Service Design | Memorial Sloan-Kettering
Andy Conrad, Kate Pemberton, Fei Qi, Angela Robertson
Fall 2009
This is Sam and Leah. They’ve been dating for 9 months. Recently, Leah received some surprising news. She was diagnosed with Leukemia.
What does this mean for a couple?
A traumatic event like cancer can have devastating effects on intimate relationships. The closeness between partners may greatly decrease. Those diagnosed with cancer often feel that the emotional information regarding the disease is lacking.
Trauma decreases desire. There’s a loss of intimate feelings. There’s a lack of emotional information.
Being supportive and feeling valued is important...for both partners
Memorial Sloan-Kettering Cancer Center has the opportunity to provide a new service to help young couples deal with this emotional journey together
Help young couples deal with this emotional journey. The service is MSKouples.
Living with cancer adds strain to any relationship. To increase the likelihood of staying together, new couples need to increase their emotional intelligence by learning how to perceive, understand, and manage emotions in themselves and others. Our service builds emotional intelligence by educating the couple on how to handle the different emotions inherent in the cancer journey--from despair to anger, fear to hopefulness.
Emotional intelligence: perceiving, understanding, and managing emotions in yourself and others. Salovey and Mayer, 1990
Our service prepares couples by providing communication tools, knowledge about relationships and a support network. Communication tools are learned through discussion and practice with a counselor and other couples. Relationship knowledge is gained through counseling and interaction with other couples. In the support network, individuals learn from other’s journeys and experiences.
Prepares couples for the cancer journey by providing • communication tools • knowledge about relationships • support network of others in similar situations
Service benefits • couple feels prepared to make decisions about relationship • partners feel less alone through connection to support network • partner gains understanding of how to provide support
Meet two couples using MSKouples
In this scenario, Megan and Bill have been dating for seven months. Last week, Megan shared her recent diagnosis.
Scenario 1: Finding support
Megan: “Bill never takes time to read pamphlets. So I thought we’d try a MSK Healthy Cooking Class. It’s a great way to meet other couples who’ve gone through the cancer journey together while learning how to cook healthy meals.”
During the class Megan and Bill talk with Julie and Josh. Julie was diagnosed with breast cancer two years ago. Josh was by her side throughout her journey.
After talking about the Bears game, Josh mentions how he and Julie met with a doctor and a counselor on a regular basis during her treatment. He found this especially helpful as he was able to be supportive and present during Julie’s journey.
Bill: Megan, we should meet with a counselor. Josh told me how helpful it was for him and Julie. I think it would help me better understand what you’re going through and how I can be supportive.
Counselor: “Welcome Megan and Bill. I’m glad you have come in to talk. This is a safe environment, where you can ask questions and discuss concerns about cancer and how it will affect each of you and your relationship.”
In this scenario, Brad is a longtime client of MSK, new boyfriend of Angelina. Angelina wants to be there for Brad but doesn’t know how or when to ask how Brad is doing
Scenario 2: MSK mobile reminders
Angelina meets with a counselor, expresses her desire to support Brad in whatever ways she can, however, she doesn’t know how.
The counselor tells her about MSK Mobile Tips. This application sends reminders to a mobile phone on days when Brad has treatment, giving personalized recommendations for ways Angelina can help him out.
The next time Brad has chemo, Angelina gets an alert on her phone reminding her that he may be feeling nauseous and low on energy.
Angelina stops at the store on her way home from work to pick up some club soda and rice, foods that are easy on upset stomachs.
MSKouples service components
Service components in a service blueprint. The four major sections of the blueprint are discovery of the service, introduction to it, education, and maintenance of relationship.
MSKouples blueprint
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Maintenance of relationship
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
We envision the discovery of service happening through ads on the MSK web site, pamphlets distributed at the treatment center, or a nurse, doctor, or other patient recommending this service.
MSKouples blueprint
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
Introduction to the service is when the client actually meets with a service coordinator who explains the service components and may also provide tips and techniques for communicating with the partner. As this is a service for both members of a couple, the client introduces the service to her partner, through pamphlets, the web site, or simply talking it over. ,
MSKouples blueprint
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
In the education phase, the couple may engage with MSK individually or together. They can learn about the emotional ups and downs they may face, as well as engage with other couples who have gone through the same thing.
MSKouples blueprint
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
Maintenance provides ways in which the client and partner can support each other. This phase includes mobile or email reminders for the partner as to when chemo or other important events are happening.
MSKouples blueprint
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
Recalling the first scenario where Megan and Bill go to the Healthy Cooking class, note that is sits on the blueprint primarily in introduction and education.
MSKouples blueprint: Scenario 1 mapping
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
Our second scenario with Mobile Reminders sits in education and maintenance.
MSKouples blueprint: Scenario 2 mapping
physical evidence
Discovery of service
Introduction to service
•
• • •
•
ads on MSK site, Google searches pamphlet about service
coordinator’s office menu of services handouts
incidentally meet MSK meets with coordinator
patient actions
Education of partners • •
cards/pamphlets on online info about communication tips counseling services/ online communication benefits information
talks with partner (using methods) talks with patient
partner engages with MSK
counselor may be present
•
partner actions
Maintenance of relationship handouts about issues couples may face
couple meets with doctors & counselors
couple or either partner seek support services
•
• •
counseling partner goes to treatment
•
mobile/email reminders retreats
line of interaction
appointment at MSK
msk onstage
• •
explanation of service components discuss relationship
line of visibility
research and compile communication methods, tips
msk backstage
support processes
• • •
web maintenance manage schedule updating calendar printing pamphlets
• •
web maintenance print materials
calls from nurses/ doctors • in situ invites • mixers • contact other couples • mail materials, invitations database of volunteer couples
•
doctor gives medical info counselor gives emotional info
•
In order to get a service like this started at MSK, we looked at our assumptions about what we are proposing and suggest some tests to figure out if we are on the right track.
MSKouples... moving forward
Our first assumption is that the partner has the time to come in. We suggest testing the service at different times and tracking when people are able to come in. From this test, we can learn if the service can be offered at set times, 9-5 Monday-Friday, or be a bit more customized, possibly offering evening or weekend hours. Another assumption is that cancer is a big hurdle in a relationship. We suggest surveying those in unmarried relationships when diagnosed and counting how many break up due to diagnosis. If there is a high incidence of break-ups, then cancer is indeed a large hurdle. Third, we assume that all service components are equally valuable. To find out which components should be built on or cut, we can survey or profile our users and find what offerings have the biggest impact.
MSKouples assumption testing
Assumptions that need to be tested
Resources required to test these assumptions
How to measure the results of experiments
Insights these experiments give to you
• partner has time to come in
• volunteer couples & staff with flexible schedules to test service at different times
• track number of people requesting different times of day
• discover if service can be offered at set times vs custom per couple (possible evening appts)
• cancer is a huge hurdle in the relationship
• survey of those who were in unmarried relationships when they were diagnosed
• count number of people in early relationships who broke up due to diagnosis
• expect that a high incidence of breakups due to cancer means that cancer is a large hurdle
• all service components are equally valuable
• surveys or profile of users
• gather feedback to see which components are making the biggest impacts
• discover which components to build and which ones to cut