JR Jader, Czar Paguio, Ella Reyes, Fra Santos | LS 145-X | Final Project Relief Watch EMPATHIC RESEARCH: Hospitals

I. Design Challenge How can we help hospitals effectively provide medical care during times of disaster or calamity? Typhoon Ondoy, one of the most devastating cyclones in recent times, is the main inspiration of our design challenge. The country was woefully unprepared for the strength of Ondoy due to the badly underestimated forecast made by PAG-ASA. As a result, we all suffered direct and indirect losses which left us emotionally and mentally scarred. The images of death, loss, destruction and despair continue to haunt us to this very day. There were no quick cures for bereavement but as time went on, natural human resilience eventually helped tide us over. We realized that every experience is a lesson waiting to be learned and that this project could be the perfect avenue for us to make a difference and right the wrongs of the past. Disaster preparedness, relief and rescue operations have become legitimate concerns for the Filipino people because of Ondoy. However, we felt that the efforts exerted by the government and other public/private sectors were not enough to extensively equip the public with the right knowledge on what to do and how to act during such calamities. Moreover, we had our own set of observations that we felt had gone unnoticed by the public or the government. One of which, is that people flocked to nearby hospitals during the flood.

II. Existing Knowledge During Ondoy, the citizens did not just go to the hospitals to seek medical care for physical injuries; they also traversed the flood-ravaged roads to seek shelter and relief from the heavy downpour of rain. Due to the sudden onset of people, hospitals had to send people away and direct or transfer them to other hospitals because of the lack of space to accommodate everyone. Moreover, stranded people were phoning to be rescued from their rooftops or to be transported to a hospital for emergency reasons. The problem was that the vehicles of the hospitals were not equipped to travel in flood-stricken areas. There were also limited ways to contact the hospitals and/or the patients. In order to address these problems, we felt that the technologies needed are the internet, hybrid vehicle technology and the different forms of communication channels. The aforementioned technologies are not present or being utilized properly in the existing solutions that we have today. Only a few amphibious vehicles and helicopters are being mobilized for search and rescue operations and the internet sorely lacks the information needed by the public. With this in mind, we formulated assumptions regarding the existing problems. First, an amphibious ambulance is needed by the hospitals to rescue citizens that are in need of help. This would eliminate the problem of stranded bedridden patients. Moreover, the vehicle could also function as a rescue vehicle for nearby stranded residents. Second, an app or a new communication channel/program must be devised for a

more efficient rescuing scheme. Third, a hospital tracker that could alert people on the capacity of the hospitals and the whereabouts of the ambulance should be created. III. Identify people to speak with 1. Nurses 2. Medics 3. Patients 4. Ambulance drivers The lone requirement for our interviewees is that they should have had personal experiences related to health service institutions during calamities such as typhoons or flash floods. IV. Interview Guide For Medical Professionals: 1) What is the process of admitting a person (walk-in and emergency calls)? 2) What are the difficulties/problems encountered during the past calamities? 3) Do you have existing pre-flood, flood, and post-flood preparations/protocols? If yes, what are they? 3.1) Supplies 3.2) Patient accommodation 3.3) Coordination among hospital staff

For Patients: 1) experiences during the flood 2) hospital/ambulance-related difficulties V. Learnings Medical Professionals: The medical professionals tried to enlighten us on their processes and protocols in the hospitals. The patient can either be admitted from the ER or via direct admission with orders from a Consultant. If the patient will be for admission, the Admitting Office will inquire the Floors Staff if there are any available rooms in their floors to accommodate the patient. When the patient is brought up, the nurse will accompany and fix the papers of the patient for admission. There were also a lot of difficulties and problems encountered during floods/other forms of calamity or disaster. For the hospital staff, there was difficulty getting to the hospital due to the flooded areas which meant that less patients would be coming in through the ER. There were also a lot of people who went to the hospital in order to save themselves from the flood water that was entering into their homes. Aside from this, a lot of stranded patients needed help; but unfortunately, the number and scope of ambulances were not enough. We were also told that the supply of oxygen tanks became dangerously low during the flash floods.

