Doing It Together - Design Research Book by David Cheng

Doing It Together A Quality and Improvements Project with Austin Health

Project/Doing It Together Project with Austin Health

Engagment. Care. Playfulness.

Acknowldegment By Chieh Chung (David) Cheng In association with RMIT University Industrial Design & Austin Health School of Architecture and Design Supervisor: Juan Sanin All photography and graphics by David Cheng @ 2016 unless otherwise stated.

RMIT University Industrial Design ChiehChung/David, CHENG Cheng is an Industrial Design student at RMIT University since 2013. Over the years of his studying, the term “Design” have completely shifted for Cheng. The industrial design course has helped him to expend his knowledge in Design. From only consider the aspect of “ergonomic” to how to design from a “Human-Centred” and “Co-Design” perspective, and how material, structural of a product can change user’s experience and perception. Furthermore, how a service/product affect our life and change people’s behaviours. In his Honours Project with Austin Health, he interviewed with the field of experts to understand the problems and applied design methods to concur the current feedback issue the hospital is facing and to deliver a solution to the problem. 7

CONTENTS Project Abstract About Austin The Community The Project The Approach The Design Challenge Research in progress Field Observation Project Principles Co-Design Activity The Hub Methods of Evaluation and Validation Reflection Bibliography

11 14 15 18 21 35 39 44 52 66 74 82 88 92

Project Abstract

Project Abstract What is the best way of engaging with patients, carers and families?

The project question raised as the Department of Patient Engagement Centre realised the difficulties of engaging with their patient in Austin Hospital. The issues of current engagement methods employed in Austin were conducted through numerous survey forms. The problem was these feedback mechanisms were designed from Austin’s (Clinical) perspective rather than patient’s perspective to serve the purpose of seeking for improvements of their services. Patient’s experience and emotion were ignored. Opportunity has been discovered, the idea of this project is to design a information access point for patient and visitor to engage with Austin. A concept of a hub was developed and aiming to provide and improve existing 12

and create new strategies for communicating information and improvements between Austin and its patients. The Hub will focus on physical interactions with patient and to provide greater and easy access to information for patient and visitors. Furthermore, to alter people’s directions as they walk through these information. Throughout the project, methods of Co-design were employed approaches to this design project to develop a sustainable solution for this design challenge. The Hub will allow patients and visitor to easily access Austin news update and Austin activities. Meanwhile, provide a pleasant atmosphere as they entry or leave Austin.

About Austin

Austin Health is the main health services provider in the North-East region of Melbourne and is comprised of three main facilities; The Austin Hospital including the Olivia Newton- John Cancer and Wellness Centre, Heidelberg Repatriation Hospital and the Royal Talbot Rehabilitation Centre; these facilities feature â&#x20AC;&#x2DC;over 980 beds and operate on a budget of over $700 million per annumâ&#x20AC;&#x2122;. In 2014 Austin Health provided care for over 180,000 patients.

The Community

Language Demand 2014 - 2015

Turkeish Persian Vietanmese Arabic 4% 5% 7% 11%

Slavic 12%

Italian 14%

Chinese 18%

Creek 18%

Other 11%

Austin Health’s community profile is detailed in the Strategic plan. Key details include: • Age range of 0-85+ • Six of eight Local Government Areas (LGA) have high levels of cultural diversity • Four of eight LGA have high levels of socioeconomic disadvantage • High proportion of Aboriginal and Torres Strait Islander people in Darebin • Secondary catchment areas include regional areas of Murrindindi and greater Bendigo • State wide services are provided to Murry district of NSW and sometimes Tasmania • A significant veteran community Diversity of Austin Health Consumer Representatives Review September 2015 15

The NSQHS Standards

The National Safety and Quality Health Service (NSQHS), Standards, are directed by ‘the Australian Commission on Safety and Quality in Healthcare’. For many healthcare associations including Austin Health the standards are now an obligatory practice. The NSQHS Standards aim to: Protect the public from harm, improve the quality of health service provision, provide a quality assurance mechanism that tests weather relevant systems are in place, ensure that minimum standards of safety and quality are met and provide a quality improvement mechanism, that allows health services to realise aspirational or development goals.’ The standard that relates to this project is NSQHS Standard 2 ‘Partnering with Consumers’. Standard 2 was to create a responsive health service to the patient, carer and family’s needs. The standard allows the hospital to form systems and strategies of an active partnership with consumers ensuring the improvement of patient experience. There is growing evidence shown the importance of partnership between health service organisations and health professionals, and patients, families, carers and consumers.

