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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 physicalinjuries; 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

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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. Medics3. 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.

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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 VicePresident 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

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II. Framework

Innovating : We listed down our ideas for our innovative prototypes

Medical: List of common medical problems during floods/calamities

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Preparation: pre, during, post-flood preparations

Accommodation

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Communication

Transportation

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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.

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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 normalpeople.

1http://www.abs-cbnnews.com/lifestyle/09/28/09/health-concerns-after-ondoy

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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 thehospitals 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

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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 thepurpose 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

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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 PrototypeWe 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 andprepare 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

2http://www.zambotimes.com/archives/news/58159-Pablo-victims-in-Compostela-Valley-need-more-food.html

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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 thedonations 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 wereeven 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.

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IDEATION AND PROTOTYPING

I. Framework

Influx of volunteers

Task-related

Location/Capacity

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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.

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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. Thiscould 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.

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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 reliefcenters 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 ofthe 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.