Learning to dream with the market in mind

da Vinci Center graduate student studies alarm fatigue and learns about himself

In 1987, Jim Robb moved out to the country near Farmville, built his own cabin – complete with solar panels – and lived Thoreau-style for two-and-a-half years, getting, as he described it, all the way back down to the basics.

Like his Transcendentalist inspiration, Robb is a dreamer – in the best sense of the word.

“I’ve always been an ideas person,” he said.

But, in the past, he would usually stop there: He would come up with concepts, plans, dreams – you name it – and never take them any further.

So several years ago, Robb started talking to Kenneth Kahn, a nationally recognized scholar and consultant in the field of product development and the director of the Virginia Commonwealth University da Vinci Center, created in 2007 as a collaboration among the Schools of Business, Engineering and the Arts.

With a B.F.A. from VCU in Theater Design, a specialty in 3-D computer visualization, 25 years in the design industry and 16 years of teaching experience, Robb was looking for a way to foster his growth as a creative, especially by strengthening his business and marketing acumen. He found it in the da Vinci Center’s Master of Product Innovation program, which aims to create “T-shaped” individuals: individuals who are anchored in a discipline – business, engineering or the arts – but also have the capacity and openness to span across other disciplines.

For example, Robb said, “If you’re not an engineer, you should know how engineers speak, what they’re after, how they think, what drives them, what their processes are. You don’t have to know all of those things, but if you know enough about them, you can at least talk intelligently to them.”

In fall 2012, despite already being a very busy man – among other activities, Robb parents two teenage girls, adjuncts at J. Sargeant Reynolds Community College and teaches at St. Catherine’s School, where he is also associate director of marketing and communication – he joined the da Vinci Center’s inaugural class of graduate students, entering on its arts track and hoping to become a more T-shaped professional.

“It’s all about keeping an open mind and working in ever-changing teams to try to solve problems.

Auspiciously, one of his first experiences in the program promised just that.

As a participant in the second iteration of the VCU School of the Arts CoLab Internship Program, Robb worked with a diverse team of students to try to find ways to use Google Glass – the technology giant’s head-mounted digital communication interface – to solve problems in Richmond’s health care systems.

While the team explored a range of possible applications, including the use of Google Glass by EMTs to record their activities and by medical staff as an educational aid, Robb was most impressed by the technology’s potential as a partial solution to the growing problem of alarm fatigue in hospitals; indeed, at the conclusion of the CoLab course, he decided to continue studying the problem for his final undertaking in the MPI program, a 12-credit project spread over two semesters.

Alarm fatigue begins, Robb explained, with the absence of any federal standardization of alarm sounds; the only requirement is that monitoring devices emit some kind of sound to signal measured events, including device failure.

From here, the problem is threefold. First, hospitals are using more and more monitors because it helps provide early warning of changing patient conditions. Second, the monitors make sounds that are difficult to interpret. And third, under certain conditions, monitors sound false or non-medically-actionable alarms, e.g., sensor leads might be loose or worn, batteries might be low, patients might move. Some studies show up to 90 percent of alarm events are false or nonactionable. As a result, nurses and staff may become desensitized to the sounds.

“They may stop hearing them, and then stop responding to them,” Robb said. “In some cases, they disable them, turn them down, make them less sensitive. Not with any malice, but sometimes they’ve had enough, or they’re making adjustments without the proper training or authority to make those changes. But they’re making them nonetheless.”

After studying the problem of alarm fatigue more extensively, Robb realized that, despite its merits, Google Glass could not fulfill his initial ambitions and would cease to be a major component of his project.

“If you were building a new hospital,” Robb says, “I think you could come in and integrate something like [Google Glass].”

But because hospitals are already so heavily invested in systems they already own and operate, the status quo is a significant barrier to entry.

What’s more, in the heavily regulated environment of a hospital, where patient privacy is an ongoing concern, the ability of Google Glass to capture photos and video poses an additional hurdle worthy of further study.

As a short-term solution to alarm fatigue, Robb’s project instead identifies the need to provide innovative clinician training to improve medical device configuration, which will in turn improve the quality of patient care while reducing false or nuisance alarms.

According to Robb, the long-term solution to alarm fatigue must include a central monitoring system that can communicate with a variety of devices – present and future – using standard protocols that work within a hospital network environment. In the meantime, many stopgap measures, including the use of Google Glass, can mitigate the problems created by the absence of standardized alarm sounds and of a central system for handling them.

After spending the spring semester researching the extensive information available online, Robb reached out to regional medical professionals – including staff at Johns Hopkins Hospital and Boston Medical Center – to hear firsthand the issues facing the industry in order to develop his prototype solution. This work comprised an essential part of his efforts this fall.

Along the way, Robb has learned a lot about himself as a creative.

“My thinking prior to this program was, I have a good idea and everybody should think so, too,” Robb said. “I think the market is really the biggest piece … If you can’t sell [your idea], and people aren’t willing to buy it, then it’s not really a business. It’s just a hobby.”

Approaching his final semester as a master of product innovation student, Robb identified one of his greatest takeaways from the program: Successful innovators are those who can adapt to new interpersonal environments and change their opinions in light of new information.

“It’s all about keeping an open mind and working in ever-changing teams to try to solve problems.”


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Jim Robb. Photo courtesy of Gary Garbett.
Jim Robb. Photo courtesy of Gary Garbett.