A low-cost, DIY gauze counting aid fabricated from existing hospital linens to reduce the incidence of surgical gauze retained in the body

User Research
Rapid Prototyping


I was selected in winter 2019 for Stanford’s two-quarter graduate-level Design for Extreme Affordability course. Our partner organization—Dr. Atul Gawande’s surgical safety NGO Lifebox—challenged our interdisciplinary four-person team to design a low-cost solution addressing the medical error of surgical gauze retention: when gauze is inadvertently left inside the body at the end of a procedure. Gauze retention occurs in approximately 1 in 1,000 medical procedures performed worldwide, resulting in often-fatal infections.

Our team spent the first phase of our research corresponding remotely with our partner in Addis Ababa, Ethiopia and analyzing the surgical gauze retention problem that persists in the United States. We learned that adherence to the World Health Organization’s (WHO) guidelines for counting surgical gauze before, during, and after surgery can drastically reduce the risk of foreign body retention.

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I was one of two members on our team selected for a research expedition to hospitals in Addis Ababa. Over 50 hours of observing surgeries and interviewing nurses, physicians, operating room managers, and hospital staff revealed that the clear-cut WHO guidelines belie the complexity and ambiguity nurses face tracking gauze in a chaotic OR environment:


Our field research also revealed key insights informing a feasible, culturally-compatible design concept:

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We prototyped and tested extensively in close communication with the Lifebox team in Addis Ababa.

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This eventually led us to the concept of CountOn:

A low-cost caddy for sorting and counting gauze
fabricated by hospital tailors from existing surgical linens.