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Patient Care

The People's Cot: Feedback Leads Ferno to a Patient Movement Breakthrough


EMS has always been about taking care of patients. Often, the safety and comfort of those who deliver it has been an afterthought.

We’ve recognized that discrepancy in recent years and started working to remedy it, but gaps in our tools and processes persist. Most providers, if asked, could effortlessly cite multiple areas ripe for better mechanisms and easier, less-risky ways of doing things.

Over the last few years, Ferno asked that a lot. It was part of an unprecedented product-development process that culminates this spring with the introduction of the company’s much-anticipated iN∫X patient transport and loading system.

The iN∫X is more than just a cot, and its roots go back through several years of painstaking research. Working with customers and thought leaders across the country, Ferno and its partners poked, prodded and scrutinized patient-movement challenges and deficiencies to craft a solution that could remedy actual problems encountered by front-line providers. As a result the iN∫X was honed through multiple rounds of active solicitation and feedback and refinement from the people who’ll be using it.

“The whole idea was to get it right the first time,” says Steve Schwandner, president of SeeIdeas, Inc., an Ohio-based product-development company that worked with Ferno. “We’re not supposed to get it right the third time. If we get it right the first time, the market should look at this and say, ‘Wow! How’d you guys come up with that idea? That’s something I would have done!’ That’s the kind of response you want to hear.”

Customer-centric Process

The company wanted its process to be customer-centric, but it initially didn’t know what that might lead to. “We didn’t want to focus on a product from the start,” says Jerry Socha, Ferno’s marketing director. “It could have been anything, though we did feel it would ultimately be a patient-handling device.”

The process began with exploratory research: blind surveys of field-level providers in focus groups across various U.S. locations. Those providers were asked what they did throughout their days—what went into getting into an ambulance, traveling to scenes, and treating and loading and transporting patients? What did they like and dislike about their tools and experience? What would they change if they could? 

That information helped guide production of a few hundred initial renderings. “We just threw everything up on the wall at first,” says Tim Wells, Ferno’s product manager for the effort. Those were narrowed down, then taken back to the field for feedback. Again working in blind focus groups, users saw potential pieces like wheels and handles and IV poles, and evaluated and rated them as individual items and among types. That helped sharpen focus further and create working requirements for actual construction.

Soon Ferno had six finished conceptual renderings of complete patient-transport systems and an early concept model of the iN∫X. It took those back to the streets for more input.

“We wanted to make sure the push buttons were in the right locations, the handles didn’t have too far of a reach,” says Wells. “EMTs and paramedics have different hand sizes, so you have to take that into consideration.”

Key contacts and industry partners got early looks at preliminary models as they were developed and continued to contribute suggestions and refinements. And now, with beta testing underway at select agencies, a few last bits of intelligence are being corralled from actual field use.

“It’s been an iterative process,” says Socha. “As you look at the iN∫X, you can really point to just about any feature or function on it and tie that back to something that came from a customer, whether it was in those formal research groups, the initial needs discovery, or even just the customer visits we’ve had, bringing customers and experts in to play with the prototypes and give us feedback.”

What the People Want

So if the people have been heard, what do they want?

“Definitely, everybody’s well aware of the injury rates that are part of EMS work,” says Socha. “Our early needs discovery really showed us that lifting and raising, loading and unloading, was an important issue to customers.”

A key characteristic of the iN∫X that meets those concerns, then, is an integrated loading system that features independently operating x-frame legs. This keeps almost all weight off the provider when getting the patient  into and out of the truck. Among customers, that was the top-ranked solution in Ferno’s research.

Those independent legs also allow navigation of stairs and uneven terrain (see the image on page 46) without carrying. It also has integrated lighting because, as it happens, we very often work in dark locations and across unilluminated ground.

“From the beginning, one of the big ideas to come out was the lights on the iN∫X,” says Wells. “Operators told us one of their biggest issues is being able to see where they’re going with a patient.”

Other considerations were maneuverability, ruggedness and keeping the profile as small as possible. To the end of strength and durability, the iN∫X’s legs and arms are made of carbon fiber, the same material used in firefighters’ helmets. “It will take the day-in, day-out beating,” says Wells. “Aluminum is in a lot of our products, and it’s very strong, but carbon fiber takes us to the next level.”

With those requirements met, the final challenge was delivering the necessary function in a sleek package with a sophisticated appearance.

“The mission we had was very clear: They literally told us, ‘Make it look sexy,’” says Rajib Adhikary, whose company, Kaalo Design, did the iN∫X’s industrial design. “Even though that was loosely used, the point was, it should be as good-looking as it performs. Both function and form should be in sync with an image that this is state-of-the-art, a product of the future, and it’s going to save lives.” 

Among the agencies beta-testing the iN∫X is Minnesota’s Gold Cross/Mayo Clinic Medical Transport. During a three-month trial period, it’s rotating its iN∫X throughout the areas it serves, giving providers a chance to use or at least see it. The feedback has been extremely positive.

“It’s a smart concept and easy to use,” says Matt Will, the agency’s director of support services. “Our guys can already see some of the advantages of the Ferno product. The independent legs give us increased flexibility for the unique circumstances we sometimes encounter. And I don’t know if I’ve ever seen lighting on a cot before.”

That’s the kind of feedback a manufacturer likes to hear. And for Ferno, it validates the unusual amount of work put into developing the iN∫X. “It really brings the best technologies available together,” says Socha. “What we’ve created is a product with unique value that can really meet needs customers have not had met to date.”   

For more information:, 877/733-0911. 

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