Using Service Design to innovate NHS pathways and health services together with patients and staff

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Using service design to innovate NHS pathways and health services together with patients and staff @juliaschaeper Former Service Design Lead at the NHS Kunnskapssenter 2013


01 Service Design 02 Case studies & tools 03 Design in institutions


02 Service Design


Innovation is business critical. Service Design helps us innovate


Service Design Helps organisations figure out where, when and how they can improve their services to create better conditions for patients.


As Service Designers we visualise, formulate and choreograph solutions that are not yet available. They watch and interpret needs and behaviours and transform them into potential future services. Prof. Birgit Mager


Source : http://thisisservicedesignthinking.com


A proven and repeatable problemsolving methodology. It’s not ‘design a car’ but design for ‘personal mobility’. The goal of the definition stage is to target the right problem to solve, and then to frame the problem in a way that invites creative solutions.


Source : NHS Institute for Innovation & Improvement


Source : NHS Institute for Innovation & Improvement



Design processes help to: - retain a focus on the user; - give a structure for being creative about problem-solving; - test iterations of possible solutions in order to learn more about the problem; - identify new, more relevant ideas and services and steward them through delivery; - engage users (citizens and employees) in the design of change.


Characteristics Diverging & converging Co-creative: with not for Iterative by prototyping Learning from observation ve e

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Observation The thing people say and what they actually do are often not the same thing. Observation is useful for getting beyond what people say to understand what people do and feel.


73% of doctors say they wash hands before patient contact


73% of doctors say they wash hands before patient contact 9% actually do


When we used observation while working with hospitals looking for ideas to help reduce infection rates...


Patient was left overwhelmed having to use the blood pressure machine on his own. Publicly exposed he had to ask the nurse a couple of times to help - it took more than 10 minutes to complete compared to 2 minutes as part of the doctor consultation.

Important information disguised behind plant. Patient kept interrupting receptionist because of unclear signage and not knowing which of the four waiting areas to go to.

Wasteful pockets Useful information left ignored in surgery. It was sent via post again to patients.

Nurse kept searching for equipment adding unnecessary extra time to the consultation


What I hear I forget What I see I remember What I do I understand Lao Tse


Role playing a new portering service


People

Organisation

Technology


Useful Usable Desirable Reliable Efficient Sustainable.


Source : Engine Service Design


Service Design in the NHS to - gather insights to inform service innovation - design new pathways to sustain health services - build skills & capability to innovate and sustain changes


02 Case Studies and tools



A methodology that enables patients and staff to use service design in order to improve their own services.


About gaining insights from experiences (not attitudes or opinions) to identify opportunities for improvement



42 improvements to a service which was considered ‘the best’


Design framework


Building capabilities


Tool: Observation


Time saved during ward meal round 60 45 30

- Duplication in work - Wasteful activities - Inefficient communications - Inefficient labeling & handover

15 0

Before

17 min saved 38% -

Improved procedures Fewer interruptions Correct labeling Reduced admin

After


Tool: Experience questionnaire


Tool: Shadowing


Tool: Journey mapping


Tool: User diaries


Tool: Story telling


www.institute.nhs.uk | Assisting the NHS in transforming healthcare


al Emotion n transitio support. atives l e r g n i t Assis ansition in the tr process

‘Expert’ relative s Pro vi din g a dvice on what to think abo ut, w hat to expect

Transition days. Days where future residents can get to know the surroundings

package. On services provided, who works there,who lives there, what to bring, prices...

nto ‘Jo urney I rsation Care’ conve s m uc h gathering a as infor mation the possible on e care d person to b for

Reintroduce daily routines (washing, gardening - things people used to do before coming to the care home)

www.institute.nhs.uk | Assisting the NHS in transforming healthcare

Clear info

Flexible hours. Where some people join activities before they become residents?


03 Design in institutions


Emerging models

No designer design work Managers deploy design methods without professional design input (perhaps following training)

Design-led start ups Design led teams move outside traditional institutions to start services that meet a specific public need independently.

Brokered intervention Organisations broker design work, thereby introducing new experitse in a de-risked way and supporting design businesses through procurement

Embedded designer Full time strategic-level employee responsible for developing organisational design capacity, as well as for specific redesign programmes (e.g, Cornwall Council)

Internal agency A service design unit (normally multi-disciplinary) works with other parts of the organisation on a project by project basis. (e.g. SILK, NHSi)

External agency consultancy from an independent design practice on a project by project basis (e.g. Thinkpublic, Engine)

Source : Design Commission Report, Policy Connect


How could you involve patients and staff using service design?


How to encourage ‘front end’ design research and provide the resource for the work needed? Who to involve and how to engage meaningfully? How to create ownership in the approach, identifying a true ‘champion’? Do we need methods and processes?


Thank you hello@juliaschaeper.co.uk @juliaschaeper www.institute.nhs.uk | Assisting the NHS in transforming healthcare


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