An on-site makerspace leads to quick solution experimentation and implementation.
- Nurses have responded to the COVID-19 pandemic in inventive ways.
- Creating a culture of innovation enhances the ability in which clinicians can respond to unique situations.
- Creating a makerspace within an organization can encourage innovation and speed prototyping and implementation.
- The eight pillars of trust are clarity, compassion, character, competency, commitment, connection, contribution, and consistency.
Throughout the COVID-19 pandemic, frontline clinicians around the world have created novel solutions to never-before-seen patient care challenges. At St. Luke’s Hospital in Cedar Rapids, Iowa, one of a few U.S. hospitals with a medical makerspace, clinicians moved their creations from the supply closet to a world-class lab, where all hospital staff have access to technology (such as 3D printers and laser cutters) and technical training to design and prototype solutions. The proximity of the lab to hospital units helps accelerate project timelines—from creation to quick feedback loops and safety review, which, in turn, facilitated our response to the pandemic.
Investment in creative problem-solving
Most hospitals invest in disaster-response training in preparation for situations such as a pandemic, but St. Luke’s made an additional investment to support the creative problem-solving and prototyping capabilities of all hospital staff. Nursing leadership chose me to be the nurse champion for this program, with support from hospital leadership and the hospital foundation.
In fall 2017, an initial investment was made in the form of Create (MakerHealth), a cloud-based platform with guided drop-in prototyping labs open to all hospital staff. Over 2 years, the hospital’s culture began to shift, with ideas openly shared and discussed. Leadership quickly realized that an intermittent physical pop-up lab couldn’t keep up with the demand for prototyping at the point-of-care. In spring of 2019, I sought leadership approval and foundation funding to open a physical makerspace, designed and operated by MakerHealth. The doors opened in November that year.
Before the pandemic, the makerspace was thriving. From its opening until March 2020, 66 new projects were underway with more than 200 visits to the makerspace. In March, COVID-19 reached our state and clinicians and hospital staff leaned into our growing innovation culture. They began building solutions to the pandemic’s diverse challenges. The makerspace provided opportunities for micro-feedback loops, testing and experimentation, and supply-chain gap solutions.
Similar to the rest of the healthcare community, St. Luke’s was creating solutions as challenges arose. What set us apart was our ability to complete micro-feedback loops so that a project can move from an idea to prototype, out to the unit for feedback, and then back to the lab for iterations. The loop continues until a final product is completed.
For example, a pop-up tent was created using PVC pipe, painter’s plastic, and nurse-designed 3D printed clips. The tent was used to transport patients suspected to have COVID-19 from the back of an ambulance, through the ambulance bay, into the halls of the emergency department, and then safely into a patient room. This project went from idea to prototype in the makerspace and then to the frontline, then back to the makerspace for iterations. After the final device was developed, it went through internal safety review and was ready for use. All of this happened in a matter of hours.
Testing and experimenting
From examining splatter patterns of a simulated cough using luminescent liquid and black lights to creating an inline ventilator HEPA filter, the makerspace provided staff with the necessary environment to test their ideas. As the world reported complications in patient care, the St. Luke’s team worked upstream by experimenting with prototypes that might become solutions if those complications became our reality.
The medical makerspace served as a hub for presenting ideas and innovations and then safely experimenting with them to create usable solutions. Having a controlled environment allowed us to use a just-in-time fabrication response as we developed devices almost as quickly as the ideas were presented.
From personal protective equipment to patient care devices, supply-chain gaps have been evident everywhere during the pandemic. Inside St. Luke’s medical makerspace, we responded to those gaps by creating several projects to help supplement the demand. From customized telehealth carts to 3D-printed otoscope covers, we responded. We sewed cloth face masks, created 3D-printed face shields, and constructed an assembly line to put it all together. We had a physical space where ideas could be brainstormed, constructed, tested, and put to use.
Call to action
Throughout the pandemic, St. Luke’s staff have generated over 25 projects, including novel devices, adapted uses for existing devices, and new protocols. Some of the novel devices remained prototypes, and others were put into use on the units after an internal review. To date, more than 450 clinician-made devices have been implemented at the hospital and more than 1,550 across the healthcare system. Not only did we create quantifiable results, we also engaged the healthcare community in innovative ways.
As The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity states, “Nurse leaders can facilitate the creation of innovative approaches by challenging the status quo, breaking down traditional barriers to change, teaching and encouraging team members to solve problems.” Whether you have a designated space for health making, those working with patients every day should be empowered to bring their ideas forward. Create a culture where clinicians are enabled and eager to share their ideas. Now more than ever, we have a unique opportunity to take the lessons we’ve learned to create a stronger, more innovative workforce.
Rose Hedges is the nursing research and innovation coordinator at UnityPoint Health – St. Luke’s Hospital in Cedar Rapids, Iowa.
Marshall DR, McGrew DA. Creativity and innovation in health care: Opening a hospital makerspace. Nurse Leader. 2017;15(1):56-8. doi: 10.1016/j.mnl.2016.10.002
National Academies of Sciences, Engineering, and Medicine. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press; 2021.
Newby JC, Mabry MC, Carlisle BA, Olson DM, Lane BE. Reflections on nursing ingenuity during the COVID-19 pandemic. J Neurosci Nurs. 2020;52(5):E13-6. doi: 10.1097/JNN.0000000000000525
Key words: Prototyping, Nurse innovation, Nurse invention, Covid-19, Makerspace.