Blog Layout
A background to tritonshield
NHS Bed Capacity Challenge
The bed segregation/screen solutions that were already available were designed (both in terms of price and functionality) for limited use. Systems were bulky, taking up too much room in the very limited space available between beds, as well as being too expensive (ranging from £1,500 - £3,000 per unit) to be feasible for large scale application. The new challenge presented by Covid restrictions required roll-out across entire NHS Trust facilities and an appropriate, cost effective solution was not available. In the main, bed segregation was not a common feature in NHS hospital wards.
Tritonpeak was asked to present a cost effective solution for rapid implementation from which we created the Tritonshield. A key feature of the Tritonshield design has been to offer it below £500/unit ex VAT.
This makes if far more feasible for NHS Trusts to roll-out across all wards.
Technical advance
In this project we sought to design a cost effective solution for mass roll-out of bed segregation to reduce viral load passing between patients. The brief was to design a bed segregation solution which:
• Did not take up a lot of space or interfere with existing wall-mounted equipment
• Was clear (see-through) to allow for patient visibility
• Able to be cleaned to covid standards (1000ppm Chlorine based solution)
• Did not roll-up (which would hold germs/viruses)
• Worked alongside existing ‘privacy’ curtains
• Was retractable when not in use
Our solution was designed to be light-weight and ceiling mounted which would be space saving and not impact on wall-mounted equipment. This has been and still is a unique feature of our design. The screen was split into 4 panels of clear vinyl set on a 4-track runner system, which allowed the panels to retract and ‘stack’ out of the way when not in use and fitted alongside the privacy curtains. The materials were independently tested for fire retardancy. No data was available for impact of cleaning solutions on the vinyl, however products that have been in place for 12 months now have shown no sign of deterioration in terms of the chlorine solution.
Other solutions that were already available or developed for Covid were either wall mounted which required bulky wheels which take up space and are a serious trip hazzard, or shower curtains attached to the existing privacy curtain tracks. These interfered with the use of the curtains and did not offer ceiling to floor protection. We are currently in the process of replacing wall mounted solutions, purchased in 2020, at one Hospital Trust as the current ones have not been practical to work around on a busy ward.
Technical Uncertainties
The current MK2 Tritonshield product has developed significantly from the initial product prototypes. The main technical challenges in our project were:
• Making a seal for the weighted bar which must be watertight for infection control. We experimented with a number of solutions including heat sealing and VHB (very high bond) adhesive tape, none of which were satisfactory as were not strong enough to hold the seal. Finally, we made a number of trips to a specialist supplier of vinyl welding using ‘High Frequency’ technology. Rather than heating the vinyl, High Frequency welding vibrates the molecules in the plastic to permanently bond them together. We were able to purchase a machine which was installed and with experimentation has worked very effectively.
• The bottom weighted bars needed to be yellow to give patients visibility of the barrier.
• The headrail and running bars that allow the panels to slide have received significant attention as the initial prototype was simply not robust enough for a medical environment.
Throughout this process over many months different prototypes were made and tested to get the Current MK2 Tritonshield and innovation continues as more feedback is received from users.
Outcome
As a result of this project implementing Tritonshield, we were able to dramatically increase bed occupancy
which is crucial both operationally and financially for NHS trusts. In some cases we were able to recover maximum bed occupancy from a drop of up to 40%. The product also allowed Operating Theatres to re-start elective surgery
as prior to the introduction of the screens Covid regulations would not allow Theatre recovery wards to receive patients.
Day wards including Oncology and Renal transfusion, which previously had no screening or in some cases any curtain systems at all, were able to maintain full capacity for critical drop-in and day interventions.
Breast screening, which had been significantly impacted as waiting areas had no segregation and even when services were resumed had very high non-attendance as patients were wary of being in close spaces with other patients, were able to dramatically increase their capacity and throughput. Re-instatement of elective procedures has been vital in starting the process of reducing waiting lists and operation lead times.
There were and still are many technical challenges to overcome as this vital new piece of equipment becomes a standard feature in hospital wards and waiting areas.
