Collaborating to Help Pediatric Surgical and Trauma Patients

Despite the challenges of working together during a global pandemic, a recent collaboration among Radford University’s School of Nursing and graphic design program with Carilion Clinic and the Virginia Tech Carilion School of Medicine (VTCSOM) has produced new resources to help children participate in their care—which in turn may lead to a better hospital experience and aid in their recovery.

The Project Begins

In late 2019, a $9,941 Waldron College of Health and Human Services Research Grant was awarded to Radford University assistant professor of nursing Christi Callahan, D.N.P., RN, PPCNP-BC, and Carilion physicians Terri-ann Wattsman, M.D., FACS, a Carilion Children’s pediatric surgeon and associate professor of surgery at VTCSOM; Violet Borowicz, M.D., FAAP, a Carilion Children’s pediatric hematology-oncology and palliative medicine physician and assistant professor of pediatrics at VTCSOM; and Margaret Nelson, M.D., a pediatric resident at VTC.  The project, “Post-Operative and Post-Traumatic Pain Control & Implementation of Enhanced Recovery After Surgery (ERAS®) Principles in Pediatric Patients,” was designed as a multidisciplinary collaboration among Radford University faculty, physicians at Carilion Children’s and VTCSOM students.

There are several key goals of the project, including 1) implementing ERAS principles (pre-operative counseling, standardized anesthetic and analgesic regimens, early mobilization, pulmonary exercises) when treating and caring for the Carilion Children’s pediatric surgical and pediatric trauma patient population; 2) decreasing the use of narcotics while caring for the pediatric patients, while still optimizing their recovery; and 3) designing a print resource called “My Hospital Journey” intended to help patients understand different aspects of their hospital stay.

Collaborating with the Graphic Design Program

The researchers had originally included funds in the grant budget for a graphic designer and artist to help accomplish the third goal of producing a printed piece. Soon, it became clear that rather than search externally, they could tap into a resource pool of talented designers in their own backyard.

“We thought it would be both more inventive and cost-effective to create a partnership with the graphic design program in the art department at Radford University,” said Callahan. “Additionally, collaborations across degree programs like this are mentioned as being one of Radford’s Strategic Plan goals for 2018-2023. It made sense to pursue it.”

Callahan reached out to Joseph O’Connor, M.S., an assistant professor in the graphic design program, to pitch the idea of his students helping develop the print materials for the project. O’Connor was intrigued and agreed to meet with the group to learn more.

“We met in Roanoke and brainstormed some ideas,” O’Connor recalls of the January 2020 meeting. “We came up with three main products, including an activity book featuring coloring pages that would appeal to both young and older patients; accomplishment charts and stickers; and marshmallow wall targets, which were physical targets that patients used to perform breathing exercises by blowing a marshmallow through a small tube called a marshmallow launcher across the room to hit a target.”

Having just started the spring semester, O’Connor offered to include these products as class projects for two of his spring semester courses: Graphic Design Production Techniques (ARTG 281) and Digital Illustration (ARTG 384).  

The next step was for the clients to meet their designers. Members of the research team visited the campus in January 2020 to meet with the students just as clients would in real life.   

“Christi and Terri both came to our classes and pitched their needs to the students,” O’Connor said.

The healthcare providers shared with the students that their target audience would be children ages 3 to 17, that the materials should be inclusive and represent diverse pediatric populations, and that materials should encourage pediatric patients undergoing surgery and/or being treated after suffering traumatic injury to be participants in their own care.

“When the researchers first presented this project to us, they had a vision for the outcome,” said Brooke Gorman, a student in one of the design classes. “As designers, it was our mission to execute this vision. We spent well over a month producing and perfecting coloring pages, achievement charts and marshmallow targets.”

A Global Pandemic Strikes

It seemed as if this collaboration had been implemented flawlessly as the design students continued their work on the materials. Everything seemed to be working perfectly — until the COVID-19 global pandemic suddenly paralyzed the world and confined everyone to their homes.

“They worked tirelessly right up until the now-infamous spring break where we didn’t return to campus,” O’Connor said, referring to the announcement in March 2020 that courses at Radford would go online and be taught remotely for the remainder of the Spring 2020 semester due to the pandemic. This change in how classes would be offered naturally disrupted the grant project’s completion plans. Like many Radford students, faculty and staff affected by the quarantine, O’Connor and his students refused to be slowed by adversity.