The UERM and UST hospitals have flood protocols that order them to try to assist as much people as possible. If there are materials needed or any emergency or whatsoever, they have to report this to the Director of nursing who will alert the runners on every floor. If there are no rooms available, some patients may stay in the ER to wait for patients to be discharged. There was a time in TMC wherein they were full and a lot of patients were coming in, the Vice President created a strategy in terms of offering discounts for those who would go for an early discharge. It helped in discharging a lot of patients and accommodating new patients. After the flood, people also came to the hospital because of acquiring flood-related diseases such as leptospirosis, amoebiasis, cholera, diarrhea and fever accompanied by cough and colds. Patients: Families with bedridden patients were the ones who made pre-flood preparations in partnership with nearby hospitals. Their greatest fear was that their family member might need immediate medical assistance in the middle of a raging storm. We also got to interview families who said that they went to the mission hospitals nearby because they viewed hospitals as a safehaven. They couldnt really contact their relatives because communication lines were down and everywhere they went was flooded. IDEATION AND PROTOTYPING I. Post-its

IMPACT: Innovating Medical Preparation, Accommodation, Communication and Transportation

II. Framework Innovating : We listed down our ideas for our innovative prototypes

Medical: List of common medical problems during floods/calamities

Preparation: pre, during, post-flood preparations

Accommodation

Communication

Transportation

III. How Might We Statements For preparation: How might we help hospitals prepare for natural calamities and its adverse effects? How might we help hospitals in gathering ample supplies to aid in pre-flood,during flood, and post-flood conditions? How might we help patients and hospital staff become physically, mentally, and emotionally prepared for natural disasters?

For accommodation: How might we address the shortage in rooms and facilities in hospitals? How might we improve service availability in hospitals during natural calamities? How might we increase the efficiency of hospitals in admitting and discharging patients during natural calamities? How might we increase the efficiency of ambulances in transporting and caring for patients during occurrences of floods and the like?

For communication: How might we improve communication between patients and hospitals, hospitals and other hospitals, patients and ambulances, and hospitals and ambulances during natural disasters?

For transportation: How might we increase the efficiency of ambulances? How might we increase the efficiency of ambulances in attending to people who do not have access to medical assistance?

IV. Prototype at least 3 different solutions

Transportation: AMPHIBULANCE (amphibious ambulance) The current type of ambulance being used in hospitals does not have the capacity to pass through flooded areas. Having an amphibious ambulance will cater to the problem of stranded patients. Moreover, it boasts of an innovative feature that allows the driver to lower the attached lifeboats in order to rescue other stranded people besides patients. Due to our lack of drawing skills, we searched for a picture on the internet that closely identifies with our design.

Img src: http://www.freepatentsonline.com/6840825.html

Preparation: MEDISUIT Medisuit is a lightweight and waterproof garment designed to protect rescuers from the diseases caused by flood rains. According to the Department of Health, it has been estimated that the most number of reported cases of hospitalization and diseases after Typhoons Ondoy and Sendong were largely attributed to water-bourne diseases such as measles, acute respiratory infections, acute diarrhea, influenza, and leptospirosis 1 . Because of this, we envision to provide the generous rescuers with a suit to protect them from acquiring possible diseases or infections as they save the lives of the typhoon and flood victims. The suit contains several compartments for storing necessary equipment for rescuing like flashlight, pocket knife etc. This design is also made for rescuers instead of the normal citizens because these individuals are more prone to crossing the floods and staying there for prolonged periods in order to ensure everyones safety than normal people.

http://www.abs-cbnnews.com/lifestyle/09/28/09/health-concerns-after-ondoy

Accommodation and Communication: CLICKTHEHOSPITAL SMARTPHONE APP ClicktheHospital is a smartphone application designed to assist people during situations of floods or calamities. Whenever patients need to be admitted to the hospital at these times, ClicktheHospital will enable them to distinguish which roads are passable and not through the cctv monitoring installed by the MMDA. ClicktheHospital also provides alternative routes going to the different hospitals around the metro but more importantly it gives information about the hospitals current situation. This would address the pressing problems of hospitals and patients regarding full capacity and limited accommodation.

V. Get Feedback We showed our prototypes to medical professionals, a fireman who participated in the search and rescue operations and a family with a sick and bedridden grandmother. For the Amphibulance: -The family with a sick and bedridden grandmother liked the idea of having a vehicle that is capable of rescuing patients no matter how high the level of flood is in the area. This solution would lessen the amount of stress that they face during times of calamity because they know that in case of an emergency, their grandmother can be rescued and brought immediately to the hospital. However, they felt that an amphibulance that had lifeboats attached to it, would slow down the process of rescuing patients that needed immediate help and attention. Other stranded people would want to hitch a ride with the ambulance as well and this could be problematic for a patient. According to them, the time it takes for an ambulance to rescue a

