Ostomy project report

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OSTy

Report 10 week project in collaboration with UmeĂĽ Institute of Design 2 MFA Advanced Product Design

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Janis Beinerts Latvia


About the project

Table of content

Term project: Let Philips come even closer

Introduction

Method

Result

The development of knowledge and the easy access to information in a 24/7 connected world result in an increased awareness among people. Coinciding with this trend sophisticated technology is becoming more and more accessible to everybody, both inside and outside health institutions. From this understanding we should research and make an exploration of relevant design opportunities in the area between consumer and professional healthcare solutions.

About project Ostomy Surgery and stoma Types of ostomy Market research Life with ostomy Problem analyses Persona Goals and wishes

Workshop 1 - group research Workshop 2 - group ideation Workshop 3 - common core Lectures and feedback sessions Product wear testing Product pressure testing Technology research Chosen design direction Concept idea

Overview The base plate The Valve The Gas Filter The Bag Color themes Summary Appendix

Base plate Valve Gas filter Bag This particular project named OSTY has looked very deeply into life’s of ostomy patients. An extended research has been made to better understand the needs of these patients, the causes of their daily problems and has proposed several major improvements for both ileostomy and colostomy patients.

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Ostomy An ostomy is a surgical procedure that creates an opening on the abdominal wall for waste products to move out of the body.

It is a lifesaving procedure that is usually assigned for patient when all the other are exceeded.

Ostomy can be assigned for various reasons: Cancer / Injury / Inflammatory diseases / Obstruction / Birth defects / Paralysis/ etc.

Ostomy is often an permanent condition - in other words for rest of the patients life. If it is temporary, it is still at least 2 years.

300,000 New patients per year

Some patients refuse to have ostomy operation because of the unbearable life conditions afterwards even when this operation would be the only option to save their life.

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Surgery and stoma The surgeon makes an opening through the skin on the abdomen and stitches the bowel to that opening. Contact point heals and creates a waterproof seal. This opening is called a stoma. Then stool passes out of your body through the opening.

Depending on position of stoma, type of ostomy and other factors, the shape and size of the stoma varies.

This is stoma

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Types of ostomy Depending on the ostomy location it is divided in 3 major types: Ileostomy, Colostomy and Urostomy.

This project looks deeper in the first 2 types only.

Colostomy Surgery in large intestines A colostomy is done when part of your colon or rectum has been removed and the part that remains cannot function normally. Reasons a colostomy is done include:

Infection of the abdomen, such as perforated diverticulitis or an abscess Injury to the colon or rectum • Partial or complete blockage of the large bowel • Rectal or colon cancer • Wounds or fistulas in the perineum

Ileostomy Surgery in small intestines Ileostomy is done when problems with your large intestine can only be treated with surgery.

Some of the problems that may lead to surgery:

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Inflammatory bowel disease (ulcerative colitis or Crohn disease). This is the most common reason for this surgery. Colon or rectal cancer Familial polyposis Birth defects that involve your intestines An accident that damages your intestines or another intestinal emergency 11


Market research Most of the product groups fit both ileostomy and colostomy patients. But some are dedicated to a specific group only.

There is a large selection of accessories and products that have slightly different purpose of use. Products come in various shapes, sizes and color to match users needs.

Closed bags

Drainable

Flanges

Measurements

Protection shields

Decorative covers

Barriers

Cleaning products

Belts

In general market is dominated by analog disposable products, that are meant for short period of time.

There is obvious lack of innovation as technology is similar among all products and hasn’t been evolved during past years.

Gas valves

Solid seals

Irrigation sleeve

Irrigation water bag

Stoma caps

Irrigation electric pump

Drainable bag cleaner

For ileostomy patients For colostomy patients

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Life with ostomy

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Life with ostomy

This projects was mainly focused on the procedure of how patients are changing the their bags and flanges.

Bag management is one of the biggest issues for ostomy patients

Most important daily procedures between ileostomy and colostomy are summed up in the following table

Procedure

Ileostomy

Colostomy

Type of content

Very waterish

More solid consistency

Empty the bad

8-15 times per day

4-8 times per day *

1-3 min / this many action steps

1-3 min / this many action steps

2-3 times per week

2-3 times per week

10-15 min / 24 steps

10-15 min / 24 steps

Change the flange

Irrigation procedure *

1 per 1-2 days. 30-60 min.

