Of all the PPE required to care for patients in a hospital, isolation gowns might appear lower on the list. For an infectious respiratory illness like COVID-19, masks and face shields are often thought a much higher priority. But isolation gowns play a crucial role in caregiver protection – preventing the spread of disease if the wearer comes in contact with infectious liquids and aerosolized or solid materials. And as the world began to source or produce masks and other common PPE items to keep hospital shelves stocked, it became apparent that gowns, too, were in short supply. In an effort to provide well-rounded stock for Cleveland Clinic, isolation gowns were added to the Innovations’ list of MAKE initiatives. Stepping boldly outside their comfort zones, generation of isolation gowns became the task of General Manager, Technology Commercialization, Mary Kander, General Manager, Business Solutions, Jim Zalar, and Senior Director, Product Development, Therapeutics Suguna Rachakonda, PhD.
Realizing they needed first to understand the product and material specifications for reusable gowns, the group then set to work contacting local medical material manufacturers, industrial sellers, and fabric distributors with the goal of acquiring sample fabric that met specifications. Placing phone calls from sunup to sundown, Kander, Zalar, and Dr. Rachakonda weaved a web of connections across and between states with groups ranging from large retail organizations to local fashion schools. With most eager to help, sample fabric began arriving at both the homes of team members and Cleveland Clinic’s main campus within 24 hours. There even were roadside pickups at meeting points halfway between Cleveland and Ohio Amish country to grab fabric samples and prototype gowns in an effort to speed up production. After some home experiments on the received fabric samples, the team selected a handful of frontrunners to send to a testing lab. Testing to see which, if any, met American National Standards Institute (ANSI) level-one standards for fit and water penetration, the team was unwilling to cut any corners as it relates to the safety of the caregivers who would eventually wear the product. All said and done, the initial sourcing and testing of materials took about ten days. At this time of peak response, however, fabric became scarcer by the minute.
Though originally looking only at certain hospital-standard colors, the group accepted they would have to make do with whatever fabric met ANSI specifications and was still available. Fabric rolls that were in stock at a distributor at 9 am had disappeared from the shelves by noon. From greens to yellows to pinks, isolation gowns would eventually be produced in a range of colors. After verifying capacity and distributing design specs, official orders from Cleveland Clinic were placed with three main suppliers: commercial sewing company, Stitches USA, non-healthcare PPE supplier, National Safety Apparel (NSA), and cold weather sportswear manufacturer, WSI Sports. Located in Ohio Amish country, Cleveland, and Minneapolis, Minnesota, the enterprises set their supply chain managers, sewers, and pattern makers to work on an entirely new product line. Together, the groups were able to produce 40,000 isolation gowns for Cleveland Clinic’s supply in a little less than two months. Additional supplies of about 7,000 gowns were produced over the following few months.
Constant communication with Cleveland Clinic’s Supply Chain and Finance proved essential to the operation, moving quickly to secure fabric and production capacity. Kander spoke highly of the suppliers, distributors, testers, and other miscellaneous groups involved in the gown production process. Said Kander, “Everybody bent over backward to work with us.” Between shipping samples and manually running supplies to working weekends on an entirely foreign product, the flexibility and selflessness displayed by both internal and external parties lives on by way of protected, practicing caregivers.