• creativity
• children’s hospitals
• child healthcare
• hackathon
• innovation
• low middle income countries
• medical innovation
• paediatrics
• paediatric innovation

Paediatrics presents unique clinical challenges with major implications for morbidity and mortality where care is suboptimal.1 Similarly, setting up a children’s hospital in a low-income to middle-income country (LMIC), such as Pakistan, brings its own set of trials and tribulations: from resource allocation to the provision of high-quality affordable care.2 With work on a new children’s hospital about to begin at the Aga Khan University (AKU) in Karachi, Pakistan, the Critical Creative Innovative Thinking (CCIT) forum organised its second Hackathon, ‘Hack Paeds’, in February 2017. The essence of CCIT’s philosophy is to counter restrictive thinking so often encountered in medical practice. The forum, funded by the parent institution, encourages professionals and students to share, nurture and implement their creative and innovative ideas and solutions.3 Hack Paeds was similar to typical healthcare hackathons in the way that it, too, was a multiday event in which participants or ‘hackers’ worked in teams to produce solutions to problems encountered within paediatrics. This concept of healthcare hackathons began in the USA in 2010 and has, since, spread worldwide.3 4 This write-up aims to outline the proceedings of Hack Paeds and introduce the concept of alternative hacking models.

Hack Paeds 2017 was held over 3 days. On the first day, over a hundred hackers gathered in the Centre for Innovation in Medical Education at AKU for an introductory session. This was followed by an opportunity to present (or ‘pitch’) paediatric problems related to children’s hospitals or paediatric healthcare along a continuum (community, emergency room, in-patient wards and so on), in a 1-min presentation format. A total of 78 pitches (68% of attendees) were initially made, which were then condensed into a few very specific questions relevant to children’s hospitals and child healthcare in LMICs. Ultimately, 18 teams of four to eight members were formed each of which then spent the next 2 days producing cogent solutions (figure 1). On the final day, each team presented their ideas in a 5-min format to a jury comprising professionals from the sectors of health, business and innovation. The Hackathon brought about a range of creative and innovative proposals easily applicable to an LMIC setting. Standout ideas included: Smart-ER that proposed the development of an app that would help parents decide whether their child required immediate emergency services; Stealth and Nap Cuff worked around the concept of developing vital signs monitoring instruments that are child friendly and accurate in the emergency department and HACK-Fun aimed to design the children hospital’s waiting areas in such a way that paediatric patients’ siblings are kept busy, thereby reducing the psychological burden on parents while they care for their sick offspring.

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Figure 1

Participants ‘hacking’ away.

In addition to the main event, a shorter alternative hackathon, the ‘Hackidathon’, was organised for children/adolescents aged 5–19 years. This was based on the premise that children have quirky and interesting views on matters that involve them. A few of the participating children had experienced significant paediatric care within a hospital setting. The results of this side event were thought-provoking and perhaps not so surprising: the children envisioned more child-centric interior design, outdoor playgrounds as well as indoor play and reading areas in their utopian children’s hospital. All of this was reflected in the models that the children created using the raw material provided to them (paper, colours/markers, cardboard, cotton wool, tongue depressors, string, so on; figure 2). A few imaginative children emphasised the need for zip lines running through the entire children’s hospital for fast and fun movement across the facility.

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Figure 2

Hackidathon participants displaying their projects.

In conclusion, Hackathons within healthcare engage the community, including the youngest members, to be active participants in innovating and creatively working around the problems that they feel require urgent attention.5 We feel that any medical institution should give the concept serious consideration, including children’s hospitals in resource-limited settings, aiming to ideate, innovate, and thus evolve in a child-centric fashion. Everyone stands to gain from sharing ides in such an environment.