Clear-ly innovative barriers for safety

​The need to balance staff safety with continued provision of care has created opportunities for SingHealth’s staff to innovate. Two of our latest inventions strike the balance between safety and improving the work experience for staff were made possible by the SingHealth Duke-NUS COVID-19 Innovation Fund.

The research is still up in the air for airborne transmission of the SARS-CoV-2 virus, but experts generally agree that it can occur under aerosol-generating environments like in hospitals. Healthcare professionals carry out many aerosol-generating procedures, putting them at high risk of infection from COVID-19.

Safety considerations spurred SingHealth’s staff to get creative about minimising any disruption to our delivery of patient care. Some of the smart solutions born from this necessity includes SG SAFE, SwabBot and TEMI. Get to know two more inventions proudly made in Singapore, funded by a grant specially created for COVID-19 related innovations.

Aeroshield – The invisible barrier

Dental health practitioners are a group that works in close proximity to patients, specifically their oral and nasal cavities. “During the Circuit Breaker period in Singapore in 2020, patient attendances fell by 35 to 60 per cent, as dentists could only see to emergency cases. Even with the gradual resumption of dental services after the Circuit Breaker, many patients delayed their dental visits for fear of COVID-19 risks,” said Clinical Associate Professor Goh Bee Tin, Principal Investigator of the Aeroshield project and Director, National Dental Research Institute Singapore (NDRIS).

Aeroshield was created with the safety of our patients and dental health practitioners in mind. It was designed to fit within the standard equipment in a dental operatory. “Existing equipment used to prevent aerosol contamination are larger, but also obstruct dentists from carrying out delicate treatment in the mouth,” said Prof Goh.

Illustration of how Aeroshield uses air curtain technology to create an air barrier between patient’s mouth and dental practitioners

Taking reference from existing air curtains commonly seen at shopping malls, Aeroshield forms a safety barrier between a patient’s mouth and dental practitioners by directing the aerosols generated from the procedure away from the medical practitioner. The compact plug-and-play system easily attaches to the dental chair and air compressor outlet, making it easy to operate. With this simple technology, contamination was reduced by three to five times, showing potential to be adapted for use by other medical practitioners at high risk of aerosol exposure, such as ophthalmology, otolaryngology and anaesthesiology.

With the Aeroshield, patients can see their dentists with more assurance.

SpiroBooth – Thinking outside the box

Meanwhile, technologists in lung function laboratories around the world are presented with a safety predicament. To help diagnose respiratory ailments, such as asthma and chronic obstructive pulmonary diseases, patients often need a lung function test (spirometry) that involves  forceful expulsion of air into a spirometer.  Adequate infection control protocol is mandatory within the lung function laboratories to ensure safety of patients and staff.  Additional infection control protocols were however needed during the COVID-19 pandemic.

“Spirometry testing was suspended during the early phase of COVID-19 pandemic as it is considered as a potential aerosol generating procedure. Parents with children scheduled to have the test were concerned about the potential effects of not doing spirometry  on the clinical decision making and management of their child’s condition,” said Dr Biju Thomas, Senior Consultant, Respiratory Medicine Service, Department of Paediatrics, KK Women’s and Children’s Hospital. With the resumption of spirometry testing at limited capacity, infection control measures like full personal protective equipment (PPE) affected the staff’s ability to provide effective coaching during the test.

In response, Dr Biju and team designed, built and deployed the SpiroBooth. Much thought was invested in creating a novel, self-contained, purpose-built booth to safely perform spirometry during the pandemic and beyond. “It needed to be robust, safe, easy to use and child friendly,” said Dr Biju. “The SpiroBooth needed to be small enough to fit in the space available in the respiratory laboratory, but big enough to allow easy access and minimise claustrophobia. Most importantly, it needed to meet the stringent infection control requirements to ensure safety and effectiveness.”

SpiroBooth. 1: AIRTECH ACP-897CH Clean Partition HEPA filter system; 2: UVC system; 3: Chair; 4: Intercom; 5: stainless steel base for the clip-on height adjustable holder for the spirometer mouthpiece (optional); 6: spirometer; 7: holder tray; 8: PC monitor; 9: UVC disinfection system control panel. HEPA, high efficiency particulate air; UVC, ultraviolet C [Color figure can be viewed at wileyonlinelibrary.com]

Some of such features include incorporating a high efficiency particulate air (HEPA) filter and an automated ultraviolet (UVC) disinfection system.. An intercom system allows for the technologist to communicate seamlessly with the patient during the procedure to obtain the best possible effort from the patient without the need for the technologist to wear full PPE during the procedures.

Feedback from patients on the SpiroBooth has been positive, with potential for adoption in lung function laboratories around the world. Click here to learn more about the SpiroBooth.

The SpiroBooth was created in collaboration with the Department of Medical Innovation and Care Transformation at KK Women’s and Children’s Hospital, SingHealth Medical Technology Office, SingHealth Office for Innovation, the Institute of Bioengineering and Bioimaging, A*STAR, and SingHealth Duke-NUS Medical School.

Powered by SingHealth

Both projects were funded by the SingHealth Duke-NUS COVID-19 Innovation Grant. This grant is premised on the need to respond urgently to the COVID-19 pandemic. It was jointly supported by Joint Office of Academic Medicine (JOAM), SingHealth Office for Innovation (SHOFI) and SingHealth Duke-NUS Institute of Patient Safety & Quality (IPSQ).

The grant, which was open to all SingHealth staff in any work discipline, supports projects that improve operational efficiency and productivity for work processes affected by COVID-19, improve quality of care and patient safety, and ensure the safety of healthcare professionals while increasing access to healthcare services for non-COVID-19 patients. Practical and effective, Aeroshield and SpiroBooth are two projects that showed great potential for improving healthcare operations across the cluster, and around the world!

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