Violence in Health Care Reporting app - Process Book by Lauren Henderson

CORE DESIGN 310: ASSIGNMENT TWO

Violence in Health Care Reporting Application Cheryl Li, Lauren Henderson

Table of Contents Contextual Research Literature Review

Current System

Co-creation Session

Precedence

Exploration Ideation Process

Thesis

Personas

User Flow & Wireframes

Conceptual Development & Refinement Color + Type Selection

Interactivity

Technology and Application

Refinements

Final Proposed Solution Final Outcome

Rationale

GANTT Chart + Self Assessment

Bibliography

Contextual Research

CONTEXTUAL RESEARCH

Literary Review Examining Reporting & Its Culture

V “This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized.”

iolence and aggression is a preva-

According to Violence in Healthcare Worker

lent problem in the Health Care field,

Survey - Research Update, violence is seen

which causes both physical and mental

as an accepted part of the job, which leads

repercussions for workers. Statistics show

to under-reporting of violence and aggres-

that 80% of health care workers have

sion in the workplace. There is often more

reported patient to worker violence. As

tolerance for verbal abuse rather than phys-

defined by the Provincial Violence Preven-

ical abuse, although both are still under-

tion Steering Committee (PVPSC), violence

reported. With verbal violence, only 52%

is verbal or physical aggressive behavior

is reported verbally and 28% reported in

that is intended, or not intended due to

writing. Whereas in physical violence, 71%

illness, injury, or lack the mental capacity

is reported verbally and 57% reported in

to demonstrate intent. Under these circum-

writing. With such low rates of reporting, it

stances, 91% of health care workers agree

is difficult for administration to conduct fur-

that violent incidents are underreported.

ther research and receive funding for imple-

Even with this awareness, underreporting

menting violence prevention programs. To

is still a prevalent issue. With this in mind,

solve this, PVPSC recommends promoting

our research explores current statistics of

a positive reporting culture by identifying

reporting, as well as both the administrative

barriers and developing interventions to

and cultural reasons for under reporting.

overcome them. An open and continued

Without reporting, there is a lack of clear

dialogue between administration and the

data and awareness around the issue and

front line workers is also emphasized.

therefore a culture that normalizes violence

Through our co-creation session with the

unknowingly. With this lack of research

Vancouver Coastal Health nurses, we have

comes a lack of funding to implement solu-

found many systematic barriers to report-

tions.

ing violent incidents, one of them being

In examining this reporting system, we

the issue that there is a wide variety of ways

intend to find a means to create a positive

to file these reports, but no centralized

reporting culture where the health care

system. These channels of communication

workers feel systemically supported to

can include an electronic and paper chart,

report any violent incidents.

meetings, or just word of mouth through

As mentioned above, the extent of underre-

colleagues. It seems that some older nurses

porting violence is prevalent in Health Care.

aren’t as computer literate and don’t feel

6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

comfortable documenting electronically, whereas the younger nurses prefer using that method. This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized. This then causes a variety of different information

being a task-oriented job. Because of this,

that in turn is hard to process and translate

reporting often falls to the back burner and

to tangible results.

is forgotten or perceived as unimportant in

Through our research, other systemic

Cheryl and participant at Co-creation Session

comparison.

reasons for under-reporting have emerged.

As a nurse in the Trauma Department (ER)

One main reason is the poor communication

said in our generative session, if an incident

to the workers in when, what, and why to

doesn’t get reported the day of, it often

report. Workers are currently confused as to

doesn’t get reported at all. The incident

what incidents qualify as “harmful” enough.

report forms take approximately twenty min-

This confusion was displayed by one of the

utes to fill out. Twenty minutes may seem

nurses in our co-creation session. From

short to us; a nurse reads it otherwise. Our

information found on a poster in an office,

co-creator emphasized that reporting only

she found herself unsure if she was sup-

depends on how much time and energy she

tration and even

posed to report to higher authorities outside

has left after a long day. It also seems that if

loneliness with this

of her ward. She claimed that instead she

the worker takes the time to fill out a form,

would only tell her colleagues and maybe

more time will have to be dedicated later on

delay, and won-

email her manager later. She concluded that

for follow-ups. Another co-creator said that

she wasn’t clear on what kind of violence

the one time she did report by calling the

somethingw as ever

qualified as important enough to report,

Employee Event Report Line, she received

going to be done

and that after she reported she probably

an automated message that asked her to

wouldn’t do it again.

leave her contact information. Two weeks

with her report.”

