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Reimagined For Clinicians, By Clinicians

Companies often come to 219 Design to leverage our software engineering expertise to develop second generation devices. When TurnCare needed to accelerate development for their next gen Guardian System, 219 Design ramped up quickly and helped them achieve their goals. The new product incorporates features that improve the user experience for both the patient and health care provider.

Client Vision

To protect the high-acuity patient

A Unique Solution to a Common Problem

The TurnCare Guardian System helps critical care clinicians better protect and manage their most complex patients with less clinical effort. Guardian is a portable, therapeutic, inflatable support surface that effectively prevents sacral region vascular compromise using unique, patented Vasotactic technology. Sacral region vascular compromise can lead to complications in high-acuity patients, such as pressure injuries (bed sores), systemic inflammation, and pain & discomfort. The Guardian protects patients on beds, seats, procedure tables, and wheelchairs. This enables clinicians to mobilize their patients earlier, more often, and for longer periods of time. In a 399-patient randomized controlled trial, Guardian showed an 81% decrease in sacral region HAPIs, decreased LOS in certain health conditions, and an overall reduction in patient pain.

The Guardian System includes an anatomically-specific, inflatable Enhancer surface consisting of multiple air chambers designed for sacral-region bony prominences, and a high-precision, computerized controller that combines a complex, proprietary therapy algorithm & real-time adaptive pressure control capabilities. These components work together to provide continuous pressure gradient therapy that effectively prevents sacral region vascular compromise.

“Working with 219 Design has been a most pleasant and rewarding experience. 219 Design provides support as a true project-partner, at times as if an extension of our own staff. There is never a time when I had the feeling of delays in scheduling. The best way I could describe our communications about our projects and work segments would be to say “They get it." I feel, based on my experiences, we are farther ahead then we would have been if we had chosen a different Team.”
Robert Loiacono, Engineering Manager, Turncare

Achieving The Best Patient Outcomes

TurnCare software runs on a panel mount SBC from Garz & Fricke. In mid 2018 they wanted to upgrade their software, so they asked Garz & Fricke for a recommended consulting resource. Since 219 Design had previously worked with Garz & Fricke on a GUI to highlight features of their SBCs, Garz & Fricke didn’t hesitate to recommend 219.

TurnCare’s goal was to help hospitals achieve even better patient outcomes with their second generation Guardian System. The new system leverages years of clinical experience and feedback to incorporate features that improve both the patient and medical provider’s experience.

TurnCare came to 219 Design with an initial list of improvements for the software based on that testing. They also wanted a flexible development partner that could support iterative development that incorporated testing with end users to really dial in a great experience.

Some key areas of improvement were: 

Quick Wins and Longterm Success

TurnCare had a tight launch deadline. 219 Design was able to deliver features while improving the quality of the software. Our main focus was on two areas, the graphical user interface (GUI) and the Controller.

When TurnCare approached 219, they had a GUI that was implemented using QML. 219 was able to leverage our existing expertise to jump right in and add requested features. We improved the user experience by re-architecting the workflow and reorganizing the clinical steps. We also made improvements to the “internals” so TurnCare will be able to make changes faster in the future without sacrificing deadlines.

The legacy Controller software for the first generation solution was written in Python. Our most important task was to introduce automated tests to facilitate maintainability. This allowed 219 Design to add features more rapidly while simultaneously improving the internal architecture of the software. This, in turn, enabled even more rapid development. When hardware reliability issues were discovered during validation testing, 219’s software engineers were able to consult with our own hardware engineers to find solutions that TurnCare could implement while still meeting deadlines.

Currently, we are working on improving the performance of the embedded software by increasing the sensor resolution and moving complex calculations from a sub-system into the Controller software.

“TurnCare has provided the opportunity to develop a product that is personally important to me and will have a huge impact on the lives of thousands of people. As soon as they contacted us, I knew that we would be able to deliver what they needed to get the Guardian into hospitals . ”
Daniel Gallagher, Partner at 219 Design

What’s Next

TurnCare and 219 Design will continue to work together to improve the system through updated internal hardware and software.

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