Be Like Water: Strategies for Infusing Design in Healthcare Organizations

Be Like WaterStrategies for Infusing Design in Healthcare Organizations

@jeremybeaudry + @katiemccurdy

interaction17 | February 7, 2017

BE LIKE WATER: Strategies for infusing design in healthcare organizations | @jeremybeaudry + @katiemccurdy

We’re designers

We work at The University of Vermont Medical Center

Over 7,600 employees

A million patient encounters annually

Building an expanding network health system with affiliate hospitals across Vermont and northern New York

Where we work also looks like this

It’s a big, old institution with a specific culture

BE LIKE WATER: Strategies for infusing design in healthcare organizations | @jeremybeaudry + @katiemccurdy interaction17 | February 7, 2017

That’s just the way things get done around here.”

Amazing, committed people work here

People are very nice, people are very polite

Meetings where people sit and talk

Lots of consensus

Limited idea of “participation”

Lots of hierarchy

People feel helpless — “that’s above my pay grade”

Uneven power dynamics

Strict project management protocols

Skewed sense of how long things should take

People hide out in their offices, working alone

Emailing, emailing, emailing

Passing around Word docs with “track changes” on

Like it’s 2004

If this is the organization

Here’s us – new, strange, scarce

Modeling a new way of working

We want to tell you how we’re like water

Flowing through this place

Picking up people and information as we go

Increasing collaboration and connectedness

We think you can do this too

Build connections Co-create Model a different kind of “work”

We work on all kinds of projects

After Visit Summary Bill Redesign Cancer Patient Welcome Guide Children’s Hospital Guide Culture of Quiet Future of Nursing hiCOlab Innovation Lab Hospitalist Calling Cards Patient Portal Website Patient Flow (ED Admissions) Patient Referral Process Pediatrics Transitions of Care Progress Note Redesign (EHR) Proxy Access (EHR) Public Website Redesign Wayfinding

Conversations Relationships Interactions Print materials Websites Mobile apps Services Environments Systems Processes Strategy Culture

We work on all kinds of projects

After Visit Summary Bill Redesign Cancer Patient Welcome Guide Children’s Hospital Guide Culture of Quiet Future of Nursing hiCOlab Innovation Lab Hospitalist Calling Cards Patient Portal Website Patient Flow (ED Admissions) Patient Referral Process Pediatrics Transitions of Care Progress Note Redesign (EHR) Proxy Access (EHR) Public Website Redesign Wayfinding

Conversations Relationships Interactions Print materials Websites Mobile apps Services Environments Systems Processes Strategy Culture

CASE STUDY 01

Helping people navigate our space

We know we have a problem

“We need an app.”

“No, we need to do our research.”

Exhaustive audit of our facilities

Interviews with front-line staff

We discovered where the breakdowns are

Walk-through with leaders

Workshops with patients and staff

Workshop with registration staff

Synthesis as a team

We created findings and principles cards

Yeah, we have problems with our signs

We also lack a clear and cohesive organizing system

At this point, we needed a design sprint

We sketched ideas and prototyped the best one

A nature-themed zone system

Testing our prototype

It worked

I love this.” –Patient

I find it calming.” –Staff member

The simplicity is good.” –Staff member

I could have used this yesterday. I needed a GPS.” –Visitor

It makes me feel like: I can do this.” –Patient

Anyone can use it. Even if you can’t read you can get there.” –Visitor

Be like water

Our ethnographic research methods and design sprints introduced many people to our process and how we work.

We shared different methods and tools with our partners, and they began to use them confidently on their own.

We carried people with us, building excitement and momentum for the project across multiple departments.

Being like water helped us

CASE STUDY 02

Supporting parents stayingwith their children

Problem

After leaving the hospital, parents say that they didn’t know what resources were available to them.

Visual storytelling session

WTF is glycogen storage disorder?

Apprehensive, powerless, not kept in the loop

Insights

We heard a lot about communication breakdowns and transparency issues.

We realized we also needed fresher experiences and tips from parents who are currently in the hospital.

Traveling, shadowing, learning

What do parents see?

What is it like to stay at the hospital?