In addition to the lack of a centralized sys-

“The co-creator experienced frus-

dered whether

later, she finally had someone call her back

tem and an engaging communication strat-

and ask her to type out the event’s details in

egy, the issue is complicated by health care

the system.

CONTEXTUAL RESEARCH | 7

CONTEXTUAL RESEARCH

Literary Review Examining Reporting & Its Culture

V “This lack of a centralized reporting device proves to be one of the barriers in creating a place where all the information and reporting forms can be easily accessed and standardized.”

iolence and aggression is a preva-

According to Violence in Healthcare Worker

lent problem in the Health Care field,

Survey - Research Update, violence is seen

which causes both physical and mental

as an accepted part of the job, which leads

repercussions for workers. Statistics show

to under-reporting of violence and aggres-

that 80% of health care workers have

sion in the workplace. There is often more

reported patient to worker violence. As

tolerance for verbal abuse rather than phys-

defined by the Provincial Violence Preven-

ical abuse, although both are still under-

tion Steering Committee (PVPSC), violence

reported. With verbal violence, only 52%

is verbal or physical aggressive behavior

is reported verbally and 28% reported in

that is intended, or not intended due to

writing. Whereas in physical violence, 71%

illness, injury, or lack the mental capacity

is reported verbally and 57% reported in

to demonstrate intent. Under these circum-

writing. With such low rates of reporting, it

stances, 91% of health care workers agree

is difficult for administration to conduct fur-

that violent incidents are underreported.

ther research and receive funding for imple-

Even with this awareness, underreporting

menting violence prevention programs. To

is still a prevalent issue. With this in mind,

solve this, PVPSC recommends promoting

our research explores current statistics of

a positive reporting culture by identifying

reporting, as well as both the administrative

barriers and developing interventions to

and cultural reasons for under reporting.

overcome them. An open and continued

Without reporting, there is a lack of clear

dialogue between administration and the

data and awareness around the issue and

front line workers is also emphasized.

therefore a culture that normalizes violence

Through our co-creation session with the

unknowingly. With this lack of research

Vancouver Coastal Health nurses, we have

comes a lack of funding to implement solu-

found many systematic barriers to report-

tions.

ing violent incidents, one of them being

In examining this reporting system, we

the issue that there is a wide variety of ways

intend to find a means to create a positive

to file these reports, but no centralized

reporting culture where the health care

system. These channels of communication

workers feel systemically supported to

can include an electronic and paper chart,

report any violent incidents.

meetings, or just word of mouth through

As mentioned above, the extent of underre-

colleagues. It seems that some older nurses

porting violence is prevalent in Health Care.

aren’t as computer literate and don’t feel

6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

being a task-oriented job. Because of this,

that in turn is hard to process and translate

reporting often falls to the back burner and

to tangible results.

is forgotten or perceived as unimportant in

Through our research, other systemic

Cheryl and participant at Co-creation Session

comparison.

reasons for under-reporting have emerged.

As a nurse in the Trauma Department (ER)

One main reason is the poor communication

said in our generative session, if an incident

to the workers in when, what, and why to

doesn’t get reported the day of, it often

report. Workers are currently confused as to

doesn’t get reported at all. The incident

what incidents qualify as “harmful” enough.

report forms take approximately twenty min-

This confusion was displayed by one of the

utes to fill out. Twenty minutes may seem

nurses in our co-creation session. From

short to us; a nurse reads it otherwise. Our

information found on a poster in an office,

co-creator emphasized that reporting only

she found herself unsure if she was sup-

depends on how much time and energy she

tration and even

posed to report to higher authorities outside

has left after a long day. It also seems that if

loneliness with this

of her ward. She claimed that instead she

the worker takes the time to fill out a form,

would only tell her colleagues and maybe

more time will have to be dedicated later on

delay, and won-

email her manager later. She concluded that

for follow-ups. Another co-creator said that

she wasn’t clear on what kind of violence

the one time she did report by calling the

somethingw as ever

qualified as important enough to report,

Employee Event Report Line, she received

going to be done

and that after she reported she probably

an automated message that asked her to

wouldn’t do it again.

leave her contact information. Two weeks

with her report.”

