Engineers in Clinical Residence: Department of Surgery

13 April 2012

A discussion between Professor John Windsor (Surgery) and Associate Professor Bruce MacDonald (Electrical and Computer Engineering) who heads up the Technology for Health research theme in Engineering provided the catalyst for an initiative to “bridge the massive gap of Grafton Gully, the gap between Medicine and Engineering, and to find a way to bring these cultures together”.

Professor John Windsor says: “It became obvious that engineers wanting innovate in the health space are severely hampered by the lack of opportunities to understand what happens in health and to regularly interface with clinicians.”

Within a month of John and Bruce’s meeting of minds the Faculty of Medical and Health Sciences first Engineers in Clinical Residence programme began with a one-week pilot programme exposing three engineering students to the clinical work environment. This week long pilot was completed just prior to Easter.

Doctoral students Paul Roberts, Robert Dunn and final-year undergraduate Sarah Milsom were chosen as the inaugural Engineers in Clinical Residence.  The idea was to put them in technology-dependent medical specialties and to spend time with lead clinicians who see problems and want solutions.   They attended sessions at Auckland City Hospital’s Cardiothoracic Surgery, Clinical Engineering, General Surgery, Anaesthesia, Nutrition, Critical Care, Interventional Radiology and Neurosurgery departments, as well as visits to witness robotic surgery at Ascot Hospital and the Simulation Centre for Patient Safety at the Tamaki campus.

During their debrief with Professor John Windsor the three were still synthesising the vast amount of information they had taken in through observation and what the practical implications might be. Discussion bounced from concepts of good design, personalised medical devices, technology for the masses, issues of over-engineering as well as engineering solutions and new applications of existing technologies which might be readily available and cost-effectively applied.

PhD candidate Robert Dunn suggested “All it would take would be to have an engineer sitting in surgery for a few days to observe how these things were used in practice” to identify an array of potential improvements. “One thing that surprised me,” he said “was the lack of cable management in surgery. All the cords and tubes go everywhere – they fall in the way, tangle up. In electrical engineering – you go into a container – every single cable is bolted to the wall, fixed and organised in a very rigorous fashion. Maybe you can’t get around that easily...”

Rob, also completing his PhD in Electrical and Computing Engineering noted one of the astounding things for him was the similarity of problems between engineering disciplines and medicine: “For example, there is some very expensive device such as an ECG or a ventilator but the biggest functional problem is something small - a connector that always breaks, or a piece of metal occluding the battery compartment...”

Even the patient journey experienced through a systems engineering lens opened discussion on optimisation of people, ward and computer systems management – as well as health and safety.

“The Faculty of Engineering sees technologies for health as a key research focus and it is just so important and critical that engineers and clinicians to talk together, regularly and about all their interests, if we are to create the innovative solutions that are both needed and very possible given the strength of the expertise in the two faculties” says Associate Professor Bruce MacDonald. The success of the residence programme is encouraging and the faculties will follow-up on potential ideas that emerged, and to promote additional and longer engagements.

This need for ongoing engineering problem-solving through exposure to clinical hospital setting will help define and develop what Engineers in Clinical Residence programmes might look like in the future and also deliver subsequent practical and economic opportunities.

“In a broader sense,” Professor Windsor points out “the health sector is asked every year to save millions of dollars and find efficiency gains while every year the population is increasing.  There is no doubt that we need to find new ways of doing things.  This is an exciting initiation to work with Engineers, to pool our expertise.”