Jules ShermanHealthcare product design & research since 2012

Physical Product · 2019

Pelvic Lift Cushion

Emergency department clinicians require a better way to support patients during pelvic exams to improve exam effectiveness and patient comfort while reducing bio-waste.

Pelvic Lift Cushion
Stanford Medicine | Stanford, CA | AHRQ-Funded | 2019

Problem

Emergency department clinicians require a better way to support patients during pelvic exams to improve exam effectiveness and patient comfort while reducing bio-waste. When an OB/GYN bed with stirrups is not available, clinicians and patients are left to improvise positioning, which compromises the exam and the patient’s comfort and dignity.

Solution

  1. A standardized patient lying on a pelvic lift cushion with her legs apart, talking to an OB-GYN who is testing the positioning of the new cushion design for performing pelvic exams without an OB/GYN stirrup bed.
  2. 3D CAD models of the pelvic lift cushion for performing pelvic exams without an OB/GYN stirrup bed, showing external and internal views with detailed contours and features.
  3. Jules briefing ED doctors in a simulation lab before testing the pelvic lift cushion for performing pelvic exams when an OB/GYN bed with stirrups is not available.
  4. A pelvic lift cushion mold before manufacturing for testing.
  5. Jules and other Stanford team members from the Safety Learning Lab for Neonatal and Maternal Care holding foam pelvic lift cushions in an office, ready to test with patients.
  6. A positive form from the pelvic lift cushion mold.
  7. A white mold on a metal table in a workshop, used to manufacture the pelvic lift cushion.
  8. Two new pelvic lift cushions sitting on a wood floor.
  9. An ED doctor practicing a pelvic exam in a simulated clinical setting with a mannequin and the new pelvic lift cushion.
  10. Jules, mechanical engineer, Doug Schwandt, and Stanford OB/GYNs in a simulation lab, discussing a patient mannequin positioned on a gurney with one of the pelvic lift cushion designs supporting the exam position.

The Pelvic Lift Cushion is a reusable foam cushion that supports patients during pelvic exams when an OB/GYN bed with stirrups is not available, improving exam effectiveness and patient comfort while reducing bio-waste.

How to Use

Research & Discovery

Pelvic exams screen for and diagnose a wide range of conditions: malignancy (cervical, ovarian, uterine, vaginal or vulvar); infections (chlamydia, gonorrhea, warts, candidiasis, bacterial vaginosis); and other pathology such as atrophic vaginitis, cervical polyps, uterine prolapse and fibroids. They are also performed prior to the provision of hormonal contraception and as part of the Well-Woman exam.

Roughly 30.02 million pelvic examinations are performed in the U.S. every year, and we estimate that half of them happen without an OB/GYN bed with stirrups. Obstetric tables cost approximately $10K–$12K, which puts proper positioning support out of reach for many emergency departments and low-resource settings.

Design & Testing

Our AHRQ-funded team at Stanford Medicine worked with emergency department doctors at The University of Arizona to develop a reusable pelvic exam cushion. We modeled the form in CAD, cast and refined the cushion through a series of molds, and produced foam units for evaluation.

We tested the cushion at the Center for Advanced Pediatric and Perinatal Education (CAPE), a simulation lab affiliated with Lucile Packard Children’s Hospital and Stanford University, working with ED doctors and standardized patients to refine positioning and support before broader testing.

Outcome

The cushion was later evaluated by a Stanford clinical team across 19 patient and clinician interactions. Clinicians scored it above the bedpan and rolled-towel workaround in every area. Published in Human Factors in Healthcare, 2022.

Read the study

The Team

The Pelvic Lift Cushion was made possible by the Stanford Medical School Department of Pediatrics and the Center for Advanced Pediatric and Perinatal Education (CAPE), a simulation lab affiliated with Lucile Packard Children’s Hospital and Stanford University. AHRQ Grant #P30HS023506. PIs: Neonatologists Henry Lee, MD and Louis Halamek, MD.

Design Team: Doug Schwandt, MSE, Jules Sherman, MS, MFA, Richard Amini, MD, Daniel Beskind, MD

Patent: US 8,973,188

The thread

The research behind it

Design Research

Pelvic Lift Cushion Study

Gynecological exam beds with stirrups are considered by many the gold standard for patient positioning when performing a pelvic exam and suturing following a birth.