In addition to the lack of a centralized sys-

“The co-creator experienced frus-

dered whether

later, she finally had someone call her back

tem and an engaging communication strat-

and ask her to type out the event’s details in

egy, the issue is complicated by health care

the system.

CONTEXTUAL RESEARCH | 7

One of our co-creators indicating who she is realistically comfortable in confiding with after a violent incident.

“Many nurses simply don’t report because they feel a lack of sup-

The co-creator experienced frustration and even loneliness with this delay, and wondered whether something was ever going to be done with her report.

because they feel a lack of support from their

culture, a change in the administrative and

in reporting incidents, which will then lead

A co-creation activity

colleagues and administration- as a co-cre-

cultural systems in health care surrounding

to more research and funding that can be

that explores to who

ator noted, she would find trouble telling

reporting violence and aggression needs to

translated into strong violence prevention

her manager and supervisor about a violent

happen. These changes may include making

programs for the future. •

incident, because she felt that they weren’t

the reporting process easier, having a better

supportive. In some health care facilities,

and more engaging communication strategy

only the most serious incidents are reported,

of the importance of reporting, having more

and just because reports are required for the

perceived support in the act of reporting,

workers’ compensation board to pay. This

and translating reports to tangible, significant

peer pressure from nursing staff is definitely

positive improvements. One of our co-cre-

an issue that causes under-reporting.

ators, who comes from a tight-knit ward

The engrained care culture in health care is

with very open communication and virtually

something else that supports under-report-

no stigma surrounding reporting, said that

ing. Care culture is the placement of care

communication and an open mindset are

istrative system operates in such a way that

for patients by the nurses over their own

keys to creating a positive reporting culture.

doesn’t support reporting; however, it’s

well-being. They often don’t report incidents

In her ward, communication can happen in

important to also consider that much of

because they don’t perceive their safety and

both written and verbal form in addition to

under reporting is also due to the cultur-

dignity to be as important as the well-be-

sit-down meetings. She said that they also

al system in health care. Some health care

ing of the patient. Health care workers don’t

do team-building exercises, and emphasize

cultures attach stigma to reporting vio-

like flagging a patient as violent or aggres-

open communication between everyone –

lence. Stigma can include shaming, threats

sive, because they understand that it is not

colleagues, managers and supervisors.

of further violence, isolation, and fear of

the patient’s intention to act violently, but

judgment. One of our co-creators said that

rather it is caused by frustration, agitation, or

Health Care sector suggests that reporting

when she experienced a serious physical

mental health disabilities. In addition, a flag

provides nurses with an opportunity to com-

This evidence demonstrates that the admin-

Our research in reporting culture in the

port from their

assault and had to file a police report and

on their chart is similar to having a criminal

municate existing issues of violence to each

go for a medical check-up, she felt “degrad-

record in the health care world – it greatly

other, while also sharing preventative advice

colleagues and

ed”. Another nurse noted that after facing a

affects how they will be treated in medical

for the future. It also demonstrates that by

administration.”

violent incident she felt stupid in front of her

facilities in the future. The sense of apathy

creating this sharing culture they also can put

co-workers for not knowing how to prevent

for violence and aggression grows with

an end to the acceptance and normalization

it first. Nurses often perceive that reporting

health care culture. Because of this apathy,

of violence. In combating the issue of under

would upset administrators and the resulting

violence is then normalized therefore caus-

reporting, it will lead to obtaining clear data

repercussions would be worse than the initial

ing under-reporting.

and hopefully create a positive reporting

incident. Many nurses simply don’t report 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

In order to create a positive reporting

and with what nurses currently report.

culture and a system that supports workers CONTEXTUAL RESEARCH | 9

One of our co-creators indicating who she is realistically comfortable in confiding with after a violent incident.

