DEBORAH ADLER Deborah Adler is a principal designer and the inspiration behind Target s ClearRx SM system. Motivated by a desire to make people s lives easier and safer, she designed a comprehensive system for packaging prescription medicine as her master s thesis. The result was a completely reinvented prescription bottle and label. Currently, Deborah is a senior designer at the multidisciplinary design firm Milton Glaser Inc. in New York City. Her work includes projects ranging from identity systems, magazines and book jackets to product packaging, restaurant interiors and stadiums. Adler s work with the comprehensive new ClearRx prescription dispensing system awarded her the Master of Fine Arts Design award from the School of Visual Arts. Her work has been featured in Glamour magazine, and on NBC Nightly News, CBS Sunday Morning and National Public Radio, among others. The ClearRx bottle was also featured in The New York Times Magazine s The Year in Ideas issue of 2005 and listed in The Best Inventions of 2005 in TIME Magazine and BusinessWeek. By Jennifer Freedman 48 HEALTHY SKIN
SPECIAL FEATURES The patient in room 123B has a pressure ulcer. As the staff nurse, you evaluate her wound and categorize it as Stage III, full-thickness skin loss involving damage of subcutaneous tissue. You make proper notation in her chart and try to remember which dressing would be required for which type of wound and how often you need to change it. You go to the supply closet, where there are stacks of assorted wound dressings. Your mind fills with questions as you scan each package. The labels on the pouches do not include a photo of the dressing, a listing of indications or instructions on how to apply. Perhaps there was more information on the outer boxes or on an insert in the packaging, but those are usually thrown away to save space. You ultimately choose the dressing that you think you need but you re not completely sure. PACKAGING DESIGN BECOMES A 2-MINUTE COURSE IN WOUND CARE On a daily basis, nurses find themselves in situations just like the one described above. Valuable time is wasted searching for the right dressing and often the wrong one is used or the proper steps are not taken to care for the type of wound. Is there a way to improve this process and ensure that nurses have all the product information they need, when they need it? How can a medical product manufacturer help professionals care for a patient s wound in a safe and efficient manner? Medline posed these questions to its wound care advisory panel. The room was buzzing with discussion of what advanced wound care problems they encounter and which tools they could use at the bedside to perform their jobs more effectively and safely. And then the focus turned to packaging. The key, Medline discovered, is to re-design wound care packaging. FEEDBACK SPARKS A DESIGN SOLUTION Inspired by all this talk, Medline jumped into action. It began with a phone call. On one end of the line was the award-winning graphic designer Deborah Adler, the mastermind behind Target s ClearRx bottle. On the other end was Sue MacInnes, Medline s president of marketing. Improving Quality of Care Based on CMS Guidelines 49
25-50% of all my phone calls are from outpatients asking about their wound care dressings how to apply, how to remove and when to change the dressing. I spend a great amount of time returning phone calls helping the patient or a family member change a dressing over the phone. Recently, a patient called because he did not think that the dressing was right well, it wasn t. He was removing the carrier sheet backing and throwing away the dressing applying the carrier sheet on his wound. When a patient is discharged from the acute care facility we have to give a lot of information in a little amount of time and we have to hope that the crash course was adequate for that patient and family. We have a huge focus on discharge planning not only tell the patient and family what to do but make sure they know what to do! We use handouts and pamphlets, but right now there is nothing consistent. Andrea McIntosh, BSN, RN, CWOCN, APN Manager, Wound Center, Silver Cross Hospital, Joliet, Ill. The Target ClearRx prescription bottle is now considered a design classic. MacInnes had read a feature story on Adler in an issue of Glamour magazine. At the prime age of 30, Adler had made the Glamour Buzz List 06, labeling her a Design Genius. The magazine described her as one of the 24 Women Who Could Change Your World This Year. Deborah is a senior designer at the multi-disciplinary design firm Milton Glaser Inc. in New York City, where she works directly with the legendary Milton Glaser. MacInnes knew that Adler had the potential to go beyond the pill bottle and continue making a difference in the healthcare industry. She needed Adler on the phone immediately! A little investigating and a few phone calls later, MacInnes was asking Deborah Adler if she would work with Medline on a comprehensive packaging system for advanced wound care. This project and Medline seemed like a natural fit for me. I was intrigued by the thought of designing for practitioners in hospitals, nursing homes and home health, where compliance is an issue. It s an arena I would love to be able to contribute to and, hopefully, make lives a little bit less complicated. So, I worked closely with my boss, Milton Glaser, who brought a lot of wisdom and experience to this project, said Adler. INNOVATIVE DESIGN MAKES HEALTHCARE SAFER Adler s design came out of a firsthand experience. Her grandmother accidentally swallowed prescription medication meant for her grandfather, an error that she attributes to inadequate labeling. This sparked the idea for a thesis project in the redesign of the traditional prescription bottle and a safety campaign in the industry. Target acquired the concept and developed it into the ClearRx prescription system, launched in Target pharmacies nationwide in 2005. Adler s design is now being called a design classic. I grew up in a family of doctors, so the world of medicine has always been a strong interest of mine. It was important for me to develop an idea that had substance and would have meaning in my life. When my grandmother made the mistake, it became clear that I had an opportunity to develop an idea that was both close to me and satisfied my need to do something that would in some way help others, Adler said. Her innovative design talent and impassioned commitment to advancing health care made Adler the perfect partner in Medline s quest to make wound care safer. 50 HEALTHY SKIN