Studies have demonstrated significant benefits from such partnerships in clinical quality and outcomes, the experience of care, and the business and operations of delivering care. The clinical benefits have been identified as being associated with better patient experience and patient-centred care.

The Project Creating an engaging partnership with patient through Human-Centred Design + Co-Design approach.

â&#x20AC;&#x153;Focus on user communication, interaction, empathy and simulate the people involved, obtaining an understanding of their needs, desires and experiencesâ&#x20AC;?

Giacomin, 2012

This project is to improve or create new engagement strategies for between Austin Health Hospital and its patient, furthermore, to assist Austin Health Hospital to obtain accreditation of the ten National Safety and Quality Health Service (NSQHS) Standards. NSQHS is the standards of safety and quality of health care in Australia, and this project is to fulfil NSQHS Standard 2, the criteria of partnering with consumers (patients) for Austin Health Hospital. The project will cooperate with the department of Consumer Engagement Centre from Austin Health Hospital to achieve the requirements of Standard 2. The challenge of this project is to investigate the best way of engaging with patients, carers and families during their time in Austin.

The Approach

For this project to achieve standard 2, the methods of Human Centred Design (HCD) and Co-Design process have undertaken to gain a comprehensive research throughout the project. To approach standard 2 requirements, the method of HCD have been applied to focus on the improvement of Austinâ&#x20AC;&#x2122;s communications, interactions with the patient. Furthermore, the methods of HCD allows designers to incorporate empathy, simulate the people involved, and to obtain an understanding of patientâ&#x20AC;&#x2122;s needs, desires and experiences. The aim of HCD methods is to design with care for the human being to achieve the improvement of patient experience and to provide patient-centred care in Austin. Co-designing with patients, carers, and families are essential for this project as by cooperate with them we are able to gain feedbacks, and then redesign to derive the best solution for Austin to engage with their patient. 22

In the project with Austin Health, as a designer, able to employ design thinking into the project is essential. Design thinking is a method to derive creative solutions from problems identified in a situation and, furthermore to improve future needs. However, the notion of design thinking not only been utilised in the design sector, people from other fields are starting to become aware of it. The term, Co-design is one of the design thinking methods and it only has been around in the past five years. The word, Co-design means collaborating and designing with users throughout the process of a design challenge or problem. Co-design itself is not a new concept for designers. Hence, it is a combination of participatory design thinking and user-centred design thinking.

The history of Co-design thinking has evolved from participatory design and user-centred design. The participatory design was an approach leading by Northern Europeans from the 1970s and it has similarities with co-design, as participatory design seen users as a partner throughout the design process. In participatory design, the line between designer and researcher was blur, and the user was the critical element of the process. The terminology of “the practice of collective creativity”, which user has been applied in participatory design in the past 40 years. (Sanders, 2008) The reason it did not catch the attention in 90’s was that participatory thinking was opposed to consumerism, meaning it has been seem as not suitable for the competitive market needs. Whereas, in US the methodology of user-centred design has grown and accepted into the market as it was a “product-driven” terminology. At the time, companies were only seeking for products that meet people’s need. Therefore, user-centred design thinking was more applicable. Hence, it focused on how the product being designed to its optimum rather than collaborate with users and it only needs to ensure products meet the consumer needs. In user-centred design, the user does not engage in the design process. The user has been seem as a customer for case study to suit the needs and for product testing to refine and get feedbacks. However, today’s businesses are began to change, “businesses are not as usual” anymore. (Sanders, 2002) People were starting to realise and aware of products that were not designed under the foundation of user interactions, experience and emotions. As the result, Human-Centred Design methodology was expanded from the user-centred design. 24

â&#x20AC;&#x153;Roles of humans in complex systems. enhancing human abilities, aid to overcome human limitation and foster user acceptance.â&#x20AC;? Rouse, 1991 pp.6-123

The methodology of the human-centred design was not fully developed in the 1980s, it was growing under human-centred interaction. Human-centred design only started to evolve around the late 1990s. The notion of humancentred design was shipped from a technology driven to human focus. In the book, Design for Success: A Human-Centred Approach to Designing Successful Products and Systems, Willam B. Rouse outlined the ideology of the human-centred design.