“Many nurses simply don’t report because they feel a lack of sup-

The co-creator experienced frustration and even loneliness with this delay, and wondered whether something was ever going to be done with her report.

because they feel a lack of support from their

culture, a change in the administrative and

in reporting incidents, which will then lead

A co-creation activity

colleagues and administration- as a co-cre-

cultural systems in health care surrounding

to more research and funding that can be

that explores to who

ator noted, she would find trouble telling

reporting violence and aggression needs to

translated into strong violence prevention

her manager and supervisor about a violent

happen. These changes may include making

programs for the future. •

incident, because she felt that they weren’t

the reporting process easier, having a better

supportive. In some health care facilities,

and more engaging communication strategy

only the most serious incidents are reported,

of the importance of reporting, having more

and just because reports are required for the

perceived support in the act of reporting,

workers’ compensation board to pay. This

and translating reports to tangible, significant

peer pressure from nursing staff is definitely

positive improvements. One of our co-cre-

an issue that causes under-reporting.

ators, who comes from a tight-knit ward

The engrained care culture in health care is

with very open communication and virtually

something else that supports under-report-

no stigma surrounding reporting, said that

ing. Care culture is the placement of care

communication and an open mindset are

istrative system operates in such a way that

for patients by the nurses over their own

keys to creating a positive reporting culture.

doesn’t support reporting; however, it’s

well-being. They often don’t report incidents

In her ward, communication can happen in

important to also consider that much of

because they don’t perceive their safety and

both written and verbal form in addition to

under reporting is also due to the cultur-

dignity to be as important as the well-be-

sit-down meetings. She said that they also

al system in health care. Some health care

ing of the patient. Health care workers don’t

do team-building exercises, and emphasize

cultures attach stigma to reporting vio-

like flagging a patient as violent or aggres-

open communication between everyone –

lence. Stigma can include shaming, threats

sive, because they understand that it is not

colleagues, managers and supervisors.

of further violence, isolation, and fear of

the patient’s intention to act violently, but

judgment. One of our co-creators said that

rather it is caused by frustration, agitation, or

Health Care sector suggests that reporting

when she experienced a serious physical

mental health disabilities. In addition, a flag

provides nurses with an opportunity to com-

This evidence demonstrates that the admin-

Our research in reporting culture in the

port from their

assault and had to file a police report and

on their chart is similar to having a criminal

municate existing issues of violence to each

go for a medical check-up, she felt “degrad-

record in the health care world – it greatly

other, while also sharing preventative advice

colleagues and

ed”. Another nurse noted that after facing a

affects how they will be treated in medical

for the future. It also demonstrates that by

administration.”

violent incident she felt stupid in front of her

facilities in the future. The sense of apathy

creating this sharing culture they also can put

co-workers for not knowing how to prevent

for violence and aggression grows with

an end to the acceptance and normalization

it first. Nurses often perceive that reporting

health care culture. Because of this apathy,

of violence. In combating the issue of under

would upset administrators and the resulting

violence is then normalized therefore caus-

reporting, it will lead to obtaining clear data

repercussions would be worse than the initial

ing under-reporting.

and hopefully create a positive reporting

incident. Many nurses simply don’t report 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

In order to create a positive reporting

and with what nurses currently report.

culture and a system that supports workers CONTEXTUAL RESEARCH | 9

CONTEXTUAL RESEARCH

Current System Paper Reporting Forms The current system in place at Vancouver

Violence Prevention Training System

General Hospital uses a variety of different

Health Services of BC has provided this online

forms and platforms. They use SLS Electronic

learning course to train nurses in how, what,

Charting in addition to various paper forms

when and why to report violence in the work

displayed to the right. These forms demon-

place. We looked into Module 7 and 8 which

strate the extent of information that the

covers post-incident response as well as Behav-

nurses must fill out after a violent incident

ioral Care Planning for violence. These modules

and the time it must take to do so.

outline specific things to consider when filing a

Figure A, B, C Incident forms found

violence report as well as the effective ways of

in Work Safe BC’s “Preventing Violence in

documenting patient behavior as a preventative

Health Care - 5 Steps”. Figure D is in the guideline booklet for

Figure A

Figure B

Code White response in hospitals. Booklet

method. We found that this was the only instance where nurses were informed about the reasons they should be reporting.

made in partnership with OHSAH, Workers’

Module 7 specifically explains how, when and

Compensation Board and the Health Associ-

why to fill out an Employee Incident Report as

ation of BC.

we showed on the previous page, as well as how to check yourself after an incident has occurred. This asks the nurse to take care of themselves first. It also notes that these events should also be documented in the patient’s care plan. The modules also give resources that nurses can use in the case of a violent incident such as counseling and compensation sources. Module 8 speaks more of preventative methFigure C

Figure D

ods in creating a Patient Violence Risk Assessment. This is meant to keep an active record of the patient’s potential for violence. Including it in their chart or even as a sticker warning on their chart or bracelet is encouraged. The module notes that this system will help the patient receive better care.

