Research Profile - Green means you’re clean

A researcher with a strong record of commercializing patient-care products has found a high-tech way to help medical staff keep their hands clean

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Dr. Geoff Fernie remembers his first attempt, about 15 years ago, to improve hand hygiene and stem the flow of infection transmission in hospitals.

"It looked a pregnant Coke machine" says Dr. Fernie, Vice-President of Research at Toronto Rehab. "It had a belly which opened and you could wash your hands. What was important was that it recorded who you were. But it was a big installation and it never made it commercially."

It was also, he says, "ahead of the trend," in addressing a problem that – pre-SARS and the now common hospital outbreaks of C. difficile and Methicillin-Resistant Staphylococcus aureus (MRSA) – had yet to become a mainstream public health concern.

Since then, Dr. Fernie, who has several successful rehab and patient-care products to his credit, has helped one of his research team members bring a wearable gel dispenser to the marketplace.

"Geoff was instrumental in introducing us to clinical partners and in setting up clinical trials for us with prototypes at Toronto Rehab," says Mr. Gilad Shoham, now CEO of Medonyx and the inventor of its mainstay product, gelFAST. "He really helped leverage it out of the lab and into the real world. People like Geoff bridge both worlds of clinical research and commercial application."

Dr. Fernie is bridging those worlds again as he revisits the persistent problem of inadequate hand-cleansing by medical staff. And he's bringing back a key feature of his first hand-hygiene system – recording who has cleaned their hands – to do it.

"We've gone back, really, to our original thoughts about individual responsibility. Because all around the world there have been attempts to increase hand hygiene and while all of them have shown an increase – it's never sustained. People fall back into their old ways."

With funding from the Canadian Institutes of Health Research (CIHR) and the Health Technology Exchange (HTX), Dr. Fernie and his team have developed an ID badge with a built-in electronic eye that tracks up to the ceiling where zones of potential infection sites - a patient's bed, for example - are marked with tiny infrared beacons. The badge registers when a doctor or nurse crosses into and out of the zone and records whether they clean their hands. If they forget, they get a little beeping or vibrating reminder. As an added incentive, an LED light on the badge glows green when its wearer's hands are clean.

"To get the sustainability, it contains a record of all the hand hygiene operations – whether the person needed prompting, whether they responded to it," says Dr. Fernie. "All of that can be downloaded, probably weekly, so that their unit manager can sit down with them and work out any problems."

Dr. Fernie is in the process of patenting the sophisticated technology and, with funding from CIHR, is beginning a clinical trial that will involve installing the system throughout a 50-bed hospital unit.

"We have a licensee – the AJ Hart Group – who has worked with us from the very beginning. But this is becoming too big, so we're developing business plans for a relationship with a larger organization – a company with more capacity to get this out."

AJ Hart's Mr. Andrew Hart sees the hand-cleansing technology as a product that – unlike the pregnant Coke machine – is perfectly timed to meet a critical need.

"It's going to come into the marketplace well, with the infection issues that hospitals are facing. The market is enormous: we're talking about 7,000 hospitals in North America. All of them will need this kind of system to assist their staff."

Meanwhile, back in the lab...

Dr. Fernie and his team of researchers and designers at Toronto Rehab have a successful track record in developing health care products that make life easier for medical staff and their patients.

"We developed Staxi, a nestable medical transport chair, because hospitals are getting bigger and bigger and patients can't cope with the distances and get exhausted," says Dr. Fernie. "Until Staxi, there were only those clunky wheelchairs out front in hospitals, none of which ever seemed to work. Staxi is available in car parks and hallways and all over hospitals. It's used in hospitals all over North America."

Next up is SlingSerter. The hand-held device makes it easier to slide a sling under immobilized patients to raise them up from their hospital beds with an overhead lift.

"It's a totally different approach," explains Dr. Fernie. "It's a little cartridge that you plug into a portable air source and point at the patient. It pneumatically extrudes a tube which crawls under the patient. It pops out the other side and carries a strap that you can then connect to an overhead lift. You squirt two or three of these under the patient, lift them a little bit and then slide the sling underneath with no problem at all."

SlingSerter, which Dr. Fernie says is "almost to market," began life as a CIHR-funded research project several years ago.

"We tend to focus on applied research. And there's no point in doing it unless you get it translated into action. We put a lot of emphasis on disseminating best practices. We also have a unit that works very closely with policy-makers in the Ministry of Health in Ontario. But we view commercialization as an equally important avenue for knowledge translation."
Dr. Geoff Fernie