hxr 2016: designing within a hospital system: challenges and strategies

Designing within a hospital system

Moderator: Katie McCurdy, Healthcare UX Consultant

Lenny Naar – HELIX Centre, St. Mary’s Hospital, London

Nick Dawson – Sibley HUB at Johns Hopkins Sibley Memorial, D.C.

Matt Van Der Tuyn – Penn Medicine Center for Health Care Innovation, Philly

Jeremy Beaudry – University of Vermont Medical Center, Burlington VT

helixcentre.com @helixcentre

@lennynaar

http://helixcentre.com

Professor the Lord Ara Darzi Director

Paul Thompson Director

Stephanie Somerville Operations Director

Dominic King Clinical Lead

Maja Kecman Design Lead

Gianpaolo Fusari Senior Designer

Matt Harrison Senior Designer

Chris Natt Junior Designer

Lenny Naar Design Strategist

Ifung Lu Senior Designer

Ivor Williams Senior Designer

Anne Nazemetz Business Development

Matt Prime Clinical Research Fellow

Hannah Patel Health Policy

Sarah Huf Clinical Research Fellow

Mobile

Mobile Data-driven

Mobile Data-driven Unparalleled access

Why is healthcare stuck?

PLASTIC SURGERY

Anatomic Area

Organ SystemAnatomic Area

Organ System Patient GroupAnatomic Area

Plastic surgery is a unique specialty that defies definition;

it has no organ system of its own,and is based on principles

rather than specific procedures.

Plastic Surgery International Volume 2012 (2012), Article ID 962169

Nikhil Panse, Smita Panse, Priya Kulkarni, Rajendra Dhongde, and Parag Sahasrabudhe

People think designers do tummy tucks and face lifts

INDUSTRIAL DESIGN

VISUAL DESIGN

SERVICE DESIGN

DESIGN FORBEHAVIOUR CHANGE

INTERACTION DESIGN

GRAPHICDESIGN

SYSTEMS/TECHNOLOGYDESIGN

ENVIRONMENTDESIGN

UX DESIGN

228%

D.INDEX

S&P INDEX

Dec 2013Jun 2003

$39,922.89

$17,522.15

$40K

$5K

$25K

$15K

Design-Driven Companies Outperform S&P By 228% Over Ten Years—The ‘Dmi Design Value Index' Design Management Institute, Michael Westcott, 10 March 2014

Design-Driven Companies Outperform S&P By 228% Over Ten Years—The ‘Dmi Design Value Index' Design Management Institute, Michael Westcott, 10 March 2014

228%

D.INDEX

S&P INDEX

Dec 2013Jun 2003

$39,922.89

$17,522.15

$40K

$5K

$25K

$15K

Is healthcare a creative industry?

Human beings make mistakes because the systems, tasks and processes they

work in are poorly designed.

Professor Lucian Leape Harvard School of Public Health

Asthma

Bowel Cancer

Patient Experience

End of Life Care

Discharge

Enhanced RecoveryLimb Rehabilitation

Childhood Obesity

Engaging kids in managing asthma

5.5m Asthma sufferers in

the UK

75% Asthma hospital admissions are

avoidable

90% Deaths due to

asthma are avoidable

£1bn Cost to NHS for

asthma treatment

@helixcentre

MILD

MODERATE

SEVERE

CONTROLLED PARTLY CONTROLLED

POORLY CONTROLLED

@helixcentre

2/3 people do not fill in their Asthma

Action Plan

@helixcentre

@helixcentre

29

Floot

@helixcentre

helixcentre.com @helixcentre

@lennynaar

building a culture of design at Johns Hopkins

the process: careideatemake

The Hub exists to envision what healthcare will

look and feel like in 5 years and to

make that vision real today.

The Hub focuses on projects which

improve patient care, empower

and engage staff, and improve

clinical quality.

The Hub works openly and always

engages patients as equal

stakeholders in the design

process.

1

Senior Focused Transition

A NICHE Project

Matt Brown, MSN, RN-BC Suzanne Dutton, MSN, RN, GNP-BC September 2015

A NICHE Project

# 16: How often did the hospital staff tell you what the medicine was for?

69.9

44

71

92.3

0

20

40

60

80

100

65-79 80+

6East % that answered always

6E 2014 6E Post SFT

Age Range in Years

whew!([email protected])

mailto:[email protected]

Accelerating Ideas to Transform Health Care

Who are these designers?

