the construction process for a vehicle, or improve military logistics, but the application of engineering practices to hospital operations can initially seem an unlikely union. Resnick, who will graduate in spring 2015 with a degree in engineering physics, has noticed that the application of engineering skills in a hospital setting can be a foreign concept to some people. When Resnick describes the summer internship project, he is often asked whether he is a pre-med student.

“I have to explain to them that, no, I am not pre-med,” said Resnick. “I was just doing engineering work at a hospital.”

Horwitz is not surprised by the initial confusion felt by some when hearing of an engineer working at a hospital.

“Doctors often don’t have a sense of what engineers can do,” said Horwitz. “And engineers can feel unwelcome in a hospital.”

There is, however, at least one doctor at the Tulane Medical Center who is quite aware of how an engineering mindset can benefit the medical sector.

“Engineering students are really good at creating improvement,” said Rosinia. “And this kind of collaboration is starting to happen a lot more. For this particular project, we had nurses, doctors, engineering students, professors…all of those components were really necessary to reach this solution.”

For Michaelson and Resnick, the internship opened their eyes to new uses of their engineering skills. Michaelson, who will also graduate this spring, realized that engineering skills enable him to solve problems in unexpected industries.

“I would never have thought that engineering expertise would be useful in a hand hygiene study,” said Michaelson.

Resnick echoed his classmate’s view.

“After this internship, I realized that engineering concepts can be applied to any field,” said Resnick. “And I came to the realization that, after four years of engineering classes, the number one skill I'm leaving with is problem-solving, and that skill is useful in all industries.”

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