Rutgers RWJMS COVID-19 Innovation Task Force

Introduction
In March of 2020, the United States became overrun with the global COVID-19 Pandemic. Healthcare workers on the frontlines faced insurmountable challenges as emergency departments overflowed with patients exhibiting symptoms of respiratory viral illness. Intensive care units adjusted to new paradigms as in-person family meetings came to a halt. Surgical units suspended all elective procedures. Personal protective equipment (PPE) shortages became widespread. This was particularly apparent in New Jersey, one of the country’s epicenters of COVID-19 cases.While many students and external organizations shifted their focus to the much-needed challenge of acquiring and donating PPE, the country’s healthcare systems and hospitals faced so many other unique obstacles that also affected standard healthcare practice. In New Jersey, at Rutgers University’s Robert Wood Johnson Medical School, a small coalition of medical students and faculty, led by Gregg Khodorov, MD, MBA (RWJMS Class of 2020) and Faculty Advisor Dr. Paul Weber, MD, RPh, MBA, began working on a novel approach to addressing the varied challenges facing our primary teaching hospital and health system.

Two main problems were identified:

• Medical students were restricted to learning and working from home at a time when our healthcare system needed us the most.
• Hospital clinicians, staff, and administration were constantly "putting out fires", and could not afford time to brainstorm innovative solutions

These problems required a novel solution: a new infrastructure that would allow the healthcare system to capitalize on the collective creative potential of medical students to tackle the most pressing issues.

Introducing: The RWJMS COVID-19 Innovation Task Force

On March 30, the RWJMS COVID-19 Innovation Task Force (CITF) was inaugurated. The goals of the CITF were as follows:

• Gather input from key Robert Wood Johnson University Hospital and Robert Wood Johnson Medical School stakeholders on the most pressing COVID-19-related issues plaguing our health system. This would include current problems, as well as predicted problems on the horizon.
• Locate key Rutgers University faculty, staff, and organizations that would be willing to help collaborate [e.g. Biomedical Engineering/School of Pharmacy staff, Rutgers MakerSpace, Rutgers Entrepreneurial Society (RES), etc.]
• Provide bi-weekly summarized updates to key hospital/medical school clinical mentors on active projects, enabling the task force to recruit additional collaborators.
• Assemble and train a capable response team of students to help address pressing COVID-19-related problems using 2 week “Design Sprints”. Sub-teams would each tackle an individual problem or group of problems.
• Create a centralized portal to manage and monitor all sub-teams as they continue to workshop and build out modern solutions to address these problems.
• Provide bi-weekly summarized updates to key hospital/medical school stakeholders on active projects, enabling the task force to recruit additional collaborators.
• Award Distinction for Medical Innovation and Entrepreneurship (DiMIE) credit for those students who participated.
• Apply for elective credit for those students who participated.
• Share and collaborate with national efforts of other schools/students/designers via the Emergency Design Collective.

Design Thinking and Design Sprints: An Overview

Design Thinking is a rigorous methodology that focuses on creating useful and sustainable innovations through a human-centered design process. In the context of healthcare, this translates to an end-user-centered design process, with the end-users being patients or their healthcare providers.

Design Thinking generally consists of the following key steps:

• Empathize: thoroughly understanding the end-user through interviews, surveys, and primary research
• Define: succinctly stating the problem that needs addressing, generally using a single sentence that starts with “How Might We…”
• Ideate: brainstorming solutions and gathering input from everyone involved in the day-to-day use of the potential innovation, including patients, healthcare providers, custodians, etc. No idea is a bad idea at this stage.
• Prototype: building early physical manifestations of the teams' best ideas as soon as they have a sense of what a solution might look like. It’s important to begin prototyping before you have a final model drawn up--this is an opportunity to learn from a simple model made of pipe cleaners and cardboard, or a slide show demonstrating a smartphone application.
• Test: showing your prototype to the end-user and using their feedback as a means for future iterations.
• Implement: approaching widespread adoption of your finalized innovation.

In an ideal world, Design Thinking is a methodology that should have no time limit-–quality user-driven innovation takes ample time and many iterative cycles to get right. However, given the time limitations imposed on the Task Force by an impending peak in COVID-19 volume in our hospitals, the RWJMS CITF adopted a rapid-cycle approach made famous by Google Ventures (GV), known as the Design Sprint.

A GV Design Sprint is meant to help companies move quickly into new markets with rapid innovation of new products or service lines. It consists of 5 Phases:

1. Understand
2. Diverge
3. Converge
4. Prototype
5. Test & Learn

The Plan

1. Reach out to clinical faculty and ask for problems they are experiencing on the front lines that may require radical, out-of-the-box thinking in order to innovate appropriate solutions.
2. Recruit a team of medical students, with diverse backgrounds including, but not limited to, biomedical engineering, IT, telemedicine, emergency medical services, clinical research, and corporate consulting.
3. Introduce Design Thinking methodology and Design Sprint format to students with a kickoff lecture.
4. Assign fourth-year medical students to lead sub-teams to address the most pressing problems submitted to us by faculty.
5. Reconvene after a two-week Design Sprint to present our findings/solutions to hospital and health system leadership.