Wednesday, May 13, 2009

The Hospital Gown, Fashion Malady, Worries Would-Be Redesigners Sick

Posted by Kim:

How do you feel?


On May 11, 2009, the following article appeared in the Wall Street Journal and I am shocked by the newsflash that it appears to bring to light. Doesn't everyone know that the hospital gown is not only a fashion concern, but a demeaning, dysfunctional product that succeeds only making people feel vulnerable and out of control of their care? After all, this is what BINSI has been saying for years now. It is out passion and opinion that BINSI Labor and Birth Apparel directly affects a woman’s stress level by giving her comfort, control, and empowerment during the birthing process. Most women in childbirth are healthy and need to be active - so why shouldn't they look and feel that way?

While I think that our apparel can be used in all aspects of women's care, we are not a solution for men while they need to be hospitalized or in the care of a physician so there is some disconnect there. However, the gown in general is so demeaning that I can see why men may choose not to pursue care or additional opinions when this path also means they would have to "wear a dress". Because in their minds that is probably how they see it and do we even have to talk about how much it bothers men (and women) to feel completely out of control of their situation and at the mercy of their doctor?

You may have read my first son's birth story, and if you did you will remember that he spent a few weeks in the NICU at The Children's Hospital of Denver. Well, one of the many things I learned while Connor was hospitalized, was that as the parent I (or the patient in other situations) ultimately was the person responsible for my child's care. I NEEDED to manage his care. It is not disrespectful to ask a million questions or to even question the doctor or nurse before a procedure or before they begin an injection. Not necessarily because they are inadequate, uneducated or unprofessional, but because they are human, many times overworked and stressed. For instance, because of the discovery of Connor's Hirschsprung's disease, he had to have an enema before he was discharge to discover the severity of the disease. The first time the NICU nurse escorted us down to radiology, explained everything that was going to happen and what the procedure was going to be like. Because Connor was unable to poop, they did not use Barium for the procedure as he would not be able to expell it. Three months later, we had to go back for the exact same procedure just before his surgery to verify that everything was the same. This time I was alone and as the nurse prepared for the procedure I asked her what was in the bag that she was prepping and she said Barium. I thought, that seems odd, isn't that radioactive? How will we get that out? So I asked her, how will we get that out of Connor, as I am sure that is not the same substance they used last time. What did she say... "He will poop it out." WHAT?!!! Didn't she even look at Connor's chart, that's why he is here, HE CAN'T POOP!!! She gracefully went into the other room, probably discussed this with someone else and brought back a differnt bag. Now if I hadn't asked her, would they have used Barium on a baby that can't poop thinking he would poop it out? Not sure, but I was VERY glad I interjected and second guessed her decision.

Anyway, my point here is that wearing the gown is not only a fashion fauxpas, it is a vulnerable, control, modesty, religious, self-respect thing. What the perfect solution is for all situations, I am not sure, but I definitely think BINSI can be a solution for women's care and at least is a solution outside the box. We also say "Down with the Gown."

The Hospital Gown, Fashion Malady, Worries Would-Be Redesigners Sick


By LUCETTE LAGNADO

RALEIGH, N.C. -- The traditional American hospital gown -- flimsy in front, open to the breeze in the back -- has been around about as long as the Band-Aid. If anything, it has changed less.

The one-size-fits-none garment remains one of the least loved aspects of American medicine. A bare-bottomed Jack Nicholson wore the most common model, open in back with a couple of ties, to comic effect in the 2003 movie "Something's Gotta Give."

Medical historians believe the current gown evolved from nightshirts patients wore in hospitals in the 1800s that were slit open in the back. Variations of the current style have been in use since at least the 1920s.

"Nobody is happy with it," says Blanton Godfrey, dean of the College of Textiles of North Carolina State University. "It is amazing -- we have created a product nobody likes."

Nobody, perhaps, except some hospital purchasing managers. Patient gowns are now a $76 million market, according to Premier Inc., an alliance of hospitals that negotiates to buy supplies and works with hospitals on quality improvement. Traditional models cost as little as $2 to $3 apiece, and can be washed and reworn dozens of times.