The differences between user-centred design and human-centred design are, the fact that product/system built under user-centred design, users do not interact directly with the product/system during the developing process. On the contrary, human-centred design focuses on user communication, interaction, empathy, and stimulate the people involved, obtaining an understanding of their needs, desires and experiences. (Giacomin, 2012) To be more simple and precise, the methodology of usercentred design is to design a product/system to suit a certain projectâ&#x20AC;&#x2122;s purpose or objective. Which means, the aim of user-centred design was not plan to provide solutions for the living being and only emphasise the usability. Whereas for human-centred design, the word â&#x20AC;&#x153;Humanâ&#x20AC;? changes how people think of the methodology. People know straight away this design thinking serves a purpose of overcoming a challenge/problem for human being. In other words, design with care for human being. 27

Nowadays, businesses have shifted their focus away from the technology and manufacture aspects. Instead, turn their attention towards a growing preoccupation on working with the clients and consumers. Designers are employing the methodology to help businesses to closely comprehend the problem through a bubble up from below perspective rather than being imposed from the top. Human-centred design has been brought to attention by IDEO; this methodology is widely used in IDEO for problem-solving. IDEO believes the principle of human-centred design is to build a deep empathy, understand the target audience and brainstorm scores of ideas. Also, by working with experts from multidiscipline, the benefit is to gain views from multiple perspectives. One of the aims IDEO outlined is to stay optimistic and embrace all possibilities to propose a creative approach to solve problem for peopleâ&#x20AC;&#x2122;s actual needs. IDEO proposed a three phrases humancentred design process, inspiration, ideation and implementation to derive to the solution. In the first phrase of the process, designers will discover and understand peopleâ&#x20AC;&#x2122;s need by immersing themselves in their life. In the second phrase, designers will identify design opportunities and generate ideas. Finally in the last phrase, prototype the possible solution and at the end bring the solution to life. 29

Case Study One of the projects done by IDEO using human-centred design approach was the Injection Device for Eli and Company, Refillable Human Growth Hormone (HGH) Injector. In this project, IDEO was asked to design a new device specifically for children that would improve their acceptance of the HGH therapy. The challenge of this project was the emotional issues with medical growth children. These children are often fall into the negative stigma of being different from their peers and the positive celebration of growth. The HGH therapy treatment could from as young as age seven into adulthood and with the regimen of drug reconstitution and daily injections, often becomes an integral part of a family’s life for years. The design team began with the assumption that kids might prefer a “toy-like” approach. However, after spending time in the field with various young users, research yielded telling new insights about paediatric adherence to treatment and redirected the project in a far more sophisticated direction. This underscored the importance of using in-context, user-based observations to inspire and guide design, as opposed to the guesswork that occurs in many board rooms and design studios. In addition to the field research, the design of IDEO’s delivery device was partially informed by that of the client’s existing drug-reconstitution device. This ultimately helped to create a more integrated, systematic approach to the treatment process.

By rethinking seven parts of an existing injector, the design team created three pens for Lilly’s HGH differentiated by colour and numeric coding- 6, 12, and 24 (each number denotes a different dose concentration, in milligrams) with clear identification at-aglance. The reusable pens address young users’ desire for reassurance, trust, and approachability while appealing to their aesthetic tastes. IDEO translated kids’ needs into a pen-like device with specific physical characteristics and carefully placed information, including: • a large pen body, which is steady and easy to hold • a flared end cap, which offers flexibility in the placement of the pen, gives it the ability to stand up on a flat surface, and takes up less space when stored in the refrigerator; • a printed concentration number on the front of the pen that’s also embossed on the dose knob end, which helps children and parents determine that the correct pen is being used. Human-centred design is through understand people’s emotional attachments and needs, to uncover what’s most desirable. Once determined numerous solutions then start to see what is technically feasible and finally derive to actually implement and how to make the solution financially viable.

In the project with Austin health, the design methodology of Co-design will be applied throughout of the entire project. I will be taking from a Human-Centred Design approach with the method taken from participatory design which users are involved in every stage of development process. As because, human-centred design only incorporate users in the early stage of design process and to further develop my solution towards the problem, users are critical to provide opinions/design suggestions throughout the design process. â&#x20AC;&#x153;Builds on traditional design skills to address social and economic issues. It uses the design process as a means to enable a wide range of disciplines and stakeholders to collaborateâ&#x20AC;? (Burns et al., 2006) 32

The Design Challenge

This project will be co-design together with the Department of Patient Engagement Centre, patients, carers, and families. To deliver a new strategy of engagement for Austin. In order to achieve this, it is critical for this project to take into account the patient’s experience. Therefore, methods of Human Centred Design and Co-design became essential in this project. As to be able to overcome this design challenge, it is crucial for the designer to think from patient’s perspective to understand patient’s experience, and by employing methods of HCD allows the designer to immerse into the environment, and conduct a series of research understand the needs of patient. Furthermore, to consider and incorporate patient’s experience into the design outcome through the utilisation of Human Centred Design methods will assist this project to redefine the methodology of engagement in Austin. 35

