Human-Centred Design meets Professional Healthcare
Designers have many approaches to build the future. Some of them centre around future visions, concepts and speculations, which can inspire new discussions, strategic business decisions and radical innovation. On a slightly different spot of the spectrum, we have designers as problem solvers, who are dismantling current situations and implementing small interventions to fix problems by innovating incrementally. Although varying in outcomes, the approaches are more similar than different, sharing the much of the same thinking, methods and tools.
For the Design for Social Innovation class of 2020, we partnered with the North Estonian Medical Center (PERH), the largest healthcare provider in Estonia, to tackle four distinct challenges. Early on in the launch of the project, we established the common wish to deliver practical results, interventions that the partner could implement today. This meant that a considerable amount of validation and development had to fit in our seven-week timeframe, but also set several design principles from the get-go. Designers from the Umeå Institute of Design, Kolding School of Design and Art Academy of Latvia joined our team to aid in ideations.
Empowering hospital staff to think and act like service designers
Danai Asteriadi, Jete-Maria Vürmer
Remote personal medicine is the future. The students’ brief was to help PERH envision an effective and safe remote sample collection service. The team conducted stakeholder interviews, observations both in the hospital and on a ride-along during the collection tour, and quickly mapped several problem areas, such as logistics of route creation, time constraints caused by the delicate nature of goods, and communication between all parties involved.
Mapping their findings on a service blueprint and analysing their insights, the students realised they were working on the first steps of an emerging system, with infinite problems, possibilities and directions yet to come. So they decided to refocus from providing solutions to empowering the hospital employees themselves in actively participating in the service’s evolution.
The students organised a series of co-designing workshops, where they built shared understanding and ownership around the service stakeholders, created empathy with patients with personas, introduced design methods and also gathered insights for next steps. To facilitate the further development of the service, the team created a simple Service Design Toolkit, a set of tailor-made instructions, templates and cards the hospital staff could use for future developments.
Cult-o-Meter: Challenging cultural structures with low-tech solutions
Joosep Noorväli, Kaari Sibrits, Mikk Sander Lemberg
PERH employs over 4500 people in a steep hierarchy; the students’ task was to find out how they could make sure all time-critical messages reach the life savers on lowest levels. Upon their investigation, the team quickly challenged their initial brief by concluding that the communication channels established in the hospital are working just fine. Instead, they set their focus on employee engagement. They realised that nurses and caregivers form the backbone of the service, by making up more than half of the staff, and being the ones in constant contact with patients. Yet, their voice is often unheard on the management level, and the hospital’s communications don’t echo their central role.
So the team set out to ideate how might they shine a light on nurses and caregivers. Their goal was to close feedback loops and bring the workers’ initiative closer to the leadership. The solution had to fit in the working culture, by being asynchronous and using tools already in use in the hospital, like pen and paper. They came up with a Cult-o-Meter, a message board divided into three sections from “Good” to “Bad”, accompanied by cards that have phrases on them to prompt creative thinking.
The idea was to encourage sharing positive feedback and bring attention to complicated topics. For nurses, it’s a platform to share gratitude and undercover role modelling, for managers a backlog of problems and a team health monitor. The team built a prototype and tested it in the hospital for five days. It was warmly welcomed, gathered nearly 40 submissions, generated enthusiasm and provided feedback for further iterations.
PERH is soon going to have a new venipuncture space. The students’ task was to find out how we might increase the humanness of this tedious medical procedure every one of us has to go through at one point. After conversations with employees and many observations at the current venipuncture centre, the team mapped vital insights that they could address in their design. They figured that the process is very well managed. Still, the patients are suffering from the “perfect patient syndrome” — often feeling confused, rushed, afraid of the unknown and need to conform with the herd (of other patients).
So the team set out to establish more confidence in the patients. For this, they needed to go beyond the initial brief of redesigning the centre’s signage and decided to redesign the whole floor plan and interior following the emotional, mental and physical principles of universal design. They mapped the visitor’s journey throughout the process and designed the space to address their needs, which differ vastly from step to step.
The plan was then iterated and validated by roleplaying and physical prototyping. The result was a fully redesigned venipuncture centre, which accommodated an inclusive waiting area, clear infographics, more streamlined administration facilities and small yet essential interactions, such as mirrors on the wall to enable visitors to tidy up and cookies for a quick energy fix after the procedure. The hospital’s engineering team behind the rebuilding recognised the students’ work, and talks are underway to implement the changes.
PERH challenged the students to reimagine the Colon Cancer screening service. Upon stakeholder interviews, the team learned that a small number of the target group ever reach the screening, so they embarked on a quest to discover how we might increase the turnout rate. Mapping the journey, the students had to expand their horizons as they now had a new problem owner — The Estonian Health Insurance Fund, who manages the invitation process. Interviews with nurses, family doctors and patients hinted at several stumbling points during the process. Still, analysing the stories and insights further, the students realised that close interpersonal relationships play a crucial role in health behaviour.
The pressure to care, act and be responsible is put on the single individual, yet many people who proactively visit health institutions do it due to peer pressure from the family and close ones. There’s a gap in the society-wise system and social norms: during childhood, we’ve got our parents to count on, during elder years, (hopefully) our children. But couldn’t we have someone also in-between?
Finally, the team introduced the concept of Interdependence: a system of changes in the thinking, legislature and technology, that would expand the responsibility of personal healthcare to chosen close ones. The system could be initiated through the Estonian Citizen Portal, giving the Health Insurance Fund, family and speciality doctors access, and the close ones the resources to nudge and help people take better care of themselves.
The students were mentored by Riina Raudne (Akkadian) and Tanel Kärp (EKA), with additional mentoring help from Josina Vink (AHO, Norway).
A big-big thank you to Siiri Heinaru from PERH!
This course has been partly supported by the Nordic Council of Ministers´ Higher Education programme and the Cirrus network.