* With irrigation procedure it is possible to regulate bowl movements. It is possible to achieve a state over time where you need relieve yourself once per a day or even once per 2 days.

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Problem analyses There are a lot of problems ostomy patients are dealing with. Current solutions often causes side problems as a result a chain of problems can start from one single issue.

Ordering supplies in time

Ostomy patients usually try to hide their condition from public. They feel embarrassed, uncomfortable, and stressed. Their self image is extremely low, and most patient suffer a deep depression for at least first 1-2 years.

Visible under clothes

Bag management

Low confidence Cramps

Frustration

Chronic skin problems

Bad visuals

Life planning

Insecurity

Fitting the bags

Fear of public

Leakage

Sounds Gas pains

Ballooning

Hernia

Discouraged

Diarrhea

Overfull

Emergency situations

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Large costs

Excessive gas

Stenosis of the stoma (narrowing)

Dehydration

Eating disorder

Special Diets

Large amount of supplies Mucus Drainage

Blockage

Bad sleep

No Appetite

Used bag proper disposal New wardrobe

Bad smell

New routines

Stoma bleeding

Most of these mental issues start from unbearable ostomy bag management and the problems they are connected with - bed smell, leakage, skin irritation, bag exchange, low visual appearance.

Main problems:

Low sexuality

Time consuming irrigation

Rectal sensation Embarrassment

Even though their condition allows them to take any activity or hobby they did before, patients often face significant life quality decline. Especially when it comes to sex, active sports, traveling and being in public.

Damaged self image Bag management Bad smell Leakage, overfull Skin irritation Gas management

Emotionally hard

Damaged social life

Skin irritation 19


Persona

Persona Laura : 21 year old College student of psychology. She has ileostomy. She shares and explains her life and problems regarding her condition on her self-made “ ” blog in YouTube. She is one of the main inspiration for this project and persona as well. Her videos and testimonies have helped a lot of people. Not often people dare to talk about these topics publicly

Daily situations > Wakes up at least once a night to empty the gas from the bag. > Don’t have time to empty bag often enough - it grows big and becomes visible. > In toilet empties the bag standing, so worries other people might think she is a man. > Once the whole bag went off on a date. Very embarrassing. > Worry about dehydration. You don’t feel it, so must be checked constantly. > Worried about blockage, so always carries grape juice. > Big fear - if starts to smell bad, first touches bag for leakage. > Fear of having issues in a public place : blockage, leakage, gas pain. > Hiding is a way to avoid talking about ostomy and explaining your condition > Made her own food and drink intake book, to not to forget to drink enough. Has to worry about taking lots of pills in the right time. > Goes through a lot of medical procedures and constant analyses. Has other parallel issues that makes coping with colostomy even harder. Laura changing the bag and the flange. https://www.youtube.com/watch?v=bpGfcd7RL4o 20

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Goals and wishes

Goals >To assist user in managing the ostomy bags : changing and emptying >To prevent leakage and / or inform user if leakage happens. >Improve the visual appearance and so patients self-image through ostomy bag design. >To make it customizable products that would fit both ileostomy and colostomy patients

Wishes > Implement smart technology, that would suit Philips portfolio

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Workshop 1 Group research on human healthcare together with Ozgur Tasar Sr. Design Consultant from Philips Design

Focus of the workshop was to analyze what problems and life challenges people go through at different periods of life. How and if these challenges are any different for women or man.

Man focus has been placed to a problems and areas that could be addressed with home personal healthcare solutions.

Analyses of this workshop was the first base for individual problem selection, that each student wants to continue working on.

Group research Personal healthcare and human body

Method

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Workshop 2 Ideation workshop on selected problem areas with the rest of the team members.

Each student presents their focus area and together with the rest of the team generates ideas of how it could be improved

Best and most promising ideas are rated and taken for further development.

Group ideation Problem understanding and opportunities

Method

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Workshop 3 3 session “ Common core� workshop with Alex Liebert (Strategic design leader at SVID, Swedish Industrial Design Foundation and Industrial Design / Management at Atlas Copco)

Workshop was introduced by lecture of branding theory and design tools that can help to analyze brand and match the new product with certain characteristics

In teams of 2 people students worked on 2 abstract shapes - cylinder and cube. Task was to do a visual styling that would fit existing Philips identity and product catalogue.

