In this first Q&A, we speak with Design Vanguard member Bon Ku, MD, MPP, a practicing emergency medicine physician based in Philadelphia. He is on the ground treating COVID-19 patients, and shares his perspective about design’s role in healthcare during COVID-19.

Bon Ku is the Director of the Health Design Lab at Thomas Jefferson University where he created the first design thinking program at a medical school. He is a Professor of Emergency Medicine, the Assistant Dean for Health & Design and a practicing clinician. Bon is also the co-author with Ellen Lupton of Health Design Thinking: Creating Products and Services for Better Health.

Design Vanguard: What are the most urgent design needs among frontline health workers right now? Are there any ad hoc solutions you’ve seen in action?

Bon Ku: While it has fallen out of the news cycle, we need to design PPE to protect frontline health workers. Many workers still don’t have adequate protection. Nurses and doctors reuse N95 respirators for multiple days, even weeks. The organization Fix The Mask developed a creative solution of converting surgical masks, which are in plentiful supply into tighter fitting masks that offer better protection. The solution only requires rubber bands!

WORKERS STILL DON’T HAVE ADEQUATE PROTECTION. NURSES AND DOCTORS REUSE N95 RESPIRATORS FOR MULTIPLE DAYS, EVEN WEEKS.

It’s exhausting to wear N95 masks for 8, 10, 12 hours at time. It’s suffocating and many of us have skin breakdown from continuously wearing them. We need to design masks that are more comfortable, but still offer protection. The “new normal” of health care may require health care workers to wear PPE when treating patients who present with respiratory or infectious symptoms.


DV: Beyond PPE, how can designers support frontline workers?

BK: I’ve been thinking about this a lot. Designers have the skill of simplifying complex problems. In the healthcare space, I have been inviting designers to help us with the problems we face on the front lines. Recently, I worked with architects from Kieran Timberlake to help us rearrange the waiting areas in the ER to keep patients >6 feet apart.

DESIGNERS HAVE THE SKILL OF SIMPLIFYING COMPLEX PROBLEMS.

My colleagues and I from the Health Design Lab launched Designing on the Front Lines, a virtually weekly hangout with doctors, designers, and others. It’s been a great format for designers to connect with health care workers and gain insight into the challenges we are facing.

DV: Being hospitalized for COVID-19 seems incredibly lonely and frightening; are there any design solutions you suggest might help ease this?

Patients are afraid; sometimes, they end up in the worst case scenario of dying alone. Because of the risk of infection, visitors are not allowed to see patients hospitalized with COVID-19. Healthcare workers have been using workarounds like facetiming with patients and their family members.

I’d love to see designers help us to get more creative with solutions that give patients more access to their family and friends when hospitalized.

I’D LOVE TO SEE DESIGNERS HELP US GET MORE CREATIVE WITH SOLUTIONS THAT GIVE PATIENTS MORE ACCESS TO THEIR FAMILY AND FRIENDS WHEN HOSPITALIZED.

DV: Studies show that some people are afraid to go to the hospital for fear of getting the virus; how might design better protect and comfort people who need to visit hospitals for non-COVID ailments?

BK: It can be frightening for a patient to visit the hospital during this time. Patients can’t even see our faces because we are all wearing masks. Emergency rooms have outdoor triage areas to separate non-COVID and COVID patients before they enter the hospital.

Designers can help us with wayfinding and signage to communicate to patients they will be safe when they enter hospitals and clinics. And we can use storytelling to explain how we have set up protocols to reduce the risk of infection. This might help to alleviate fears. I’m worried about patients having worse outcomes because of delayed treatment and delayed diagnoses.

DV: This pandemic has been a crash course for so many Americans in viruses, germ, health & hygiene. Are there any public health campaigns that you’ve thought were particularly effective at educating and motivating the general public?

BK: The coronavirus becomes tangible to us in the form of data visualizations: charts, bar graphs, predictive models. The Flatten the Curve chart helped to explain how social distancing would prevent health care system capacity from getting overwhelmed. I’m a huge fan of Mona Chalabi. She creates beautiful, compelling illustrations from public health data. Her data visualizations make complex topics like antibody testing easier to understand.

DV: Are there questions or topics you wish the media/public officials were asking about, but aren’t?

BK: We need to focus more attention on “super-spreading” locations. The COVID-19 hotspots are nursing homes, meatpacking plants and prisons. We need to target the places where people are dying at the highest rates and be aggressive about testing, contact tracing, and quarantine.

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