The current feedback mechanisms are unattractive. Human-centred design and Co-design became the key element in the process of development. The methods of Co-design will allow designer to get instant feedbacks from focus groups (patients, carers, families and visitors), and enable the designer to make the instant change according to the problem. By co-designing with staffs in the department of Patient Engagement Centred, patients, carers and families will allow this design project to derive an outcome that tightly engage target groups for Austin. 37

Research in progress

The project question, What is the best way of engaging with patients, cares and families? raised as the Department of Patient Engagement Centre realised the challenge of engaging with their patients in Austin. However, the question did not point out what, when, where that were needed to be design or redesign. Therefore, a series of research have been undertaken to I identify the position of this design project challenge.

The methods of Human-centred design and co-design became crucial in the research phrase as the research tools allow the designer to investigate the problem in an unusual perspective. Instead of asking patients or staffs what do you think engage is? The tools allow the designer to immerse themselves into the situation and understand the needs from patients. By co-designing with staffs and patients, we will be able to get feedbacks from the testing ideas/prototype. Improve the product/service before it implemented into the situation.

The research began with understanding the current engagement methods that were used in Austin. In the first meeting with Austin Patient Engagement Centre, the staffs said there were ten ways Austin currently used to engage with patients and having conducted a discussion with Renee, the manager of Patient Engagement Centre; Renee pointed out there were ten ways for Austin to gain their feedback from their patient, Feedback methods used in Austin: My Say Survey Angel Consumer Walk Arounds Formal complaints Victorian Health Experience Survey (VHES) The Internet and social media Thank you cards Local area survey â&#x20AC;&#x153;You said We didâ&#x20AC;? Board Austin yearly calendar and magazine 41

Of all the feedback methods, My Say was the major feedback forms that implemented across Austin for the patient to drop their opinions. “You said We did” Board, Austin yearly calendar and magazines were the ways of Austin presenting their improvements based on patient’s feedbacks. Having conducted further research on the procedures of these feedback systems, an issue was raised and indicated most of these feedback methods were done though surveying patients and family. 42

In order for these survey to work, it required Austin or patient to make the first initiative. From a designer perspective, these forms have a lack of temperatures and cares to patient’s emotions. In another word, it does not have much interaction with the patients except a list of questions and a pen. The definition of the word “engagement”, became essential throughout this design project. As because current engagement methods in Austin was through surveying people. In order to redefine the word, it was crucial to understanding the stakeholders that involved in the project. The research then began to look into Austin’s demographic to discover the types of patients, and the findings have shown Austin has one of the most culturally and linguistically diverse patients and community. 43

Field Observation

A field observation have been undertaken to identify the community, surrounding environment and the possible design spaces in Austin. The purpose of this task is to investigate and to search for a blind spots for improving engagement with Austin in a patientâ&#x20AC;&#x2122;s journey. Austing Surrounding Environment Austin Car Park Heidelberg Train Station Remembrance Park Austin School These are the places near Austin hospital and 44

The observation began with looking at the surrounding environment that stakeholders might involve during their time in Austin. The research then started focusing on the journey to Austin, travel via train or cars. The parking fees were expensive for outpatients or families visiting Austin for a long time. No clear direction signs after getting out from lifts on level one. The path from the train station to Austin, the road was to steep for disability patients.

Level 1 Entrance Direction map was not appearing. The information desk was hide from a column. Does not have a clear direction sign to instruct people. People often ignore the sanitiser. The field notes and photos were taken during the observation on level one; the result had shown that the direction map was not clear to visitors when they first arrived in Austin. The information centre was blocked by the column, therefore for people who newly arrive in Austin, it would be difficult to find. Also, people were often neglected the sanitisers after they got out from the lifts, and people were often rushing at the entrance area, except lunch time. 45

Level One Observation

Waiting Area at Specialist Clinic Level 3

Childrenâ&#x20AC;&#x2122;s Play Area News on TV People with kids Elderly non-English speakers Family waiting High traffic area The seatings were uncomfortable Lightings make people depress A long waiting time

with patients, and the second time of the observation has shown the average waiting time for a patient was around 50 minutes.

A thirteen minutes observation was conducted at the waiting area of specialist clinic on level 3 in the off-peak period. During the observation, there was a mother with three kids waiting for over 30 minutes and a group of non-English elderlies with no family accompany waiting to be call. The seatings in the waiting area were uncomfortable to seat on for a long period of time. Despite the news on TV, there were no other activities going on to engage

Both feedback report and observation have indicated there was problem with a long duration of waiting time. This appears to me as a design opportunity to focus on, to implement a service or product to engage with patients, families, carers, or visitors during a prolonged waiting time.

