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Federica Bruschi Product Design Y3 - NHS 2019/2020
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Overview
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Site visit
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Making sense
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Research and development
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Designing solutions
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Final development
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Final thoughts
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Taylor
Andrew
Calum
Alice
Haley
Zoe
Holly
Federica
Overview
This is a project in collaboration with NHS Scotland, in which we worked with Crosshouse Hospital’s Gynaecology Department for six weeks. We have been asked to improve the patient and staff experience through design thinking and product development. We started the project as a group of 8 people working together in ethnography and understanding of the service offered by the department, after that we divided the group into small teams of max. 3 people and concentrate on developing different solutions to different opportunities defined during our research.
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Site visit
Our journey started with a 2-days site visit at Crosshouse Hospital in Kilmarnock. This first stage of our research was indispensable to understand how the process and the service in our assigned department work. The Gynaecology department is divided between two different buildings: the Ward and the
MacDonald’s Suite (Infertility clinic). These two parts are located in different buildings and they are not close to each other. We divided into two groups to get an insight into both and to be sure not to miss anything important that might be improved during the project. I spent my first day at MacDonald’s Suite.
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I find myself very interested in the human-centred design and because of that, I concentrated my research with an understanding of the space, how patients interact with it and how they’re welcomed by the staff. Shadowing secretaries and nurs-
es, I understood that privacy is really important. The Suite is a small part of the department and patients often come regularly, this allows a relationship between nurses and patients that makes them feel comfortable and relaxed.
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One of the perks was the lack of signage in the parking area. Just one signage is provided and the arrow leads you in the wrong direction. This and the fact that the infertility centre is always called “MacDonald’s Suite” make it
not so easily reachable by new patients. The lack of clear signage is a problem for the Ward too. Following the ones provided by the hospital, we found that it wasn’t so easy to reach the unit.
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Entering the department I immediately understood that there were some differences between this one and the Suite. Interviewing the nurses I found a lack of storage areas and private spaces/rooms where to deliver bad news.
The same space is missing when it comes to the privacy of patients and their families.
However, what I noticed in both the ward and the suite, was the number of brochures and information stored in boards, that sometimes present similar (or equivalents) pieces of information and might be confusing for the patient.
The team decided to take all the different types of brochures to analyze them at the studio.
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Making sense Back to the studio, we started a discussion to collect all our insights, feelings and to make a user journey based on our understanding of the service and the interviews to nurses, doctors and patients.
We made a user journey for both the Suite and the Ward, but later on this project we choose the Ward as our main focus, because of all the different services and scenarios happening in these.
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The research and collection of user reviews found in careopinion.org.uk were crucial to add new insights and understand the major pain points for both patients and relatives. The caring provided by the nurses during the recovery and the examination with a consultant are the most positive touchpoints while waiting for an appointment letter and the post-op at-home recovery were negative touchpoints. We improved the patient’s user journey and we signed in red the pain points. This was the starting point for our design opportunities.
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NHS Crosshouse Gynaecology Ward Patient Journey Seeking medical help
Points for design opportunities
Diagnosis
Appointment
Surgery appointment 7
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Has examination
Fills out paperwork
Receives surgery appointment letter
Has blood tests, scans, etc done
Goes to GP or A+E Discovers symptoms
Referred to gynaecology ward
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Calls to make appointment (unless already made by GP)
Travels to Crosshouse Gyn Ward
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Pre-operation
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Receives results
Goes home to wait for results
Researches diagnosis
Operation
Confirms surgery appointment
Post-discharge
Post-operation
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Returns to Crosshouse
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Pre-op preparation
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Taken to theatre
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Has operation
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Recovers over 1-3 days
Taken to ward
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Informed of at-home care (medications, exercises, etc)
Has follow-up appointment
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Books follow-up appointment
Is discharged
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Continues treatment
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Parking is often difficult
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Patients must wait for an appointment letter, sometimes takes up to 3 months
Navigation and signage is unclear, especially for a firsttime patient
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Patients can use a bedside alert button to call nurses
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Some patients and relatives have expressed concern about lack of communication on at-home care
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Nurses and patients mentioned that there isn’t adequate space for visitors
We found the waiting room experience anxiety-inducing and lacking privacy
NHS Crosshouse MacDonald Suite Patient Journey Pre-arrival
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Points for design opportunities
Appointment
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Discovers symptoms
Goes to GP
Onsite
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GP makes appointment with MacDonald Suite
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Goes home to wait for appt letter
Travels to Crosshouse
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Goes to the consultation room
Sits in waiting room
Completes treatment
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Does examination
Makes follow-up or next check-up appt
Patients must wait for an appointment letter.
