Tookie Vest

The ‘Tookie Vest for Renal’ –  A North East and North Cumbria Innovation Pathway Partnership Case Study.

Overview Summary

In early 2016 MedConnecT North introduced Tookie to Dr Saeed Ahmed, Interventional Consultant Nephrologist at City Hospitals Sunderland NHS Foundation Trust who was intrigued by Tookie as he himself was looking for the same outcomes but from a clinical perspective. The meeting considered the potential of adapting the Tookie vest, originally designed to prevent inadvertent catheter fall out in paediatric oncology patients, for use in adult Haemodialysis (HD) patients. An adapted vest would hopefully be able to support patients fitted with a Central Venous Catheter (CVC) to provide enhanced line security and patient well-being in treatment – ‘#ALifeMoreNormal’. (Tookie’s main ethos)

Vascular access is essential for providing adequate haemodialysis, which is ultimately a life-saving therapy. Complications of CVC use are well documented especially that of inadvertent catheter displacement with around 20% of patients affected. Each line re-instatement costs the NHS approximately £3,000.00, whilst also affecting the patient’s quality of life.

Challenge Identified

One of the main challenges which had been encountered was redesigning the original vest for a new patient population. To overcome this, City Hospitals Sunderland’s renal research team (Dr Saeed Ahmed, Dr Rachel Davison, Paul Corrigan and Debbie Sweeney) and the Research and Innovation (R&I) department (Mr Kim Hinshaw, Lynne Palmer and Emily Brand) supported by MedConNecTNorth subsequently arranged for the Tookie team to hold patient centred focus groups to re-design the vest and create an adaptable product that could be used within this patient population. Focus groups took place during which time many prototypes were considered by the research team and with the final design now agreed it is being CE Marked in preparation for a qualitative and quantitative evaluation study.

Overview of Innovation

The Tookie Vest is an innovation which has been designed to support patients fitted with a Central Venous Catheter to provide enhanced line security. The Tookie Vest is designed to help prevent catheter displacement but also to help the patients to continue to live ‘#ALifeMoreNormal’ as the vest helps to discretely secure the lines offering modesty and dignity, freedom, independence and reassurance.

Actions Taken

Between May 2016 and March 2017, Tookie Limited, City Hospital Sunderland’s Renal Team & Research and Innovation Team supported by MedConnecT North ran patient focus groups to re-design the current paediatrics vest for use in the Renal adult population. The Renal vest has been through various prototypes and now the final design when CE Marked will be ready for a NIHR CRN Portfolio Adopted evaluation study; sponsored by City Hospital Sunderland NHS Foundation Trust.

Outcome/Progress to Date

The next step currently underway is the design of a proof of concept pilot study. The multi-centre study will aim to explore the un-met need of the renal patient to provide a suitable wearable vest to improve their Quality of Life (QoL) and enhance mechanisms that enable the efficient delivery of their treatment. The study will also assess the impact of the garment on clinical outcomes i.e. fall out rates.

Specialist NIHR CRN Researchers have been drafted in to strengthen the Research Team and to begin writing the evaluation study protocols in preparation of the next phase of work.

Impact

The impact on a patient is an increase in comfort, line security and modesty:

Dorothy (Tookie Renal Patient Ambassador) – “The concerns for the comfort of HD patients was obvious from the beginning. To give them comfort and modesty in a mixed unit, but most important of all, the vest giving security with restricted movement to the neck line both during the night and day for both male and female patients, alleviating the possibility of having to replace the neck line, causing even more discomfort and anxiety for the patients concerned.”

Mr Stephen Tooke, Commercial Director, Tookie Limited said: “The impact of this regional collaboration will allow all suitable patients in the region equity of access to the new Renal Vest, to help them lead #ALifeMoreNormal. We are most grateful to all everyone involved in this project and a privilege to work in the North East; with special thanks to Dr Saeed Ahmed”.

Benefit

The financial benefits are being reviewed within a wider evaluation however, what is known at this stage is that 20% of patients become affected by inadvertent line fall out and that each line re-instatement costs the NHS approximately £3,000.00. The intervention of this innovation will hopefully help in reducing the amount of line re-instatements required and the study will inform the understanding of its value proposition to the NHS.

Plans for the Future

Dr Saeed Ahmed suggests, “Tookie and CHS would promote through the research and the use of the innovation in the 35,000 patients on Renal replacement therapy. A significant number of these patients will use a central venous catheter for dialysis. We would hope to have the innovation endorsed by the Renal Association, British Renal Society and Vascular Access Society of Britain and Ireland. This would help in adoption of the innovation in the fifty-two Renal Units in the UK.”

Facilitated by MedconnecT North a clinical focus group was held at the Great North Children’s Hospital in Newcastle to begin the process of investigating migrating the Tookie Vest into the Paediatric Renal patient group with Dr. Yincent Tse and Dr. Heather Lambert, Consultant Paediatric Surgeons as Chief Investigators.

Furthermore, work will begin shortly at Sheffield Children’s Hospital for a suitable apparel for respiratory patients based on the same core principles of line security and enhanced QOL.

Contact

NHS:         Charlotte Fox, Innovation Manager, City Hospitals Sunderland NHS Foundation Trust, charlotte.fox@chsft.nhs.uk

Innovation Pathway Partner: Mark Taylor, Operations Manager, LCRN/MedConnecT North, mark.taylor42@nhs.net

Industry:  Stephen Tooke, Commercial Director, Tookie Limited, Stephen.Tooke@tookie.co

Related links, references and further resources

Dr Ahmed is published on the complications of CVC’s: https://www.ncbi.nlm.nih.gov/pubmed/26349889 [1] https://www.renalreg.org/wp-content/uploads/2015/01/12-Chap-12.pdf

 

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