1 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 11

CONTEXTUAL RESEARCH

Current System Paper Reporting Forms The current system in place at Vancouver

Violence Prevention Training System

General Hospital uses a variety of different

Health Services of BC has provided this online

forms and platforms. They use SLS Electronic

learning course to train nurses in how, what,

Charting in addition to various paper forms

when and why to report violence in the work

displayed to the right. These forms demon-

place. We looked into Module 7 and 8 which

strate the extent of information that the

covers post-incident response as well as Behav-

nurses must fill out after a violent incident

ioral Care Planning for violence. These modules

and the time it must take to do so.

outline specific things to consider when filing a

Figure A, B, C Incident forms found

violence report as well as the effective ways of

in Work Safe BC’s “Preventing Violence in

documenting patient behavior as a preventative

Health Care - 5 Steps”. Figure D is in the guideline booklet for

Figure A

Figure B

Code White response in hospitals. Booklet

method. We found that this was the only instance where nurses were informed about the reasons they should be reporting.

made in partnership with OHSAH, Workers’

Module 7 specifically explains how, when and

Compensation Board and the Health Associ-

why to fill out an Employee Incident Report as

ation of BC.

Figure D

1 0 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 11

CONTEXTUAL RESEARCH

Co-Creation Activities

Not Comfortable: You would not mention or talk about the issue at all to these people.

Not very comfortable: You are hesitant to talk about the issue with these people. You may or may not disclose.

Systemic Methods of Reporting In this Co-Creation activity participants are asked to write out an incident they have

Somewhat Comfortable: You will talk about the issue with these people if they ask.

Most Comfortable: You talk about the issue with these people willingly.

experienced or witnessed and then place it according to if they would tell anyone or not. Then depending on what direction they chose they would proceed to place words provided in an envelope under each question to answer who they would tell, with what, when and where. In addition, if an option they need but is not provided they have the option of writing it in. After this is complete, they will take out an envelope marked emotions and place the cut out faces where they were feeling what according to their previous answers. This activity allowed us to collect data about what systems of reporting are currently in place as well as if nurse also tell people outside of their work environment. By attaching emotions to each section we could see how they felt about current applications versus their personal recounts of the events.

Social Connections in Reporting This activity gave the participants two scenar-

For the second scenario the participant is

ios. In one, a nurse is scratched by a patient,

presented with, they are injured by a patient

but the patient does not leave a visible mark.

and this time leaves a visible mark. She will

Using sticky notes, the co-creator must place

go through the activity again with this new

the named positions of the people that they

scenario in mind.

are supposed to report to. The bulls eye

This activity was meant to give us insight

shape of the above graphic shows a high

into the gaps around who they are meant to

level of comfort in telling near the center and

report to, who they are actually comfortable

a lesser level of comfort as you move out

enough to report to, and who they would

towards the edge. Once this is completed

ideally like to report to. In addition, it will in-

the participant will place new sticky notes of

form us about what individuals feel is severe

who they actually tell, and again for who they

enough to report.

would ideally like to tell.

1 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 13

CONTEXTUAL RESEARCH

Co-Creation Activities

Not Comfortable: You would not mention or talk about the issue at all to these people.

Not very comfortable: You are hesitant to talk about the issue with these people. You may or may not disclose.

Systemic Methods of Reporting In this Co-Creation activity participants are asked to write out an incident they have

Somewhat Comfortable: You will talk about the issue with these people if they ask.

Most Comfortable: You talk about the issue with these people willingly.