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forget to bring the appt letter
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Some patients prefer to rest before they go
Does consultation
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Has pre-examination measurements taken
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Goes to examination room Returns to waiting area to wait for consultant
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Checks in at the reception desk
Post-clinic
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Pre-examination
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Receives and con rms appt
Consultation & Examination
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Completes treatment
According to staff, patients sometimes misread the information provided in this letter
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Navigation and signage is unclear, especially for a rsttime patient According to staff, patients sometimes misread the information provided in this letter
Goes home until next appt
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The waiting room we found it anxietyinducing and lacking privacy, with patient’s full names being called out openly.
Completes treatment
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There’s a common thread between some of these opportunities, so we decided to split our team into two main groups: “information” - divided again in “pre-op” and “post-op”- and “use of space”. Even if divided, the information group worked closely to ensure the same quality and identity to the outputs and to provide a better overall experience in receiving/giving information from the waiting for an appointment to the very end of the at-home recovery. I find myself particularly interested in human-centred design, so I decided to work into the “post-surgery” to improve the experience of patients, relatives and NHS staff.
Use of space
Pre-op
Information Post-op
Research and development We asked ourselves When are patients experiencing the most anxiety or discomfort?
What and when is the NHS communicating with patients?
Main pain points Lack of communication between patient and hospital
Existing information is confusing
Main solution Create new points of communication between patient and hospital
Redesign existing information
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We dive deeper into specific pain-points and lack of information. Additional research led us to issues surrounding recovery and post-operation care:
Now that the intervention points are defined, it is possible to map a further user journey specifically designed for the post-op, from the moment a patient is taken to the theatre
for an operation until they are fully recovered at home. The development of this new user journey led us to each perfect moment where information is needed.
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Designing solutions
To provide better support and information for both relatives and patients post-op.
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We came up with possible solutions, each defined by a value proposition. This helped us to stay focus on
our main problem statement and to locate the best solutions to implement.
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The relationship between patient and relative is something that Holly and I took as a pillar for a fast and better recovery. Not just because of what we discovered with all our researches in blogs and review’s websites, but also because during our first week at the ward we interviewed some relatives and they stated they feel like they don’t know what’s going on in the lives of loved ones.
Final development It was time to bring our prototypes and ideas to life. The core idea was to create an info package. Along with the "pre-op" group we agreed on formats, layout and colours to keep it similar. Together we also came up with the idea for a folder where the patient can collect all the documents given. We reviewed all the NHS leaflets once again, copying the relevant text for the new design and removing the unnecessary or redundant one. Dividing it into different brochures and sometimes combining together pieces of information.
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This process led us to four different leaflets that needed to be designed. Some of them required general information, while others need to be filled by a nurse or selected based on the surgery the patient had.
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We tried different shapes and formats for the workouts, but we agreed that a sheet was the easiest way to use it while exercising on the floor. The folder was developed with a tab to allow its use as a stand for the exercise’s sheet.
The sharing of information about the recovery and how to help new patients led Holly and me to the development of a tool to track recovery’s progress. We wanted it to be used by the patient and their family
together to track progress and to give doctors and nurses the possibility to follow one’s status during rehabilitation in case of emergency. To do so, we developed both an app and a diary.
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Final thoughts This was my first project at GSA and the first project related to healthcare too. On-site visits and ethnography were really helpful for the project and it was the first time that I properly did that. At PoliMi we always choose our team members so it happens that you already know how people work and how to work together to come up with a solution. Having an assigned team scared me at first because you don’t know if you’ll work well with the teammates or not. Once I started the project I understood that you won’t choose your teammates in a future job, so these pre-assigned groups help you to tackle with different people and different work methods. My team was great and the communication between us easy.
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Even if I’m not into healthcare, I liked the project and I’m more than satisfied with our outcomes. I think that our solution to provide the client with two versions of the artefacts (the NHS brand identity and a new one) helped to reach our aim of something that might be implemented short-time.
