The Acclaimed Incubator That Hospitals Never Used, and What Designers Learned

In our latest installment of our Design that Matters series, the team applies lessons learned from their NeoNurture incubator experience for their next project.
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In our latest installment of our Design that Matters series, the team applies lessons learned from their NeoNurture incubator experience for their next project.

About 4 million babies worldwide die within a month of being born, and about half of those babies would have a much higher chance of survival if they could be kept warm for the first week of their lives. In 2010, Design that Matters, a non-profit design company based in Cambridge, Massachusetts, decided to help. They partnered with the Center for Integration of Medicine and Innovative Technology in Boston to create the NeoNurture incubator.

The innovative NeoNurture won awards and accolades. It was one of Time magazine’s “50 Best Inventions of 2010” and was featured on CNN, ABC News and in countless exhibits around the world. To all appearances, it was a completely successful product design. But NeoNurture was never put into production. Rather than feeling defeated, the Design that Matters team applied the lessons learned from their NeoNurture experience for their next project. This is the story of how they persevered.

An Incubator’s Beginning

Design that Matters is a relatively small organization. Like most nonprofits, they depend heavily on the services of volunteers. Elizabeth Johansen, the Director of Product Development, was a volunteer for six years before joining the team in her current position. She participated in the workshop that resulted in the NeoNurture incubator.

“The workshop was inspiring because Design that Matters brought together such a diverse group of experts,” Johansen told Not Impossible Now.

At the time, Johansen worked at IDEO, a global design firm, and she brought a colleague to the workshop, which was hosted by an industrial engineer from the Rhodes School of Design. Medical device design experts, industrial designers, mechanical engineers and others collaborated at the workshop, pooling their knowledge and skills together.

Johansen continued to leverage her relationships and experience during her time as a volunteer at Design that Matters. 

“I led a volunteer team from IDEO to perform NeoNurture research. We helped Design that Matters understand the state of the art in Boston hospitals, and then I coordinated another IDEO volunteer team to join Design that Matters in performing NeoNurture field research in Nepal,” Johansen said. “These activities were part of a 6-year volunteer effort I led in which over 100 IDEO employees provided pro bono design services to Design that Matters.”

Development Brings Challenges

NeoNurture

The NeoNurture incubator. (Photo courtesy of Design that Matters)

During NeoNurture’s development stage, one thing that immediately became obvious was that equipment that functions properly in modern, Western hospitals may not work in developing countries. In a 2012 TED Talk, Design that Matters CEO Timothy Prestero shared photos of a dilapidated and dusty broken incubator in a neonatal intensive care unit in Kathmandu, Nepal. 

“What probably happened was that a hospital in Japan upgraded their equipment and donated their old stuff to Nepal,” Prestero said. “Without technicians, without spare parts, donations like this quickly turn into junk.”

The challenge was to design an incubator that could withstand difficult conditions in developing countries, function properly and be simple to repair, and “that would inspire manufacturers and others people of influence to take the design and run with it,” Prestero said.

The result? The team focused on human-centered design and functionality and came up with NeoNurture, an incubator made from car parts. Headlights provided the heat, a dashboard fan circulated the air and an old door chime was reengineered to be an alarm when something went wrong.

 Failure to Launch, Lessons Learned

When the NeoNurture incubator was finished, the team at Design that Matters and all of the volunteers “felt great,” Prestero said in his TED Talk. But no neonatal intensive-care unit ever used NeoNurture to save a baby’s life.

Why did NeoNurture fail to launch? While Design that Matters had paid a lot of attention to who the end users of the NeoNurture would be — doctors and nurses in rural areas and families — they had not considered the entities that decide which equipment to purchase. Governments and manufacturers often make those kinds of decisions. Even hospital administrators may not be involved in making purchasing decisions in the developing world.

As a result, Prestero realized that designing for inspiration was not the most practical approach. Rather, to make a real impact and to make the world a better place, Design that Matters needed to design for outcomes

Designing for Outcomes

Otter Project

The Otter Project. (Photo courtesy of Design that Matters)

The team had to dig down to figure out exactly what it meant to “design for outcomes.” It turned out that, at least in part, designing for outcomes means designing for manufacture and distribution.     

Design that Matters’ next project, a device related to Infant Respiratory Distress Syndrome (IRDS), led to a relationship with a medical device manufacturer and the East Meets West Foundation, which was already distributing medical technology in the region of southeast Asia. East Meets West was impressed with Design that Matters’ work on the IRDS device, but said that the problem they would prefer to solve was related to treating babies born with jaundice. The result was the Firefly, one of their most successful projects to date.

Johansen said that the success of the Firefly was in part due to working with partners who have influence in the areas of manufacture and distribution. Although the NeoNurture incubator never went into production, the lessons that Design that Matters learned were crucial, and after the Firefly, the team turned their attention back to keeping babies warm, this time with input from critical partners on the Otter Project, which will help keep newborns warm during phototherapy. 

Design that Matters continues to design products that make the world a better place, and with each new project, they learn lessons that inform and improve what comes next. 

Read “How One Company Transformed a Toy Into an Educational Tool,” the first story in our Design that Matters series.

Top photo courtesy of Design that Matters