“I ported everything online,” O’Connor said, adding this allowed the students to continue their work and let fellow faculty and research team member Callahan view updates in real time. “A cycle of review-feedback-changes-review-feedback-changes began over e-mail among the students, myself, Christi and her group until the designs were finalized in early April.”

A Graphic Design Student to the Rescue

Realizing this would be a heavy-duty production to get everything put together and fine-tuned for printing, O’Connor recruited design student Gorman.

“I spoke with Professor O’Connor on multiple occasions, throwing it out there that I would be willing to help put the book together after it was completed,” Gorman said. “Not long after, I was presented the opportunity I had asked for, and I didn’t hesitate to say yes. This was an opportunity for me to learn more about what goes into a client-based job. As a senior design student with plans to graduate in May, I feel it is imperative that I take advantage of all opportunities I have to gain knowledge of real-world work experiences.”

Gorman was tasked with making changes and editing the activity pages, accomplishment charts and marshmallow targets that the graphic design students created. More importantly, she would serve as the vital liaison between the graphic design program, the research team and Radford University Printing Services.

Over the next few months, as others worked from home, Gorman dutifully traveled between campus and Printing Services, acting as a project manager to accurately assemble the 19-page booklet of activity sheets while confirming all of the details were correct for the charts and targets.

“Brooke was a familiar face thanks to all the course-related projects she had sent our way to be printed in the previous years,” said Jonathan Mayer, ’02, assistant manager of Printing Services. “Between that existing relationship and the preparation provided by Radford’s graphic design program, she knew what questions to ask and how to start setting up her files. Working with Brooke was just like working with more experienced designers in the back-and-forth of questions and making revisions based on client needs,  making sure each component was set up exactly right for the different production processes involved.”

Gorman also looked into the avenues that would allow the research team to transfer the activity book to a digital platform or app where older patients could “color” on a device.

“Being the link between the designer’s work, the print shop and Radford’s nursing program was an honor,” Gorman said. “I felt as if I was ready to take on the responsibilities that this entailed, and I am thankful that Professor O’Connor believed in my abilities.”

O’Connor said Gorman excelled in her role, which entailed wearing many hats. “Brooke did an unbelievable job as art director, creative director, production assistant and printer liaison,” he said. “She was responsible for seeing that everything was done per the specifications, and she was patient, responsive, persistent and determined throughout to see the designs through to their final stages.”

O’Connor also praises the work done by Printing Services personnel, including Mayer.

“Jonathan and the folks at Radford University printing were super helpful and creative in figuring out ways to work within the deadlines and budgets,” O’Connor said. “Jonathan was great working with Brooke on the production aspects.”

To Gorman, the project was much more significant than her regular class assignments.

“From the start, I knew this was a project that could potentially play a huge role in the way kids recover in hospitals,” she said. “To me, this wasn’t just another school project to be completed for a grade, and that is why I was more than willing to step up to the plate to help with the post-production of this project.”

Mayer added, “As a long-time Highlander, it’s exciting for me to see the expanded success and scope of the same program where I received my degree, and to see the kind of cross-disciplinary collaboration and real-world experience that are foundational to a quality education, especially within the field of design. As a service provider within the University, I am grateful to be able to continue working directly with the next crop of graphic design students, even under these unusual circumstances. It’s heartening to be a small part of their hands-on education and thereby make a meaningful contribution to their ultimate success.”

A Collaboration Culminates in Success

This summer, the design pieces were completed, printed and delivered to the research team, who will now integrate them into their overall project. Though the project is now complete for the graphic design students and Radford faculty members, they see lasting impacts of the experience.

“It’s fascinating how these diverse entities were able to navigate the strange world of COVID-19 and still get something done so well,” O’Connor said. “In the end, it was a fantastic, extremely collaborative experience working with everyone, and the designs that were delivered were exceptional.”

Callahan added, “This project was a collaboration between the arts and health sciences. The first of its kind that we are aware of here at Radford. It was exciting in many ways, and I truly hope it leads to similar collaborations like ours in the future.”