According to the My Say feedback report, the main concern from patients in specialist clinic was a long duration of waiting time. â&#x20AC;&#x153;Very Long 2 hrs wait for an appointment.â&#x20AC;?

Level Three 3 LEVEL Observation

Stairs

Lifts

airs

Special Clinic Waiting Area

Lifts

Waiting Area

Special Clinic

Reception

Waiting Area

Project Principles

Having conducted the field observation, the designer has come to a conclusion for the outcome of this design project. In order to improve Austinâ&#x20AC;&#x2122;s engagement with their patients, carers, families and visitors, designer need to incorporate five principles when designing a service or product 52

At the idea generation process, six design ideas were been generated at this point. 1.Music implementation, expose people in music environment, people feel more energetic and alive. 2. A welcoming device, for people to interact with at the entrance for greeting purpose. Interactive billboard, to give people directions, update Austin news, let people know where to go. 3. Furniture design, to provide comfortable seating and aim to create a more cosy atmosphere in the hospital. 4. Monthly social event, building community, engage patient through Austin activities, and provide a sense of care to their patients. 5. Night lighting, installation of an interactive warm lights, to improve the atmosphere in Austin and to provide a comfort hospital environment. At this stage of the design process, the possible outcome of this design project would be an interaction billboard that engages with patients once they are in the environment. It will focus on physical interactions with patients. People will be able to receive Austin news update and Austin activities. The installation environment will provide a comfortable environment for people to feel Austin cares about their patient. In order to achieve the outcome, HCD and Co-design methods have been applied to gain a more in-depth research of how to design a product that engages with patients. 53

Interview Interview with the Director of Patient Flow, Kim Oâ&#x20AC;&#x2122;Sullivan Date: 19.05.2016 Time: 10:30 am - 11:15 Location: Austin Tower Level 4

Plan Introduce my project, present/discuss the findings and research and present the current engagement ideas. Discuss the project with more in-depth in regards to patient flow. The methods have currently been applied in measuring patient flow and the ideal place for implementing the product/services. Expected outcome: data from patient flow report, identify places that have high patient flow, professional insights in relating to design opportunities and patient behaviour. Form a relationship with the department of patient flow.

Findings After presenting my current project ideas to her, there are a few points she wanted to know. Who is the target audience? People who waited in the Specialist Clinic? Emergency? Inpatients or Out-patients? The event idea works only in small limited spaces across wards, as a need to consider people who can not move around. There are various engagement problems Austin encounters at the moment: The transportation issue for disable, hard to get from their home to Austin. Patients are often lost in Austin campus for an appointment, which results in cancel/late for an appointment.

Patient does not value their appointments (cancel regularly) Doctors have a notion of patient have to wait for us, not we wait for them. Doctors have a left early behaviour. Average waiting time is longer than 20 minutes, patient might end up wait for an hour. We went for a walk on Lv 3 to experience the high traffic situation in the specialist clinics, This is a space that has a high traffic during peak-hour (10:30 am - 1:00 pm), as this is a walk way to ONJ and Austin Tower. Therefore, to implement a product or device, and looking for exposure this is a place to go for. However, this is also a high traffic space. Therefore, the product must not become an obstacle when people are passing through.

Reflection of the process The floor maps and observation were done two weeks before the interview to provide a clear understanding of where about the product would possibly be implement. These were done prior so the designer was able to gain a more in-depth feedback about the space. Arranging time with Kim was difficult as healthcare staffs have lots of meetings to attend to, therefore, after several email communication, finally get the time fixed. The patient flow data of Austin Level 3 Specialist Clinics was provided by Melinda 2 days after the interview with Kim. These data have to be analysis in gain more understanding of the area.

Things need to be identified in the project: The target audience Identify the specific audience the product trying to catch, for example, patient in specialist clinic waiting area? Visitors? Inpatient? Area Floor 1, Austin entrance point Floor 3, Specialist Clinics waiting area? Patient Journey Map Need to identify the patient journey of patient, carers, family, and visitors. In order to find out what are needed to be implemented into the product to gain a better engagement.

Persona

â&#x20AC;&#x153;I have been seating here and realised there is not clock around this area!â&#x20AC;?

William Smith Age: 35 Occupation: Engineer Overweight Type 2 Diabetes Married, 2 young sons First language English Personality

BIO William is an inpatient in Austin who got diagnosed with Type 2 Diabetes two weeks ago. He took a half day leaves from his company to do a checkout in Austin. He has been seating at level one entrance for almost 20 minutes. His here just to breath some air and relex a bit. However, he realised there is no clock around to know the time, as he forgot to bring his phone out from wards.

