Gowns are one of the most used items in a hospital, and are often overlooked for an opportunity to provide a better experience. The Live Well team, which consisted of design, business, biomedical, and nursing students, was challenged by the Hill Rom team to find ways to reduce pressure ulcers incurred during hospital stays. In 2008, at the time of this project, Medicare/Medicaid had recently announced that they would no longer reimburse hospitals for pressure sores incurred during inpatient stays. The gown was identified as the item that came between the mattress and individual to help reduce bed sores, which would ultimately reduce costs for the hospitals.
The Live Well team visited three hospitals to observe their systems of gown management, use, and perceptions. The team noted the hospital layout and flow, as well as the interpersonal relationship of the utilized gowns. Patient rooms and hallways were then measured to understand spatial limits. They then timed how long it took nurses to complete certain tasks because convenience and efficiency are of primary importance to caretakers.
From there, the team developed two personas — one to capture the role of the healthcare staff that sees the patient every so often and the other for the role of the caretaker, or day-to-day nurse.
After studying the existing gowns and systems in place, anatomy and challenges were recorded to inform the Ideation Phase.
Binding on edges
V-neck (for tracheostomy’s and choking)
Telemetry pocket with a hole
Residual stains are icky
Frumpy men’s boxer pattern
Tie closure metal snaps sometimes interfere with radiology
Overlap in material offsets back seam
Lower ties often left loose to eliminate choking
Possibility of allergic detergents in washing
Sometimes double gown
Feels cold, sterile, and out of user's control
Gowns are difficult to put on
No personal touch, no comfort
Loss of identity and modesty
Generic sizes, one size fits no one
Negativity and insecurity contributes to poor health
Loosening lower ties
Snap changing method
Bed pad repositioning aid
During the Ideation Phase, the Live Well team had the honor of attending a women's panel at Dr. Shelley Tretter's office. The following are key insights collected during that time:
“[The gowns are] not designed for women.”
Prints look like “grandma’s couch."
The disposable gowns rip too easily; they don’t stretch around curves. And when they rip, you end up even more exposed than before.
The gown bunches and tangles in the bed.
They leave you feeling cold.
Hard to fix yourself when you have an IV.
“You can only smooth one side of your gown and the other side stays all bunched up. But when I had scrub pants on, I wasn’t so worried about my gown bunching because I didn’t worry about being exposed.”
These insights were of great importance to the team and added a wonderful perspective from medical stakeholders in the redesign of the gowns.
Choosing the right fabric and color for the gowns was a vital part of the design process. Fabric had to be comfortable as well as durable and colors had to make patients feel calm and clean. Some things that were kept in mind during this exploration included antimicrobial synthetic materials, antimicrobial natural materials, microencapsulation, aromatherapy, homeopathy, laundering, recycling, non-recyclable waste and reclamation.
Caregivers and patients need variety in garment options to best support rehabilitation performance. Inspiration for the wrap closure pants and shorts came from designer Issey Miyake's garments, particularly their tear-away pants. The team desired garments that would accommodate PT and OT involvement, as well as provide flexibility in use.
When it came to designing a gown that would work best in the hospital room for things such as dressing changes, line changes, and transfers, the Live Well team sought to maintain dignity and accessibility, eliminate pressure points, and provide comfort.
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