patient during normal days could take an hour. It would take even much longer to rescue a person trapped in a flooded area. -The medical professionals that we had asked all felt that the attached lifeboats would get in the way of serving the needs of their legitimate patients. It would be a hassle to help and assist every stranded passenger to get on the amphibulance and rescue the patients that need medical attention at the same time and using the same vehicle. Our idea actually defeats the purpose of ambulance, which is to rescue ailing patients in the shortest amount of time possible. Moreover, if the patient being rescued is bedridden, they can only rescue one patient at a time. They felt that it was an unnecessary expense and that they could use helicopters to rescue people instead. -The firefighter/rescuer appreciated the idea of an amphibulance because it meant that they had less people to rescue/worry about. The number of people that would be saved will increase because of the added feature of the ambulance. According to him, it would be an efficient way to serve two purposes using one vehicle.

For the Medisuit: The medisuit may seem like a feasible idea to be used during calamity rescue operations however; having asked a flood-rescue volunteer for feedback, the idea of purchasing the pants using the volunteer's own money would seem very burdensome for that person. Paying thousands of pesos for a suit that will be used only during intense cases of floods do not seem like a very wise investment for a person who has already generously given his time and effort to help others. According to the volunteer, the idea of creating the pants would seem wise if only certain institutions would fund for it and donate it to the volunteers. Otherwise, the pants would just add on to the problems of the volunteers and hinder them from helping out in cases wherein they would not agree to buy the pants instead of focusing at the main goal which is really to help the people in need of rescuing.

For the ClicktheHospital smartphone app: The medical professional that we've interviewed said that ClicktheHospital would be helpful for them in terms of controlling the amount of people coming in and out of the hospital especially during situations like major typhoons wherein they are very busy accommodating the patients. However, since weve only provided a rough prototype of the product, the implementation and success of this app is still questionable. Her main concern here would be the obedience of the patients in finding another hospital in case the hospital nearest to them is already full. Some develop a loyalty towards a specific hospital and will be hesitant to transfer to another even when they could not be accommodated anymore. Another issue would be the reach and availability of the app. Some, especially those that do not have smartphones would not have access to the app. Given that these people are usually the ones who are hard headed, it would cause other problems for the hospitals. The family approved of the objectives of this prototype. They felt that this app would prove to be useful not only during floods, but on regular days as well. They also said that it is an efficient

way to check on the availability of hospitals nearest them. No matter where they are-- be it in the house or in the car, they could just access the app and they would know where to go. It also saves them time and effort from memorizing the contact numbers of the hospitals since everything is found on the app already. VI. Modify the Prototype We completely changed our prototypes because of the feedback that we had received from our interviewees. We also realized that it would be more feasible to focus on the relief operations.

EMPATHIC RESEARCH: Relief Operations I. Design Challenge How can we organize the current system of relief operations? Based on our interviews, we realized that there was a greater need for us to focus on the relief operations. In the recent typhoon Pablo, reports were made that the victims were getting into verbal and physical arguments over the lack of relief goods. People were lining up at the main roads, begging motorists for help while holding up placards that said "Please help us, have mercy on us."2 These heartbreaking images were what truly pushed us to find ways to assist those who were affected by the floods. Moreover, our personal experiences in relief operations made us realize that a lot of improvements can be made in order to increase the efficiency and effectiveness of the current system of relief operations. II. Existing Knowledge The selflessness and compassion of the Filipino people are highlighted during devastating times. Filipinos usually flock to relief operation centers in order to help package goods, cook and prepare food for those in the evacuation centers, and assist in restoring or cleaning up the debilitated villages ransacked by the storm. Students usually help out in their own schools or in relief ops near their homes. The announcements regarding donations or volunteers are usually posted on school websites, facebook pages and twitter accounts, which are consequently shared, retweeted or posted on peoples own private accounts. This form of information dissemination can be quite confusing or overwhelming due to the constant updates of every relief ops center. Furthermore, there were instances that the updates were not real-time and caused an unnecessary duplication in the efforts of the volunteers. Additionally, there were times when there were too many or too few volunteers in an area which caused delay in the operations. Some of those who were sent away had difficulty finding the nearest relief ops center. In order to address these problems, the internet can still be used as the major platform in which we can launch our organized information dissemination plans. Major service providers can also be utilized to further intensify and widen our reach. The current solutions that we have are
2

http://www.zambotimes.com/archives/news/58159-Pablo-victims-in-Compostela-Valley-need-more-food.html

somewhat effective but inadequate and unorganized. Independent websites and concerned citizens post the needs of the relief ops centers to raise awareness among the netizens. We felt that there was a need to have a main information disseminator that would bring together all the relief ops under one website/app. This website would broadcast the needs of all relief ops and inform the citizens important details such as the number of volunteers needed, where the donations will actually be delivered and the tasks available in a certain area.

