OREGON STATE UNIVERSITY

New C-Section System Developed for Rural Hospitals

07/05/2007

CORVALLIS, Ore. – A working prototype has been developed for a new communication and information system to facilitate emergency Caesarean sections at rural hospitals – a system that can quickly and efficiently assemble the C-section surgical team and prepare the patient and operating room.

The work is the combined effort of engineering graduate students and faculty at Oregon State University, along with doctors at Peace Harbor Hospital in Florence, Ore.

Almost 30 percent of babies born in the United States are delivered by C-section, many performed at small or rural hospitals.

The OSU venture, which started in a human-machines system engineering course taught by OSU associate professor Ken Funk, blossomed into a full-scale research and development project. The research group is now looking to partner with a funding entity to take the project from prototype to the next level.

In small rural hospitals like Peace Harbor, where only two operating rooms are available, one is not typically set up for emergency C-sections because they are performed less frequently than other surgical procedures. At Peace Harbor, on-call members of the preparation and surgical teams must be summoned and the room prepared before the surgery can begin. The goal is to make the first incision within 30 minutes of the decision to operate in order to minimize risks to mother and child.

This goal places intense time pressure on the preparation and surgical teams. The narrow window of time “from decision to incision,” in combination with system vulnerabilities and intrinsic human fallibilities, increases the risk of an adverse outcome, Funk said.

“The goal is to enhance human performance in complex, high-risk situations,” he said. “We saw this as an opportunity to develop an information and communications system using a very human-centered, rather than technology-centered, approach.”

Their design consists of software coupled with a network of wireless devices – smart phones, tablet PCs and a large display screen – that tracks the progress of each procedure needing completion before a Caesarean section can be performed. Each device is automatically updated as steps are completed, informing every member of the preparation and surgical teams of the status of the operating room, patients and team members themselves.

The current system involves the hospital ward clerk individually calling each of the five to eight team members who are on-call. If one member cannot be reached, the clerk must then call another member as a replacement.

“With such tight time constraints, a few minutes of delay can be critical,” Funk said. The C-Section Facilitator System automatically calls every member concurrently, significantly reducing the amount of time the ward clerk and other members must spend simply assembling the team.

Funk and his students are working to advance how humans and machines work together to improve efficiency and accuracy in complex situations. They strive to understand the problems in order to facilitate the processes and to support hospital staff. By modeling the process and working with medical doctors, they were able to learn the users’ needs and generate the requirements for their new system.

For this project, 13 graduate students, including Melissa Hastings, Robin Feuerbacher, Lin-hui Huang and Leslie Braitch, formed a team with Funk, Dr. James Bauer, an obstetrician/gynecologist at Peace Harbor, and Dr. David Blatt, a retired Corvallis anesthesiologist.

“This has been a great experience,” said Bauer. “These students are very talented and engaged. They work hard and like to explore new ideas. It’s very rewarding. And this system is something that’s definitely needed at small and rural hospitals.”

The C-Section Facilitator System has been tested in Peace Harbor Hospital and updated to incorporate the needs and suggestions of hospital staff during practical usage. The system is in its prototype stage, needing additional testing and funding before it can be fully integrated into Peace Harbor and commercially developed.