These developed common cores were the base input for the upcoming project design. As a clear guideline for visual and form language.

Common core Brand identity and visual language

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Lectures and feedback sessions Guided design process during all the project time

Lectures:

Feedback sessions:

> Philips design identity by Ozgur Tasar

> Idea pitch presentation through Skype with Ozgur Tasar

> Design Strategy by Alex Liebert > Design language and Common core by Alex Liebert > Persona as design tool by Thomas Degn

> Feedback session on work development through Skype with Ozgur Tasar > Ideation presentation and design direction confirmation with Ozgur Tasar and Thomas Degn > Common core implementation on current project with Alex Liebert > Individual tutoring sessions with Thomas Degn > Several feedback sessions from clasmates.

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Product wear testing In order to understand how patients feel and what does it takes to change a flange, the products needed to be tasted.

It was a simulation of ileostomy patient’s daily life. The ostomy products were placed on the belly and filled up with water.

It gave a good insight on how much time it takes to change flange. How easy it is to do it, what are the ergonomics and visibility factors.

What is the experience of having full bag under your clothes glued to your body for 3 days. What is the visual appearance.

Common core

Brand identity and visual language

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Product pressure and seal testing The flange with bag was on the body for 3 days, what would be the average duration in real life before it would be needed to replace by a new one.

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Experiment showed how adhesive material damages the skin and at the same time looses it reliability to ensure tight seal very fast.

As one of the major problems is leakage, the basic pressure test of the bag and flange connection was tested.

It proved to be very strong, so the biggest problem is actually in adhesive connection between skin and flange.

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Technology research There are very few if not any “smart� technology based products for ostomy patients as technology mostly is still in development stage

Looking todays technology and the one possibly available in the near future may reveal good solutions for ostomy patients.

3d printable artificial skin technology

Parastomal Hernia Prevention implants

Hydration, Lactic Acid and Glucose Sensor

Color changing surface technology

Smell proof underwear

Ostomy valve implants

Urine detection sensor

Device that can predict when you will need to poop

Stool volume measurement device

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Chosen design direction The research and product simulations proved that leakage and adhesive material usage for connection purposes is one of the biggest problems.

As for the further project it has been decided to look for alternative ways of creating better connection between body and stoma bag.

It was also clear that there isn’t an ultimate one solution, but rather could be a selection of products, that in certain combination suites both ileostomy and colostomy patients.

Products should be modular, very simple and small. Adaptable to user needs and preferences. Skin friendly and should be as little noticeable as possible.

Major needs Better connection No skin irritations / infections Modular products Low visibility New functionality

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Modular

Analog

Skin friendly

Flexible

Small

Personalized

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Chosen design direction Wide solution ideation process.

One of the most promising directions is a modular valve system that allows user to connect different products to it, depending on the specific needs.

Ideation

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Concept idea

Bag + filter + valve + base plate Ostomy Bag

Or

Gas filter

Valve

Cleaner and faster

No leakage Base plate

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Minimal appearance

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Base plate Challenge is to find a solution how to attach something to your body without using adhesive materials.

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Searching for the best alternative attachment solutions More research was made to understand better the options of attaching artificial product to human body in order to avoid adhesive materials, that causes many problems

In the same time the new solution should be as thin and small as possible in order to reduce the visual appearance. So user can feel more comfortable having it under the cloth and be sure people won’t be aware of their condition.

Stitches

3 alternative connection concepts were created as a base discussion object. They were analyzed to understand their positive and negative aspects.

Major difference is that a base plate would be introduced, that is attached to human body first and then all the rest of the products - bags, valves and filters would be attached to the base plate.

New connection

Skin Stoma

Fat ABS muscles

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Todays approach

Concept A

Concept B1

Concept B2

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Consultation with professionals In order to evaluate these concepts an external opinion was asked from 2 professional: healthcare representatives from Umea Hospital.

Both specialist expressed that this would improve patients lives significantly.

Though there are some challenges involved regarding how to connect implants to human skin by not creating infection breach.

This could be solved by human tissue printing technology in the near future, or by double stitching method. So project was good to move forward.

Together with doctors it was decided that concept A is the best choice for further development. As it has the least drawbacks and overall improvement in comparison with todays situation would be still significant.

Good to go!

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Practicing anesthesia doctor Anna Bengan Bengtsson.