My grandmother recently had a port inserted for dialysis with little discharge instruction on how to change the dressing, she developed a skin rash. Thinking this was normal, she continued to apply the dressing according to the discharge instructions. The skin became denuded, almost requiring a new port placement. I think that if she had better instruction and knew what was normal or not she would not have had to suffer as she did. Lucky for her, the port was not lost and she will be okay. XXX Jori Weil Granddaughter of Estelle, 83 years old Deborah Adler presents her wound care packaging concept to Medline s advanced wound care advisory board. FROM PRESCRIPTION BOTTLES TO WOUND CARE PACKAGING It s quite a jump to go from creating a prescription bottle to designing educational packaging for advanced wound care. MacInnes and a team from the Advanced Wound and Skin Care Division at Medline told Adler that they wanted to create a revolutionary new wound care packaging system that will improve patient safety and serve as a much-needed bedside tool for the wound care professional. The responsibility of how to handle one s health falls on manufacturers, retailers, healthcare personnel, designers and, most of all, consumers. Patient safety is clearly a growing concern and I believe design can play a large role in making product packaging more useful, said Adler. The grand task had been assigned and Adler immediately started researching the project. She began by meeting with Medline product managers, advanced wound care specialists and nurses to learn about traditional wound care packaging, problems with the current design and what information could help nurses at the bedside. We immersed ourselves in the world of wound care. We had a lot to learn in a short time. I attended the SAWC wound care conference in San Antonio. I also met with an advanced wound care panel. I was looking at the industry from an outsider s view what are the issues and how can we make a difference? said Adler. The traditional wound care packaging often consists of an outer box and inner package. For many products, the indications and directions for application are printed only on the package insert, which is regularly thrown away. The inner pouch with the wound dressing usually contains limited information. This can leave the nurse guessing as to what the dressing looks like, its indications and how to apply. This creates a lot of waste (time and product) and a threat to patient safety. A 2-MINUTE COURSE IN ADVANCED WOUND CARE We wanted this wound care packaging to be less confusing, more comprehensive and ultimately provide greater patient safety and tremendous savings to the healthcare industry, said Adler. Adler addressed the practitioners concerns and together with Glaser created an innovative and functional design. This new educational packaging displays all the information that the wound care professional needs on both the outer box and the inner pouch. Improving Quality of Care Based on CMS Guidelines 51
Front The WOC nurse is often the clinician who directs wound care, but more than 70% of the time it s the bedside nurse who applies the dressings in our hospital system. If the instructions are not clear and readily available there will be issues with application and removal of a dressing, when to change the dressing and what to expect. Amie Kirkwood, BSN, RN, CWOCN Denver, Colo. Back Based on clinician feedback, Adler incorporated a number of design features that will change the way wound care professionals work. One problem I heard was that a nurse did not know how long a wound had been dressed. I developed a crack-and-peel sticker on which the clinician could mark the date and time of a dressing change so that all nurses caring for that patient would know, said Adler. Step-by-step illustrations were created with instructions on each individual package so that everyone understands the indications and how to use the dressings. The design is based on a hierarchy of information. The outer box and inner packaging include: Product name and category Clear product photo General definition of product Technical product information Uses, features and change frequency Illustrated application process Color-coded bars to easily identify the name and category of product The inner pouch includes unique features: Crack-and-peel sticker for dressing change and charting Show-and-tell booklet that is a 2-minute course on wound care Each family of wound care products is color coded with a horizontal color bar across the top of the box so that nurses can easily identify the category 52 HEALTHY SKIN
Name of Product XXX Subtitle A general definition of the product Key Information Clarifies appropriate use Product Photo A clear-as-day picture of the bandage Category Giving a more detailed breakdown of the product Sticker A breakthrough! This sticker dates the dressing and alerts you to when it's time to change Basic Info Brief technical detailing of product attributes: Size, number, etc. Booklet! A show-and-tell pamphlet that is a short and sweet 2-minute course on wound care of wound dressing. This unique color bar system will be incorporated into the design of the product packaging for Medline s entire line of advanced wound care dressings The package design prioritizes patient safety and effective product application. The design actually creates a format that allows each package to serve as a two-minute course on advanced wound care. It eliminates the clutter and highlights critical information. Her work will create a new standard for our industry, said Jonathan Primer, president of the Advanced Wound and Skin Care Division at Medline. Medline is launching this innovative product packaging in June, starting with its SilvaSorb line. Medline believes this revolutionary approach to product packaging will make wound care safer, saving time and money while reducing wound healing time. I applaud companies that are pushing innovation. Companies like Medline have the opportunity to influence change in the healthcare industry, said Adler. ClearRx SM is a service mark of Target Corporation. Improving Quality of Care Based on CMS Guidelines 53