“Austin has a great environment with wonderful staffs, though sometimes I wonder patient might need more than just medication. The care of patient’s emotion is something should be consider in hospital. ” Molina Pascal Age: 24 Occupation: Carer Carers Victoria 1 Years Experience First language English Personality

BIO Molina is an experienced carer and have been working in Austin for the last two months. She is a responsible, supportive, and caring person. She likes the working environment in Austin, most of her patients got a good care during their time in Austin. However, even though Austin staffs were wonderful, but as a young carer, she started to think what can be change to make the hospital better?

“I am afraid. My son is not around. I don’t know how to communicate with staffs in Hospital.” Jacky Chan

Age: 63 Occupation: Retried Immigrated 2 years ago First language Chinese Could not speak English

BIO Jacky is a 63 man who only just migrated to Austin and live in Heidelberg, he accompany his wife to Austin for specialist clinic. He and his wife was waiting and he was feeling anxious and worried because his doesn’t know how to speak English. He worked into Austin but saw everything written in English and no one seems to be able to help him.

â&#x20AC;&#x153;I want to experience the hospital environment, see what is it like to work in here. I wish there are more energetic elements to make people feel alive.â&#x20AC;?

Amelia Evans

Age: 23 Occupation: Bachelor of Biomedical Science In 4th year First language English

BIO Amelia is a 4th year student who studying Bachelor of Biomedical Science, who is in a stage thinking whether she should continue with medical and become a doctor. She came into Austin to visit and feel the environment, to understand whether she likes the atmosphere in here or not. However the moment she stepped into Austin, she feel there should be more energy to pump into the environment.

In-depth Observation

Level One In-depth Observation

An in-depth observation has been conducted to identify and determine the possible design area for the interaction board. The final decision is made based on the exposure to large community area. Therefore, Level One entrance has been chosen. Having conducted the observation, a Co-Design activities is utilise to design the interaction board with the patient and communities. The task is to understand the kinds of information when patient, visitor, or carers entering/leaving Austin. After the activity, the discussion with healthcare professionals helped designer to understand the information Austin wants to get across to community. The idea of this interaction board, is to deliver and provide easy access to information. 65

Co-Design Activity

Co-Design Activity Result

People

Participant in the Co-design Activity.

35 30 25 20 15 10 5 0 Visitor

Patient

Info staff

Volunteer

People think these are the info they want to know... Train Timtable appear 27 times Room search appear 24 times Direciton Map appear 19 times Bus Timetable appear 15 times Austin Services appear 14 times Accomondation appear 4 times

Disscussion Austin & Designer think they should know... Austin Information Check-in Procedure Visiting Hour Hygiene Info

Ideation Interactive Board

2m 1.6m 1.6m

The idea is to create an Hub environment to provide easy access to information people need. The Hub is constructed by 6 interactive panels, three each side. On different panels, presenting different information. For example, when people walking out from lift and leaving Austin. The first panel they going to see on sight is the train timetable, weather and time. The panel is also constructed from High to low in to unintentionally direct peopleâ&#x20AC;&#x2122;s flow. 72

The Hub

Interactive Board contains... Monitor Display Interactive Feeback Sanitiser Backstage Technology Components

Interactive Functions The six interactive boards contain different type of information for people to look at when they entry or leave Austin. The pictures on the left shows the draft of how these information might be presented.

Interactive Board Large

Interactive Board Medium

Interactive Board Small

The Hub

The Hub focus on physical interactions with patient and to provide greater and easy access to information for patient and visitors. Furthermore, to alter peopleâ&#x20AC;&#x2122;s directions as they walk through these information. Throughout the project, methods of Co-design were employed approaches to this design project to develop a sustainable solution for this design challenge. The Hub will allow patients and visitor to easily access Austin news update and Austin activities. Meanwhile, provide a pleasant atmosphere as they entry or leave Austin. 80

Methods of Evaluation and Validation

Methods of Evaluation and Validation The design project, Doing It Together is a research-based project aims to improve the quality of patient engagement with Austin Health. Numerous design methods had been applied in the first semester of this honours project to help designer to understand the problem Austin Health faced. At the beginning of this design project, designers were introduced to Austin staffs to gain the background knowledge of the project. During the discussion with the department of Patient Engagement Centre, the designer was able to understand the problem Austin encountered and collected first-hand feedbacks from them. A brief structure of Austin engagement methods was given to designer to understand the current engagement strategies used in Austin. However, through interact with the field of experts in Austin, designer was unable to consume the amount of information that was given due to the lack of medical terminology. Austin staffs had to explain themselves to let designer to understand their language. Even though the first discussion was a brief introduction of the project with Austin, but the designer was able to have a glance to the design problem. The outcomes of this meeting were, knowing the existing engagement methods that were applied in Austin, establish a relationship with the 83