How might we enable a culture of innovation across our organization?

Explore “It might work”

Scale “It does work”

Sustain “How we work”

PHASE 1 PHASE 2 PHASE 3

Innovation Accelerator Program

3 months later

2x Increase in show-rate

for follow-up care

4x Increase in eye-exam

screening rates

40% Decrease in

ED visits

Designing for rapid validation §  Divergent exploration §  De-risking assumptions §  Evidence based learning

What is the role of the designer?

Design for Accelerating Platforms Providing the knowledge, tools, resources

& rewards to encourage and catalyze others to reimagine care delivery.

Thank you.

DESIGN IS CULTURE Panel Discussion: “Designing within a healthcare system: challenges and strategies” HxRefactored Conference April 5, 2016 Jeremy Beaudry Experience Design Strategist @jeremybeaudry

SOME MIGHT SAY our healthcare systems are complex

“Your New Health Care System”, U.S. Joint Economic Commi=ee, Republican Staff

DESIGN ♥ HEALTHCARE a whole lotta wicked problems (job security!)

Kaiser Permanente InnovaFon Consultancy

OOPS, I ACCIDENTALLY BROKE YOUR STRATEGY what designers do bumps up against organizational strategy and culture so let’s be intentional (er, strategic) about our impact in that space

ORGANIZATIONAL CULTURE is for the grown-ups

Herman Miller’s Office Cubicle (source: Ge=y Images)

ORGANIZATIONAL CULTURE “the way things are done around here”

ARTEFACTS

VALUES

UNDERLYING ASSUMPTIONS

“OrganizaFonal culture and quality of healthcare,” HTO Davies et al.

ORGANIZATIONAL CULTURE “the way things are done around here”

ARTEFACTS VALUES


ORGANIZATIONAL CULTURE in healthcare systems

ORGANIZATIONAL CULTURE in healthcare systems

ARTEFACTS VALUES


CHANGE IS GONNA COME from within or without, by carrot or by stick

DESIGN IS CULTURE

Expressed by

Using non-verbal modelling media Visual thinking and visualization

Visual

Seeing constraints as opportunities Brainstorming, thinking outside of the box Divergent thinking

Design Values

Generative, solutions-focused, optimistic

Action-oriented and experimental Learn by doing Making, prototyping Iteration Enacting

Empathic

Reflective

Integrative thinking

Collaborative

Talking to and listening to people Understanding the experiences of people

Self awareness, evaluation, learning

Systems thinking Synthesis and sensemaking Employing abductive reasoning Informed Intuition

Interdisciplinary Co-creative Inclusive and participatory

Expressed by

Seeing constraints as opportunities Brainstorming, thinking outside of the box Divergent thinking

Design Values

Generative, solutions-focused, optimistic

Action-oriented and experimental Learn by doing Making, prototyping Iteration Enacting

Empathic

Reflective

Integrative thinking Systems thinking

Talking to and listening to people Understanding the experiences of people

Self awareness, evaluation, learning

Synthesis and sensemaking Employing abductive reasoning Informed Intuition

Collaborative Interdisciplinary Co-creative Inclusive and participatory

Using non-verbal modelling media Visual thinking and visualization

Visual

DESIGN CHANGES CULTURE emphasizing embodied interactions

DESIGN CHANGES CULTURE inspiring meaningful action

DESIGN CHANGES CULTURE building shared understanding

DESIGN CHANGES CULTURE making an argument for how we might live

DESIGN CHANGES CULTURE

ARTEFACTS VALUES


co-creation with stakeholders

listening to end users

divergent thinking

visualization and visual thinking

informed intuition

rapid prototyping

inclusivity and participation

learning by doing and failing faster

generative research

interdisciplinarity

connecting dots

making the invisible visible

DESIGN IS CULTURE Panel Discussion: “Designing within a healthcare system: challenges and strategies” HxRefactored Conference April 5, 2016 Jeremy Beaudry Experience Design Strategist @jeremybeaudry

Thanks!

Let us discuss

Moderator: Katie McCurdy, @katiemccurdy

Lenny Naar – HELIX Centre, @lennynaar

Nick Dawson – Sibley HUB, @nickdawson

Matt Van Der Tuyn – Penn Medicine, @PM_Innovation

Jeremy Beaudry – UVM Medical Center, @jeremybeaudry