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



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



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



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 know we have a problem



“We need an app.”



“No, we need to do our research.”



Exhaustive audit of our facilities



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



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)



End result: pocket guide (paper & web)


18

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

page 27.

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

http://hsxdesign.herokuapp.com

Be Like WaterStrategies for Infusing Design in Healthcare Organizations

@jeremybeaudry + @katiemccurdy