Department of Patient Engagement Centre, and gain access to information and Austin internal resources through The Hub. Austin background research was undertaken through The Internet and The Hub, and these were the essential methods to help designer discover and identify the design opportunities for the project. The Internet allowed the designer to gain information from Austin web pages and social media. This was useful as these allowed designer to look into their homepage and see if it is user-centred and whether was easy to access the information from the page and how Austin engage and interact with public through social media. The research on the Austin digital media has given the designer an idea of incorporate social media into a service or product. On the other hand, the resources gathered from The Hub, assisted designer to gain background knowledge of existing engagement methods in Austin. One of the advantages was to be able to access Austinâ&#x20AC;&#x2122;s policy, plan, the procedure in relation to engagement. The crucial findings through this research method were able to understand the procedure of My Say and Consumer Walk Around. The documents have provided the designer with a clear details of engagement methods Austin used to engage with patients. The designer was then allowed to position possible design opportunities that will not cause conflicts to existing engagement structure.

The benefits of case studies were they allowed the designer to look at the similar precedences that had been done before and from the case studies, the designer was then able to acknowledge the design process and methods that were used in the project. Through researching the case studies, designer gained more confidence in choosing the suitable methods and tools in the design project with Austin. However, during the case studying process, designer not only looked into the context of healthcare design, but also on how engagement in related to other fields. Shadowing was another design method that had constantly been applied throughout the entire design process. As this method allowed the designer to immerse them into the environment. The observation task was conducted through taking field notes and photos, and the purpose was to discover the spots that people often ignored. In the project, this method had let designer gain a better understanding of the space and environment. Furthermore, uncovers the relationship between patient and specialist clinic. In the first observation, the designer was able to draw out a map to indicate the spaces that have potential problems and could be developing into a design opportunity in the future. Numerous ideas had been generated under the context of engagement after the observation task was done. The second observation has led the designer to focus on Level 3 specialist clinic waiting space, as according to the My Say feedback report, people were complaining about a long duration of waiting time. 85

Having conducted the second observation, the designer has narrowed down the spaces and identify the spot where there has zero engagement with patient and Austin. Personas were created after the observation was conducted, to assist designer to gain a better understanding and background of the target group. The profiles of patient, carer, family and visitor were generated based on the observation. The process of developing personas allowed the designer to define the people from different groups and understand the wants and needs from vapours perspective. The method of persona was useful during the idea generation period; the designer was able to collect possible feedback and embody the real-word perceptions to the design proposition.

The contribution from interviewing staffs from Patient Engagement Centre and Patient Flow were essential. As having an opportunity to co-design with the Austin staffs, the designer was able to discuss the topic and get an instant feedback on whether they think what need to be improved according to the precedences happened before or the knowledge on Austin environment. One of the advantages of being able to co-design with Austin staff was the value of professional opinions based on their experience. Therefore, the designer was able to listen to their insights and analysis to drag out the points that were beneficial to the project. Also, staffs were often referred you to another person or department when they see the project could gain value from other professionals. Nonetheless, this method could be a long duration of the process as the designer need to get in touch with staffs and arranging a time with them.

The reason was that staffs have another meeting to attend to and were busy throughout the day. The method of idea generation process was not applied at the start of the process, as it required to comprehend the background and context of the project before stepping into brainstorming ideas. The benefits of brainstorming were able to allow the designer to refine the question into topics of principle, ideas, opportunities and problems. This allowed the designer to frame the questions into design challenge and set out an aim for the project. The idea generation process did not come along until the principles were set. Once outline the design principles, the designer came up with ideas, and as the research progress, designer narrowed down the ideas. However, this method of design research will continue to be utilised as the project progress, as because at this stage of the project, the designer has not yet to interact with patients, families, carers and visitors in Austin. The methods of idea generation and brainstorming are essential to the project as it progressed.

There were numerous design methods had been applied in the first semester of the honours project with Austin. These design methods allowed the designer to collect and gained insights from designerâ&#x20AC;&#x2122;s perspective. Also, designer through planning and research of design methods, the designer was able to utilised method from the book and put them into practice for the project. Furthermore, having conducted these design methods, it allowed the designer to jump away from clinical perspective and discover the project in a design perspective. Through applying design methods, the designer was able to discover what were the wants and needs of Austinâ&#x20AC;&#x2122;s patients, families, carers and visitors. As the project progress, more design methods will be used to develop and overcome the design challenge.

