UPMC Service Design Presentation stage 3

Generative Phase Research & Concepts for UPMC Presbyterian Neurosurgery Clinic Carnegie Mellon School of Design with UPMC Center for Quality Improvement Service Design 路 Fall 2007 Melissa Cliver 路 Jamin Hegeman 路 Kip Lee Leanne Libert 路 Kara Tennant

Concepts Embrace Wait Time Inform, engage, and comfort patients?

Improve Workflow What if the staff has fewer tasks, less distraction, and better communication?

Balance Kassam Support his efforts to help patients, but also find time for himself and support his staff.

Sharing our research, gaining their trust.

Engaging the staff in the design process.

New Insights Workflow More staff relationship and workflow issues Dr. Kassam More workflow disruption issues Patient Patient experience off the radar

“Embrace wait time.�

Direction from Center for Quality Improvement & Innovation.

We decided to continue to explore all three directions because we had valuable insights into each area.

Concept Development

We explored concepts for all three directions.

Developing concepts helped us narrow our focus to patient experience.

Why patient experience?

Client nudging us that way Client focusing on workflow More physicians in the future will reduce strain on Dr. Kassam No one focusing on the patient experience

But, we didn’t know enough about the emotional experience.

Clinic Visit #3

They made workflow modifications.

We implemented changes to affect the patient experience.

A small change yielded good results.

Because we involved the staff into our process, they really helped us gain access to patients.

Experience Cards Designed to engage patients and elicit ideas from them on what the experience could be.

Eleven Exam Room Interviews “We’ll talk about anything to anyone.

Entertain us.”

“The first time I came, my mom and cousin were in the waiting room for three hours.

My mom finished a book. That was really hard for me.”

“Our town has one traffic light.”

“I come by myself now. I don’t bring my family anymore. I’m my own woman.”

“I’m about to get brain surgery.

I don’t want to play checkers!”

“You’re so nervous and so scared about the surgery, you can’t think of anything else.”

“When you first get here, you’re in shock. You can’t read.”

“If I wasn’t here, I’d be dead.”

Dr. Kassam introduced us to his patients as “my colleages.�

Synthesis We highlighted key discoveries for each of the 11 patients we interviewed.

New Concepts We then developed new concepts inspired by the patient discoveries.

Patient Journey

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“If the patients are forewarned, they are forearmed.”

“I’m leaving everything up to you, because I can’t think.”

Information Needs

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“My last name is very hard to pronounce. But this upbeat girl, Diane, was really comforting and had a fun time calling me 117. ‘117 the doctor will see you shortly.’”

“There is a lot going on here, and I would like to sit back and think.”

Waiting Needs

“We could have had several checkers games.”

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“If I wasn’t here, I’d be dead.”

Support Needs

“You’re so nervous and so scared about the surgery, you can’t think of anything else.”

“Where a lady named Diane went around every 15 minutes to give people in the waiting room updates.”

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Emotions

“Our town has one traffic light.”

“The first time I came, my mom and cousin were in the waiting room for 3 hours. My mom finished a book.

That was really hard for me.”

“I don’t bring my family anymore.

I’m my own woman.”

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Emotions

patient emotions

family emotions

Support Needs patient support needs family support needs

Waiting Needs

family waiting needs patient waiting needs

Information Needs

family info needs

patient info needs

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New Patient Emotions Emotions

Curious Hopeful Feels bad about family waiting Confusion

Support Needs

Support Needs

Emotional Support

Waiting Needs

Waiting Needs Distractions

Information Needs

Information Needs

Schedule Valet Place to stay Wait time Sign-in process

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Pre-op Patient Emotions Emotions

Can’t think Overwhelmed Self-concerned Confusion

Support Needs

Support Needs

Transportation Someone to collect info Someone to make arrangements Special treatment

Waiting Needs

Waiting Needs

Information Needs

Quiet Wants to be alone

Information Needs

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Testing information Surgery info/procedure Reality: good/bad t Wait time isi it v s i p -u p v process ry Sign-in t-o ow ge

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Post-op Patient Emotions Emotions

Support Needs

Dazed Feels bad about family waiting Mixed feelings: laughing/crying Shock and relief

Support Needs

Waiting Needs

Transportation Someone to collect information Physical care

Waiting Needs Distractions

Information Needs

Information Needs

Possible symptoms of surgery Medical education Medical translation Schedule/other appointments Wait time it it on

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Returning Patient Emotions Emotions

Support Needs

Thankful Understanding Bored Blessed

Support Needs

Waiting Needs

Transportation Physical care

Waiting Needs

Information Needs

More engaging distractions Interactions

Information Needs

Wait time Schedule/other appointments Do not want to repeat personal info

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low cost

Cost/Value coat rack

Stages of Care suite of cards

wheelchair with regular seating areas

clinic graduation certificate

Kassam fact sheet

note-taking kit ambient music Wall of Hope

Neurosurgery common terms glossary

patient-use phone

low value

partitioned waiting area

food & drink cart

high value

no front desk video testimonials rotating museum artwork exhibits

calming water fountain

USB memory stick for patient records waiting room TVs

closed-circuit TV to watch surgery

Kassam TV patient transportation

LCD screens for dynamic art

wait room food servers

real-time wait tracker patient information for visually impaired

wait room librarian

computer kiosks mentor

high cost

patient advocate

Concept Direction Patient Experience Emotional Needs Information Needs A system that ties them together

Next Steps Concept validation Concept refinement OR visit Kassam interview Develop personas

Thanks!