Social Connections in Reporting This activity gave the participants two scenar-

For the second scenario the participant is

ios. In one, a nurse is scratched by a patient,

presented with, they are injured by a patient

but the patient does not leave a visible mark.

and this time leaves a visible mark. She will

Using sticky notes, the co-creator must place

go through the activity again with this new

the named positions of the people that they

scenario in mind.

are supposed to report to. The bulls eye

This activity was meant to give us insight

shape of the above graphic shows a high

into the gaps around who they are meant to

level of comfort in telling near the center and

report to, who they are actually comfortable

a lesser level of comfort as you move out

enough to report to, and who they would

towards the edge. Once this is completed

ideally like to report to. In addition, it will in-

the participant will place new sticky notes of

form us about what individuals feel is severe

who they actually tell, and again for who they

enough to report.

would ideally like to tell.

1 2 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 13

CONTEXTUAL RESEARCH

Co-Creation Findings

“Maybe you’ll feel stupid because of what you didn’t do right” –One of our co-creators on reporting to her colleagues after an incident

From this activity we gathered some expected and unexpected data. We learned that there are a variety of different reporting and safety mechanisms in place already, but no centralized reporting system. We found that nurses are not apprehensive to share information of violent events with their co-workers, but rather they are cautious when sharing with family members and friends due to patient privacy laws. The most useful part of this activity was the emotions as we found some surprises in what nurses feel when reporting. For example they feel, lonely, stupid, confused, overwhelmed and frustrated, just to mention a few. Detailed results of co-creation data found from a variety of participant nurses 1 4 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

From this activity we got a great idea about who nurses feel comfortable telling versus who they are supposed to tell. This opened them up for further conversation about their working environment and how they feel when they have to fill out reports. We found that their greatest support came from co-workers and they were very comfortable telling them about incidents informally. However, when it came to formal reporting we found that there are many mixed feelings. Some nurses are more hesitant to tell their supervisor or manager as they are not as close with them. We even received feedback that filling out police and medical reports makes them feel almost degraded. This emphasized that there is an engrained problem not just systemically, but also culturally with the current reporting system. There seems to be a lack of perceived support and stigma within the workplace about reporting a violent incident. CONTEXTUAL RESEARCH | 15

CONTEXTUAL RESEARCH

Co-Creation Findings

“Maybe you’ll feel stupid because of what you didn’t do right” –One of our co-creators on reporting to her colleagues after an incident

CONTEXTUAL RESEARCH

Co-Creation Reflections

Our co-creation activities reaped a variety of unexpected results, ranging from seeing nothing wrong with the current system to feeling a real need for change and improvement.

From the co-creation session, we found that many of our assumptions going in were misinformed. One of the biggest surprises was that not all of them felt it was necessary to have change or that there was a problem that needed fixing. This informed us that either the problem is so deeply normalized or that nurses are actually happy with the current system. We also gained insight into the main cause of underreporting, finding that it had to do with the lack of time. One nurse mentioned that if a report was not filed the day of the incident, it most likely would never get filed. Confusion also surrounded why, what and when nurses should be reporting. Also, they donâ&#x20AC;&#x2122;t see where the report goes and therefore feel like nothing is being done about their report and their voices arenâ&#x20AC;&#x2122;t being heard. Most importantly, we came away from our co-creation with a greater understanding and a much greater empathy for nurses.

1 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Looking at our findings of causes, assumptions, solutions, and emotions around the issue of violence. We found that we had many similar findings as our classmates, which reinforced the importance of that point.

CONTEXTUAL RESEARCH | 17

CONTEXTUAL RESEARCH

Co-Creation Reflections

Our co-creation activities reaped a variety of unexpected results, ranging from seeing nothing wrong with the current system to feeling a real need for change and improvement.

1 6 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

CONTEXTUAL RESEARCH | 17

CONTEXTUAL RESEARCH

Precedence: Recording Apps

After looking at existing solutions and our research, we started looking at different recording and tracking apps that used different behavior change mechanisms. This was done keeping in mind our goal of making the reporting process easier, more efficient, and less intimidating to do. Lift is a behavior change interface on the web and an app. It prompts you create habits that you want to work towards, and then incorporates a social media aspect so that others can see your goals and “lift” you. You Mint

can also track your own progress for a sense of achievement. Frog Design’s Connected Care is a recording app for patients to take control of their own healthcare by self reporting any changes that occur in their health. This then allows the app to make any recommendations, as well as improves communication between the patient and the physician. This app also has a social media aspect to allow patients to share their health progress. Mint is a web interface and an app that helps you track your finances. Mint includes plenty of visualizations of your budgets and your spendings, so that you are able to track your finances easily and quickly.