Countess of Chester Breast Screening Waiting Areas Countess of Chester Hospital (COCH) approached Tritonpeak with a problem. After the initial wave of social distancing restrictions, the clinical capacity was available but patient waiting areas could not accommodate sufficient patients. A second and equally challenging problem was the level of non-attendance for appointments as patients were cautious about being in a small area with other patients. Reducing Breast Screening Waiting lists In a push to reduce waiting lists for breast screening, COCH was looking for a social distancing solution for waiting areas at the Chester Hospital site. Tritonpeak demonstrated how our ceiling mounted solution took up very little space and was easily able to provide retractable segregation between chairs. The Breast Screening unit funded 7 bespoke Tritonshield chair segregation screens which were installed within 2 weeks. The installation of the Tritonshield screens enabled the unit to open up waiting areas and make progress with waiting list reduction for breast screening. Feedback From Breast Care Unit at Chester Both staff and patients have already commented on how effective the shields appear. I’m happy to give some details and think that Steph may be able to provide additional information. Due to the social distancing requirements and also because the patients attending this specific clinics may be particularly vulnerable, capacity had been reduced by more than 50% which was impacting on service delivery. It is critical that these ladies receive an appointment within 2 weeks of referral. Due to increased anxiety about attending hospital appointments during the first and second waves of the pandemic, the service has seen a large increase in demand, increasing the pressure on the service. Following successful installations within another area of the Trust, I contacted your company who were very responsive and able to offer a flexible solution to meet our needs. We had previously trialled fixed screens which were not only unsightly and claustrophobic, but also presented a trip hazard. The installation was extremely well coordinated, with a weekend service provided which didn’t further impact on our service delivery. I felt that this personal approach which showed such empathy to our situation was something which went above and beyond many other companies. The screens are now in place and whilst we cannot increase our capacity to our pre covid levels, due to other factors, we can now increase the numbers within our waiting area to at least 75%. A huge benefit is that patients feel safe and so are more likely to attend their appointments and to pass this onto friends who may also be anxious about attending. The cleaning process is simple and the company offered specific advice to our facilities team to ensure the product remains in prime condition. Ruth Buckley Radiology Services Manager Countess of Chester Hospital NHS Foundation Trust
Product selection In the period of the first lockdown Southport and Ormskirk NHS Hospital Trust was an early adopter of the Tritonshield screens. They had researched a number of different solutions and selected Tritonshield bed screens as the most effective and affordable solution. Through implementing Tritonshield throughout both Southport and Ormskirk sites, the NHS Trust was able to increase bed capacity across all wards from an initial reduction of 40%. This included both Wards and waiting areas. Continuous Development Tritonshield is proud to be one of the only solutions available which has continually and rapidly developed through feedback from active use in live hospital wards. There have been many developments since the initial design and these are covered in our post on Product Development. Through the course of routine maintenance, screens are being upgraded to the Tritonshield MK2. Benefits of Tritonshield MK2 Enhanced robust design Easier Cleaning protocol Solid non-stick top section Additional centre bar for increased rigidity Inter-changeable screen panels
A more effective bed segregation screen solution was needed Having found that the existing screen solution solution (wall mounted with front wheels) was not only NOT increasing bed capacity it was actually causing an obstruction on the Birch Ward Liverpool Heart & Chest Hospital contacted Tritonpeak. The first step with any new enquiry is to take over a sample unit so that staff can see the benefits for themselves. Initially driven by the infection control team who made the arrangements, we had the opportunity to meet the team on Birch Ward including the Ward Manager and Clinicians, Hygiene Services and the Estates Manager. Immediate Results Because the Tritonshield Screen is designed to be installed closely alongside the existing privacy curtain it takes very little space away from the bed cubicle and as it is ceiling mounted presents no trip hazards. The team could see this was an immediate improvement. The existing screens had only allowed the use of 4 beds in each 6 bed bay. After the installation of tritonshield, all 6 beds could be utilised giving an immediate increase of bed capacity of 33%. Fast Delivery Although Tritonshield is made bespoke for each ward to allow for differing ceiling heights and bay sizes, the order was processed and delivered within 3 weeks just before the Christmas break 2021. Installation LHCH decided that they would install the units using their in-house Estates team. This has a number of benefits as the in-house maintenance team are then fully aware of the fitting and all the components of the Tritonshield bed segregation screens. They can also arrange installation times around the needs and capacity of the Ward. Tritonshield arranged a training session where the Estates team were guided through an initial installation and were very quickly happy to take over. Within a week most of the screens had been fitted on Birch ward. Follow-up Tritonpeak have built the Tritonshield solution on user feedback from both clinical and Hygiene staff. We will be arranging a follow-up meeting with Birch ward Managers and Hygiene and keep you updated in our Blog.
