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NHS Bed Capacity Challenge The specific challenge that we were faced with was around social distancing and infection control in NHS hospital wards and waiting areas. Covid restrictions had placed great pressure on hospitals where up-to 40% bed capacity was being lost as beds in many wards did not meet new social distancing requirements. 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.