Lift 1 8 | V I O L E N C E I N H E A LT H C A R E R E P O R T I N G A P P

Frog Design’s Connected Care CONTEXTUAL RESEARCH | 19

CONTEXTUAL RESEARCH

Precedence: Recording Apps

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Frog Design’s Connected Care CONTEXTUAL RESEARCH | 19

Exploration

E X P L O R AT I O N

Ideation Process

We spent a large part of our time after the research stage defining our problem space and ideating possible solutions. We constantly returned to our problem statement, and asking ourselves how each idea would solve that.

The main problems surrounding reporting violence

Defining the initial problem space

Refining problem down to a manageable size

Defining the current systemâ&#x20AC;&#x2122;s main problems

Exploring what underreporting causes

Solidifying our problem space and how to solve it

What our design needed to create

Exploring possible features of reporting

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E X P L O R AT I O N | 2 3

E X P L O R AT I O N

Ideation Process

The main problems surrounding reporting violence

Defining the initial problem space

Refining problem down to a manageable size

Defining the current systemâ&#x20AC;&#x2122;s main problems

Exploring what underreporting causes

Solidifying our problem space and how to solve it

What our design needed to create

Exploring possible features of reporting

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E X P L O R AT I O N

Thesis

E X P L O R AT I O N

Personas

We aim to create a centralized reporting application that promotes a positive reporting experience through establishing a sense of action, transparency, and community.

Background: Jane is a caring and empathetic young woman who has been a nurse at VGH for two years now. Her favourite part of the job is really getting to know patients as she interacts with them daily. Jane has always put the people she cares about before herself, especially with her patients. Jane understands the importance of reporting, but admittedly doesn’t always report verbal violence or minor physical violence that don’t cause injuries because she simply doesn’t have enough time and she would rather take care of her patients. Sometimes, she doesn’t know what exactly qualifies as reporting, especially with more minor incidents. Although her fellow nurses have always been helpful and friendly when an incident has happened and has provided support and comfort, she doesn’t want to file a report and give her supervisor extra

A sense of action is needed because nurses encounter the problem of feeling like nothing is

paperwork to do as she doesn’t want him to get angry.

being done after filing a report. By making the care workers feel like someone is listening to

Jane Chung

them and responding to their reports, it will hopefully increase the rate of reporting.

Vancouver, BC

One afternoon, as Jane is bending over to help one of her patients

27 years old Chinese female

stand up, the patient becomes aggravated and slaps her arm down,

Single

leaving a red mark. A bit startled, she leaves and goes to the nursing

Lives alone

station. VGH has recently implemented a new reporting app, and

Works in VGH Long-term Residence Care

after opening it she goes to “About” and finds out that the incident

Has been working for 2 years now as a nurse

that just happened requires a report. She fills out the report, and is

Empathetic, Quick Learner, Determined

surprised at how little time it takes and is back to work in less than 10

A sense of transparency is needed because care workers often don’t know where their report goes after they’ve taken the time to file one, thus discouraging them from reporting in the future. If there is a way for them to keep track of the reporting process and see where exactly their report is at, this will hopefully boost the rate of reporting. A sense of community is especially important because of the cultural barriers to reporting that

Scenario:

are evident in some workplaces. Nurses always often don’t put themselves first, but rather

minutes. Later on, she enjoys the little check-up that pops up asking

their patients and their colleagues. Therefore, it is especially important for us to harness that

her if she’s ok, and all the “appreciates” she has been getting from her

sense of care and establish that reporting will help others as well as themselves. Combating

colleagues who share the same patient- it makes her feel like her re-

the stigma associated with reporting is also another important issue that a building sense of

port was able to help others from getting into the same incident. She

community will need to address.

also requests her supervisor to come see her, and within ten minutes he is providing her with all the support and resources that she needs. She now feels supported by not only her fellow nurses, but also her supervisor as well.

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