A third year surgery resident Martin Claesson

“ Great idea! This approach would improve patients life significantly. “

“These concepts would work! But need to find a material that bonds to human tissue otherwise it could result in infection. Technology could be ready in 5 years” 49


Valve Challenge is to find a reliable solution, that would not take up much space

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Valve mechanism Diaphragm iris valve principle is a great solution. It is flat, easy to operate and has the qualities needed.

A quick mock up has been made out of needle case and condom to test and check its ergonomics.

Diaphragm iris valve Flat design Flexible Easy to operate Easy to clean and change Cheep components Great functionality

( “Mucon� iris valve ) 52

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Valve design exploration Several simple shape sketches / cad drawings and mockups were build. The dimensions, attachment mechanisms and size is according to existing product dimensions.

Shape exploration on initial stage is according to proper visual semantics and necessary functionality.

Test models

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Valve concepts testing 2 different approaches have been selected for further development. Both were tested on simulated user testing.

Round / modular and simple

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Dynamic / integrated and sculptural

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Gas filter Challenge is to make it compatible with valve in unified design

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Gas filter design exploration Several simple shape sketches / cad drawings and mockups were build. The dimensions, attachment mechanisms and size is according to existing product dimensions.

Shape exploration on initial stage is according to proper visual semantics and necessary functionality.

Test models

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Gas filter design testing Gas filter is an optional add-on for colostomy patients that doesn’t have to wear a colostomy bag.

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Bag Challenge is to make it easy to empty, exchange and make it disposable

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Bag design exploration

Focus areas Improved shape Oderless Compact through foldability Easier to empty Disposable

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Bag improvements

Compact Fold-able into compact volume – more convenient to have an extra bag where ever you go.

Integrated filter

Compatible

Easy to empty

Prevents bag ballooning and filters any bad odor.

Easy to snap on base plate or valve, depending on user’s preferences

Foldable sides allows to completely empty the bag with one hand movement.

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Bag ergonomics Shape of the bag allows user to see all the components and reach for handles.

Easy to see and reach

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Final design 72

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OSTy Product family for young and active ostomy patients

Modular

Base plate

Personalized

Valve

Analog

Skin friendly

Bag

Flexible

Small

Filter cap

- No adhesive - No leakage - Faster + cleaner - Stoma protection

- No odor - Less inner pressure

- Compact storage - Easy to empty 74

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Base plate attachment and usage

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Base plate attachment and usage

Attach the base plate to skin layer

Small diameter ensures high movement freedom

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Base plate attachment and usage

Stitch the stoma to the base plate

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Valve attachment and usage

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Valve attachment and usage

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Valve attachment and usage

Clip on gap Scroll ring Membrane valve

Clip on ring

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Valve attachment and usage

ck

i Cl

Cl

ick

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!

Cl

ick

k lic

!

!

!

Click on system

C

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Valve attachment and usage

Hold the valve in place

Turn the valve to open or close

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Valve attachment and usage

180 degree turn + “click� lock

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Valve attachment and usage

Hold the base plate in place

Remove the valve 94

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Gas filter attachment and usage

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Gas filter attachment and usage

Clip on ring Active Coal Cover

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Gas filter attachment and usage

Cl

!

Cl

ic

k

!

ick

Cl

ick

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i

ck

!

Cl

!

Click on system

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Gas filter attachment and usage

Hold the valve in place

Turn the valve to open or close

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Bag attachment and usage

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Bag attachment and usage

Clip on ring

Inner stool bag Changeable fabric Gas filter

Belt attachment

Dispose ring

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!

Cl ic k

k ic Cl

!

Bag attachment and usage

ick Cl !

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Click on system

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Bag attachment and usage

Hold the top of the bag

Fold in

Open clip

Roll out the opening

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Squeeze out the stool

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Bag attachment and usage

+ Folds into a compact volume + Sealed opening - can be disposed without creating a bad smell.

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Color and materials Product family comes in different sizes and colors. This allows for the user to match it to his perfect outfit or skin tone.

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Color and materials

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Summary

Benefits for user:

OSTy

No leakage No bad odor Healthy skin Faster and cleaner bag change Minimal appearance Better movement freedom Adaptable to user’s dress-code Fits ileostomy and colostomy patients Less expenses

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Appendix

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Common Core workshop Though simple shape styling exercise the visual identity of Philips was determined, that later on was implemented in the final design.

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Thank you


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