Week 4: Building the ‘Cuartito’ with Invenio

The Need

The peritoneal dialysis patients at the Hospital in Libería were eagerly awaiting their cuartito (which translates to little room). You can’t blame them for their excitement either. These patients wait in a small room with two rows of hospital beds, to perform their dialysis for about 12 hours a day. The room is about 90 ˚F (no air conditioning) and there is a small TV to keep the patients occupied. Basic enjoyments of life, such as drinking a full glass of water, cannot be indulged in because of their condition. Developing a cost-effective way to allow patients to remain at home and continue with dialysis would greatly improve their quality of life. It was these needs that inspired last year’s cohort to work on this project, and it was up to our cohort to optimize the design further.

Teamwork

The team was split into three groups: Materials, Building and Testing. The Materials team (Callie, Karlee, and Anna) were responsible for sourcing the materials needed to build the device while maintaining cost optimization as a driving factor in purchases. The Build team (Tasha, Ryan and Sanjana) were primarily in charge of building the frame, sink and drainage systems in the room. And the Testing team (Chandler and I) were given the responsibility of ensuring logistics and developing guides for Customer Feedback after our testing of the device.  Although these groups had their own specific functions, ultimately all the groups tried to help each other as much as possible to ensure that we could get the prototype built within a week’s time.

Let’s Get to Building!

After our planning at Invenio (which graciously provided us access to their space and equipment) as well as some last minute observations, we could finally start building the device. The first day, the Build team as well as some the Invenio engineers help build the frame of the room. We used a foam-insulated aluminum as the ‘walls’ of the cuartito as well as some aluminum t-slots to hold everything together. The Materials team went on a scavenger hunt to various hardware stores to find sinks, tables, chair, hooks, pipes, etc. If you have ever watched Extreme Makeover: Home Edition, the Materials team was basically running around like interior designers of that show. Our Testing team focused on essentially four aspects for the week:

1. Develop a pre-prototype interview guide with stakeholders
2. Design Easy to read infographics on the process of peritoneal dialysis
3. Figure out how to transport and set-up the deconstructed prototype to the Hospital
4. Construct a post-testing interview guide to gauge stakeholder (Patient, Doctor, Nurse, Hospital Director) feedback.

Pre-prototype Interview Guide

Even though our previous cohort had interviewed patients, doctors, nurses and others about what they would want in a functioning device, our team felt it was necessary to undergo the same preliminary interviews for two main reasons. The first reason being that there was still the potential for new insights on how to improve our designs. Last year’s team had brought a prototype last year to test, and our goal was to improve upon that. The second (and equally important) reason was to build an empathetic connection with the various stakeholders involved in the entire process of peritoneal dialysis at Hospital Libería. Without understanding the everyday problems that people endure, a truly successful device cannot be implemented.

Infographics

After watching the typical procedure for peritoneal dialysis at the hospital last week, we thought it would be a good idea to test different infographic posters. We wanted to analyze what specific layouts, colors, instructions and font sizes patients and doctors preferred. Chandler and I came up with two poster ideas. The information was the same on both posters, however the layout varies.

 

Logistics

To ensure everything went smoothly from building to transportation, our group was also responsible for logistics. This meant checking that we could:

• Borrow hospital equipment
• Be allowed entry to the hospital parking lot and unload equipment
• Conduct testing at a certain timeframe with the Doctor’s approval
• Fit materials into different vehicles for transport
• Arrange interview times with patients
  

  Chandler checking the  structural stability of the transportation

Post-Testing Stakeholder Feedback

After our prototype had been built, tested and deconstructed at Invenio, it was time to transport the device over to the hospital and begin our Customer Feedback testing. As our team graced the hallways of the hospital, carrying our interior components, we received stares of awe and wonder. It wasn’t because we looked cool, it was quite the opposite. I can only imagine how out-of-place we looked, walking through the halls carrying a beach chair, small plastic teal stools and buckets. We probably looked like foreigners who got lost on the way to the beach.

But nonetheless, Dr. Richardson and the Invenio Engineers were able to unload the frames, and we were able to start the set-up. After about an hour of set-up, there was a trickle of people in and out to see our cuartito. Let me preface that Costa Rican people are very nice, almost too nice. Practically every person we saw said that our prototype was “beautiful”, or “perfect”. Although we certainly appreciated the sentiment, for the purposes of improving our design, those responses wouldn’t suffice. After nudging them to give us feedback, we were able to get meaningful insights. The doctors, nurses and Paul (the maintenance engineer at the hospital) also provided great suggestions to help make our device more accessible to poorer people.

Reflections

After a grueling week, several complications and just general irritation (from bugs more than humans), it was fulfilling to see the impact of our hard work. The week we spent hustling and bustling was not for naught. The patients and doctors seemed to genuinely enjoy and appreciate the cuartito, even with the imperfections we saw in it. There is still room to optimize certain aspects of the design, but when the project goes into clinical trials and further implementation, we can hopefully save patients those visits to hospital and try to make life a little better for them.

Obligatory Monteverde Photos

We felt a little claustrophobic after being inside a workshop all week, so of course why not bask in Costa Rica’s amazing zip-lining in Monteverde!