For the past 2½ years, with about a quarter of a million dollars in funding from the Robert Wood Johnson Foundation in Princeton, N.J., a small team of students and faculty at the College of Textiles has been working to update the traditional hospital gown. "It is a symbol of what needs to change in health care," says Rosemary Gibson, the RWJ foundation senior program officer who devised the "Down With the Gown" initiative.

The college has sponsored six focus groups, five at hospitals in North Carolina and one in Massachusetts. The team has also met with or sought comments from so-called "stakeholders" who would have a role in making or selling the new gowns.

"We thought that it would be a much easier problem to tackle," says Prof. Traci Lamar, who has been leading the effort for the College of Textiles.

In a drawer behind her desk at the foundation, Ms. Gibson keeps an especially ragged specimen of a gown salvaged from a New England hospital. It has snaps which she struggles to snap and a hole in it from wear and tear. When Ms. Gibson puts it on over her clothes, it is clear it doesn't cover all of her. "It is as if the patient is an object -- can't we develop a more respectful garment?" she says.

Ms. Gibson says she has held it up in front of audiences of 1,000 people to make her point: The gown has to go.

In November 2006, the foundation decided to escalate its effort by awarding the College of Textiles a $236,110 grant to work on the problem -- not just the design, but production and marketing. "It is not only coming up with a prototype," Ms. Gibson explains,

There have been other efforts to design new gowns. A decade ago, Hackensack University Medical Center in Hackensack, N.J., hired designer Nicole Miller to reinterpret its gowns. Her colorful iterations, festooned with drawings of stethoscopes, syringes and other medical icons, are about double the usual price; the hospital says they are worth it.

In 2004, Maine Medical Center in Portland introduced a modest floor-length "sarong" for its Muslim patients who were so distressed with the usual gown they were missing appointments. A seamstress whipped up the new design, hospital officials said.

But in most American hospitals, the old gown design still dominates. Bud Konheim, CEO of Nicole Miller Ltd., said his fashion brand is "dying" to do more of them. But despite talks with several institutions, Hackensack remains the lone large client.

Michael Georgulis, a vice president at Premier Inc., the nonprofit alliance of 2,100 American hospitals, thinks the traditional gown has suffered a bum rap. In addition to being inexpensive, its easy-access design "works well" in emergencies, he says. "Given all the challenges facing hospitals and health care," aren't there more pressing problems worth tackling? he asks.

Prof. Lamar's team is undeterred. The group, which includes a Ph.D. candidate who used to work for Victoria's Secret and a professor specializing in textile design and product development, gathers to thrash out possible solutions. On a balmy April afternoon, the meeting gets off to a hopeful start. The team is brimming with ideas.

How about a gown with a handy pocket that could accommodate iPods and cellphones? Maybe raglan sleeves that would be loose and stylish? Should they try for a V-neckline instead of the banal scoop-neck? But that still doesn't get to the heart of the problem. What sort of design would revolutionize the gown and what kind of fasteners should hold it together: Velcro? Snaps? The familiar cloth ties?

Prof. Lamar holds up two bibs with Velcro-style closures that belong to her infant daughter. They have been laundered frequently and haven't held up. "I would not recommend it as a solution," she says firmly.

One of the team-members brings out a small mannequin and places it on the table. She wraps a gown around it; ideas begin to flow.

There's talk about a kimono-type gown. Another iteration would wrap 1½ times around the body for a more snug, precise fit. "I keep thinking of a wrap dress," says Leslie Hatch, the Victoria's Secret alumna. "You wrap it to fit your body."

The wrap approach looks appealing on the little mannequin. But then, team member Meryem Uluskan, a master's degree candidate, interjects: "If a patient has broken bones, and they don't need to be moved," she asks, how can they be put in a fitted wrap?

The group seems briefly stumped.

Prof. Lamar's team unveiled some of its new ideas at a recent in-house fashion show, displaying gowns with very wide, raglan sleeves, deep V-necklines, a pocket, as well as the 1½ wrap that they had envisioned some weeks earlier.

Dean Godfrey is hoping that these design ideas can be developed into something practical. "We are not in it for fun and games," he says. "We are in it to create products that end up in the market."

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