Insight: many parents are ‘stuck’ in the room for days

When you come in here you’re not thinking of yourself. You’re thinking of [your child], and doing everything you can to help them. Then you get here and realize you need things like clothes.” —A mom

They offered to do a tour when I first got here, but I didn’t want to leave him.”—Another mom

Temporary tip board installation

Add a tip or put a sticker on another person’s tip

The board filled up quickly (and it’s still there, a year later)

Insight: parents often gave moral support

End result: pocket guide (paper & web)

TALKING WITH YOUR HEALTHCARE TEAM

CARING FOR YOUR CHILD

Caring for yourselfAn important part of caring for your child is caring for yourself. Make

sure you get a break once in awhile. Staff and volunteers are here to

help . Ask someone to sit with your child or check on him/her more

frequently if you need to step out.

The Ronald McDonald Family Room, located on the unit (see the

map on page 3,) is also a great place for familes to take a break in a

comfortable, living room-like setting. It offers amenities like laundry

and showering facilities, coffee, other food and beverages, a small

kitchen, and computer access. You can learn more about the room on

STAFF TIPS

• Take family and friends up on their offers to help.

• Do not feel like you’re a “bad” parent if you need to spend a night

or two away from the hospital.

• If you need to keep family and friends updated, the CaringBridge

site or Facebook’s group messaging can be helpful.

– PARENT TIP

“Don’t feel guilty for getting outside for a walk every now and then to keep your sanity. Have a volunteer sit with your child. It will make such a difference!”

PARENT TIP

Informed directly by parents

The team experienced new ways of working together

Parent council felt sense of pride and ownership

Ripple effect

The same team hired another UX designer to create materials for parents whose children are seen at the outpatient specialty center.

End result: an effective product

I notice when parents don't get [the guide] — they seem more lost. They didn't know they could get a meal tray. They didn't know what questions they could ask.” —Lisa, Nurse Manager

Be like water

We traveled through the physical space of the pediatric unit, asking questions and observing, leaving no corner untouched.

We followed leads, which led us to meet more people and gather more complete information.

We seeped into the culture of the advisory council.

CASE STUDY 03

Improving transitions of care for kids with chronic illnesses

Moving from pediatric to adult health care is hard

We asked kids and parents about their experiences

We created a tool for patients to map their journey

Insight: the relationships in pediatrics run deep

Insight: the child-parent dynamic is complex

We also interviewed doctors, nurses, other clinical staff

We are learning a lot about what kids need

We need to support meaningful conversations that visualize the entire transitions journey and help families navigate it.

The tool should connect kids and parents with existing transition resources appropriate to their age and illness.

We must create a clinical system that facilitates a “warm handoff” between pediatrics and adult specialty clinics.

So that we can create a toolkit just for them

Be like water

Our action-oriented, iterative approach is a motivating force for our project partners.

They also see how important it is to focus on learning from end users.

As we talk to people across the organization, we are consolidating multiple, isolated efforts around transition of care and forging new collaborations.

What helps us do what we do?

Champions who let us be

Our amazing little space

Our teams’ willingness to collaborate differently

Our unique access to people — patients and staff

We love the work

It draws people to us

They say nice things

There's a lot of action when we're working on a project or exploring an idea. We typically aren't sitting down, there are visuals - and often Post-It Notes - and it feels like topics are discussed and next steps and decisions are made quickly.”—Communications team member

You are focused on fixing problems with the input and assistance of the people affected by the problem. Most other teams just do what they think will work.”—Anonymous

Clone yourselves!”

Being like water helps us change culture

FROM: hierarchical decision making

TO: more user-centered decision making

FROM: uneven power dynamics

TO: conversation & relationships

FROM: long, rigid projects

TO: quick iteration

FROM: hiding out

TO: getting out

FROM: sitting & talking meetings

TO: visual collaboration

FROM: “that’s above my pay grade”

TO: “I can make things better”

TO: “we can do this”

We think you can do this too

Build connections

Show up in-person.

Follow the leads, and believe that every person you meet is an opportunity to learn something new.

Understand the organizational culture so you can flow through the paths of least resistance.

Co-create

Facilitate participatory design workshops.

Use tools that support visual ways of gathering information and input.

Get out of your office (and off devices) and talk to end users, ask for their suggestions.

Model a different kind of “work”

Make meetings visual — always, no excuses.

Don’t be afraid to be the weird one doing things differently.

Pull non-designer team members into design and synthesis exercises.

Show people how much more fun you have than they do.

Healthcare system designers: join us on Slack

hsxdesign.herokuapp.com

Be Like WaterStrategies for Infusing Design in Healthcare Organizations

@jeremybeaudry + @katiemccurdy

Be Like Water: Strategies for Infusing Design in Healthcare Organizations

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