Q-NRG 2018-2019

Designers: Terrence Kealy, Eugene Canavan, David Fleming, and Mel Reynolds, Design Partners, Bray, County Wicklow, Ireland
Manufacturer: Cosmed srl., Rome (RM), Italy

Background

Q-NRG is a new generation of metabolic monitor for Indirect Calorimetry in clinical and critical care practice. Q-NRG is the first Indirect Calorimeter specifically intended for the measurement of Resting Energy Expenditure (REE) in patients who are mechanically ventilated or spontaneously breathing. The purpose of measuring REE is to understand a patient’s nutritional needs. Indirect calorimetry remains the gold standard in measuring energy expenditure in clinical settings and is proven to have enormous advantages compared to predictive equations. This measuring technology also provides an individual and dynamic metabolic assessment in real time based on the actual physical status of the patient. However, many healthcare professionals tended to resort to a guesstimate approach involving a rough calculation based on age, weight and gender, due to a lack of accessible technology.  

Challenge

Accurately gauging how much nutrition an ICU patient needs can be fundamental to recovery. Nutritional needs are also dynamic, and change based on recovery progression. Existing calorimetry carts are bulky, cumbersome and difficult to transport. They are not designed for the logistical needs of clinical environments. Use frequently involves shifting these heavy units from one area of a hospital to another and moving ICU equipment to create space. Moving ICU equipment is not ideal, but it also takes valuable time and disrupts the workflow of other ICU staff. Unsurprisingly, many healthcare professionals opt instead for an unscientific estimating approach to understanding nutritional need.

Solution

With the design and development of Q-NRG there was an opportunity to overcome these challenges and remove practical, logistical and usability-based barriers that had prevented use. Overcoming these challenges would enable clinical nutritionists to apply the science of calorimetry more widely and regularly during the care of their patients. An approach that is more user-centric and practical had the potential to bring this lifesaving science into common use and transform ICU patient recovery.  

Design Process

Working with Cosmed and the University of Geneva, Design Partners’ team utilized a human factor’s led approach to solution development. Human factors engineering methods would uncover usability-based insights and barriers to use. Industrial design, technology innovation and mechanical engineering approaches would then address these barriers and challenges over iterative development phases.  

Over the course of the development program Design Partners shadowed healthcare professionals working with patients in clinical environments. They also conducted a series of formative human factors engineering studies with progressively more developed prototypes and solutions. During these user-centered activities, it became clear that the current calorimetry units are bulky and difficult to transport. These units, often four wheeled carts can weigh as much as 200lbs (90kg). Existing units lack mobility and are very difficult and time consuming to maneuver into position and set up for use. Taking a single patient measurement frequently involves shifting these heavy units from one area of a hospital to another and moving other ICU equipment, which is not ideal, to create space. All this takes valuable time and, unsurprisingly, the old-fashioned guesstimate approach was winning the day. The goal was to create a lighter, more portable, grab-and-go type unit, to help make the scientific approach accessible, providing huge benefits to ICU patients and healthcare workers.

The result, Q-NRG, is ground-breaking. The new portability, ease and speed of use will make metabolic measurement much more widely accessible, and a tool of paramount importance in the ICU environment. Q-NRG is designed to meet worldwide regulatory standards and the product is set to make a profound difference to healthcare workers bringing patients back to a speedier recovery.