III. Identify people to speak with 1. members of the Ateneo DReAM Team 2. Students who had volunteered for relief operations IV. Interview Guide 1. problems/difficulties encountered 2. experiences V. Learnings The Ateneo Disaster Response and Management team had problems regarding disseminating information at first. They started with posting announcements using their own accounts, but realized that its reach was quite limited. With the help of the administration, they partnered up with almost every official Twitter/Facebook account related to the Ateneo to be able to reach a bigger audience. Not long after, there was an influx of donations and volunteers which caught them off-guard. Furthermore, they were not able to monitor the information being sent out since they werent the administrators of the accounts. This caused certain items to be over donated which caused an imbalance in the assortment of goods being packaged. Some volunteers were even sent away because of the lack of things to do. But after a couple of hours, a lot of people left and there was suddenly a shortage of volunteers. They came up with a batching system so that people would commit to a certain timeslot. We also had the opportunity to talk to several volunteers who claimed that they had a rich and fulfilling experience. They were, however, confused with the set-up at first since they didnt know what they had to do since they were not briefed with their tasks. Others had to transfer to other relief operation centers because they were sent away due to the number of volunteers already present. They had a difficult time locating the closest relief center they can go to.

IDEATION AND PROTOTYPING I. Framework

Influx of volunteers

Task-related

Location/Capacity

Platform for information dissemination

II. How Might We Statements -How might we control the influx of volunteers? -How might we clearly disseminate information regarding the needs of all the relief ops centers? -How might we assist the volunteers in looking for locations that are in need of their services?

III. Prototype: YOUTH TO THE RESCUE- We realized that all of our HMW statements can be combined and answered using a single prototype.

IV. Feedback We consulted yet again with the other members of the Ateneo DReAM team and they liked the concept of a main website wherein people could view the lists of the all the available relief operations center in a certain area. It would be an efficient way to direct people to the nearest center that still lacked volunteers or donations. However, they felt that signing up for a slot was unnecessary because people over the internet could just sign-up and not show up at all. This could result to a lack of volunteers. Moreover, signing up to give donations did not resound well with the people who we interviewed. For them, it felt like limiting the amount that a person can donate. They said that it would be okay to have a surplus of donations because it would still greatly benefit those in need. Furthermore, they said that we had to link or connect our posts to twitter and facebook accounts for a wider reach.

VIII. Modification of the prototype We plan to partner up with all of the relief centers in order to give them access to their own page in our website. They will be responsible for the real-time updates. *See attached ppt

IX. Business Model Generation Customer Segment: The main customer of the Relief Watch website is the Relief Centers. The website aims to create value for Relief Centers by giving them assistance in the dissemination of information during times of calamities. Value Proposition: The website promises to give assistance to relief centers by being an efficient means of communication and dissemination of information. Relief Watch aims to inform by constantly updating people who are dry and comfortable in their own homes about the current situation of people and relief centers during calamities. Channels: The internet would the primary channel in reaching our customers which are the relief centers. Customer Relationships: The relationship with the customers, the relief centers, would be that of an automated assistance. The website would automatically relay the information they put up for the viewing of the public.

Revenue Streams: During the first years, Relief Watch would be non-profit. And during these first years, the cash that would be needed would come from private corporations who are willing to sponsor Relief Watch for its maintenance. In the long run, Relief Watch could require a payment from the relief centers that would come from a small percentage of monetary donations that they receive. These payments would serve as membership fees and would be used for the maintenance of the website and its further development. Key resources: The website basically needs financial and intellectual resources. Financial resources are needed for the payment for the domain, and intellectual resource needed for the coding of the website. Key Activities: As for the basic activities, dissemination of information is the most important activity. Community tracking, which would mean being up-to-date with the current situation of relief centers and people, would be next on the list. Also, training for the people who will maintain the website will be an important activity to keep the website running properly and efficiently. Key Partners: To make the business work, help from some partners would be needed. First and foremost, financial institutions would be needed in order to finance some basics such as the putting up of the website. Second, the MMDA would be needed for some features of the website such as the CCTV cameras, the updates of traffic flow, and updates of flooded streets. Also, government organizations such as Project NOAH would be needed in assessing the hazards posed by the calamities. Cost Structure: Main costs of the website would be its development and maintenance, training salary of the staff that will maintain the website.