Reflection At the start of my last year of studying Industrial Design at RMIT, the honours project was the most challenge project I have ever encountered. I knew the last year project could be challenging and stressing, but, what I did not see was the real world problems. Over the semester, this course has taught me what were the essential elements to consider when applying design into the real world context. The research and discussions from this course were extremely helpful for me to understand how to approach a clinical problem from a design perspective and the critical factors that need to be aware of when to launch a product or service into an organisation. Having done this course, I became more aware of the principle and the wants and needs that have to be considered before redesigning a product/system to Austin.

background of Austin Health and the reason why Industrial Design students were brought into health organisation. Which was when I realised, I am going to be solving the real problem for Austin, rather than dreaming up a product that helps to improve health services. The problem is real, and rather than doing whatever I want to do, Austin was asking us to help them solve the problem.

Over the years of studying, the term “Design” have completely shifted for me. This honours project have help me to expend my knowledge from only consider the aspect of “ergonomic” to how to design from “Human-Centred” perspective, and how material, structural of a product can change user’s experience. Furthermore, how a product can affect our life and change people’s behaviours.

The challenge of this project was how to apply my design knowledge into real world practice. At the start of this project, we were introduced to the staffs from Patient Engagement Centre, and during our first meeting. I was confused and did not know what exactly was the problem that Austin want us to solve. Not only was I did not understand the project question at the beginning, but also I never have an experience with designing and forming a conversation with real world professionals. This was the challenge for me at the time, as because I was not sure whether I have confidence in applying my design knowledge into real world practice. However, our supervisor has been helpful from the start of the project; he kept telling us to jump out from the notion of you are a design student and think of yourself as a designer. This helped me to build my confidence as the project progress.

In the beginning of this honours project with Austin, during the first meeting with Juan, the supervisor of the project, I realised this project was completely different to the previous design projects I did before. Juan introduced us the

One of the difficulties I encountered during the project was as a designer; we do not have the freedom when it comes to real world practice. There are lots of constraints that an organisation has, from government

policy like immunisation for placement to the organisation structure and human relation issues and furthermore, as a designer need to live within and achieve the outcome that suitable for our client - Austin Health. During the early research period, I did not know where I should start as I have been given an organisational problem that I have no idea of. This was a challenge as, unlike the project I did before that I can just search up from the internet. The only way for me to comprehend and gained background understanding of the project was to go out and talk to staffs from Austin. Understand their needs and the reason why this project question was raised up and took into as a design project. How to approach this design project was another obstacle I found at the beginning of the project. As because in the previous design studios, only a few of them came across to the topic of how to approach the project 89

from a design perspective. Therefore, during the research period of this design project, I conducted series of research on the different type of Co-design approaches. The result of research has broadened my perspective toward design thinking and Co-design. The research on Co-design approach not only allowed me to understand the purpose and process, and realised how approach plays an essential role in the project. As in order to jump away from a clinical perspective, how I approach this project become crucial and to be able to think like a designer, it is important to look into the existing design approach and come out with my approach toward this design project. Clinical terms was another key issue that I encountered when conducting research on the design project. I was not able to understand fully the resources I found from the Hub and specific terms used in the hospital at the start of the project. However, I was able to gain more clinical knowledge through interact with staffs from Austin and searching the internet. However, this grown into another issue when I present my mid-semester presentation, as people were confused and did not understand the presentation due to the limited knowledge on the healthcare organisation. Therefore, an improvement will be needed when presenting my mid-year presentation, I have to speak less clinical terms and describe the project into language that people can understand.

Another difficulties I found during the design research period was the design methods. The majority of the design methods I have experienced and utilised in the previous design projects. However, when taking these design method into real world organisation, it could grow into problems.

The observation task I conducted in the hospital was need to be informed and approve by both staffs from Austin and my project supervisor. Throughout the process of shadowing, I needed to try not to cause any attention when I record the data through taking field notes and photograph. As this methods has potential problems toward privacy. Conducting the method of shadowing was a lot more difficult in Austin compared to doing it public. However, I was able to gain enough data to refine my project problem. The interviews with staffs from Austin have helped me gain a much comprehensive knowledge towards my design project. Having able to contact the professional from other disciplines, it help me to see the project from other peopleâ&#x20AC;&#x2122;s perspective. Gaining professional feedbacks and take away the key insights for the project. Combine, analysis, refine and brainstorm were the essential methods I learnt in the first semester of the honours project. 91

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