Patients' Waiting Experience by Wendy Hsu

CONNECTING CARE Empowering The Patient Through Their Waiting Experience

Herron School of Art + Design Collaborative Action Research Design Fall 2015

CONTENTS INTRODUCTION UNDERSTANDING IU HEALTH NORTH

METHODOLOGY

05 06

DESIGN THINKING

PROCESS & METHODS

SOLUTIONS

SOLUTION FRAMEWORK

APPLICATION DESIGN

NAVIGATION DESK TRANSITION

SELF CHECK-IN KIOSKS

CARE CARD

COLOR SYSTEM

LAB SPACE RE-DESIGN

CONCLUSION SUMMARY

APPENDIX

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DESIGN TEAM

RESEARCH ACTION PLAN

INTRODUCTION

UNDERSTANDING IU HEALTH NORTH

Upon walking into the IU Health North facility, outsiders can sense that the hospital works differently. The staff’s deep commitment to empathy and willingness to work every day towards improving patient care is not only evident in how the space is designed, but how staff and patients interact. The five core maxims that they established for themselves guide and exemplify the mission, vision and values that the hospital follows. Their pledge to uphold these core maxims ensures that they are working towards giving the patient the best experience possible. They always intend to: »» Show Kindness »» Connect Fully »» Take Ownership »» Create Joy »» Do more

Finding Problem Spaces

The IU Health North facility houses many different areas and services for patients. During the length of our eight week project, the Design Team focused on three specific service areas to try and improve the patient Waiting Experience. We engaged staff and patients to gain a better understanding of how each area worked and what they saw as opportunities for improvement. Our deep immersion into the Registration, Lab and Radiology service areas allowed us to gather data, and understand not only the problem spaces that existed individually by area, but problem spaces that affect every area. Through our understanding, we were able to come up with appropriate solutions that include communication with patients, interactions with service materials, as well as spatial problems.

INTRODUCTION

PROJECT PARTNERS HERRON SCHOOL of ART + DESIGN We would like to thank the IU Health North staff that gave us the opportunity to participate in this project and engage so openly with staff and patients alike. It was a truly immersive learning experience. Suzanne DelBoccio

Chief Nursing Officer and Vice President of Patient Care Services Indiana University Health North Hospital

Joy E. Graves-Rust

Coordinator, Patient Satisfaction Measures IU Health North Hospital IU Health Saxony Hospital

Elizabeth Settler

Partner - NCR ED Council Chair Emergency Department Indiana University Health Saxony Hospital

Professor: Youngbok Hong The Design Team: Registration

Linjun Chen Wendy Hsu Madison Stevens Radiology

Registration Sarah Budd

Siying Jin Miley Phillips Ed Sieferd

Lawoun Cusic

Lab

Radiology Carl Zenor

Jack Rong Vesta Mohebbi Lisa Semidey

Manager, Patient Financial Navigation Indiana University Health Unit Secretary, Registration

Manager Imaging Services Indiana University Health North Hospital

Kenny Hicks

Unit Secretary, Radiology

Lab Bernetta Bell

Regional Director: North Central Region IUH North, Saxony & Tipton

Frank Wimsatt

Unit Secretary, Lab

Countless patients were nice enough to share their time, insights, observations and feelings in order to help us craft this presentation. For this we

thank them.

This research was conducted as part of the course, Collaborative Action Research in Design for the MFA Degree in Visual Communication Design. In using different research methods we were able to gain an understanding of existing problems and frame innovative solutions with a people-centered design focus.

METHODOLOGY

DESIGN THINKING

Design thinking is a people-centered approach to innovative problem solving.

In this project, we adopted the perspectives of patients and staff to understand the “waiting experience” at IU Health North. We have fully captured the patient

experience through active listening and observing the current context and then imagining creative possibilities that would enhance the patient’s overall waiting experience. Participatory collaboration was

emphasized throughout the entire research process.

Design thinking follows a specific reasoning process through diverging and converging thinking. Divergent thinking allows for as many possibilities imaginable while deferring judgment; whereas, convergent thinking uses a more evaluative approach. Each mindset is valuable throughout the entire problem solving process for generating ideas to improve the patient’s waiting experience and then selecting the most appropriate solutions.

DIVERGE

CONVERGE

DEFERRAL OF JUDGMENT

METHODOLOGY

PROCESS & METHODS

Step 01: Understanding Problems Our Design Team conducted the initial fieldwork on October 5, 2015. Elizabeth

Settler,Partner-NCR ED Council Chair, introduced our design challenge on improving patients waiting experience by walking our team to the three areas of focus-Registration, Radiology, and Lab. She provided a general overview of currently identified pain points among patients and staff. In a meeting with Joy Rust-Graves, the Patient Experience Coordinator, we became familiar with the culture and the core maxims at IU Health North. Using the understanding of the value system as a framework throughout our research, we began our first step in the design process, fact finding.

We divided the design team into three groups in order to facilitate fact finding more efficiently. Two main methods were used during this step, observation and interviews.

Each member of the team observed their assigned space over the course of two weeks.

We used a “zoom in, zoom out” approach that focused on key elements which consist of the waiting experience from the perspective of the the patient as well as the organization’s higher level systems. The key elements consisted of activity, time, actors, object, goal, feeling, and space. Each insight was categorized into these components accordingly. The interview questions were designed using the same elements and were divided between patients and staff members. From the staff, we were able to get their perspective on improving patient waiting experience based on previous experiences and observations. The staff were also able to provide the back-end information that the patients were not aware of. Likewise, the patients gave valuable insights as to what activities they prefer while waiting, what types of information is important to be accessible, what concerns they face during their entire hospital experience, and in what ways they would envision improvements.

15 Lab Area:

and patient, and patients have no perception of wait time or updated information. »» System errors that occur from Registration to Lab cause delays in the patient’s check-in process. »» There is a limited number of staff in comparison to the volume of patients. »» The space is not comfortable for patients because of the colder temperature, lack of activities, and the difficulties in hearing their name being called.

»» There is a gap in communication between staff

orders and the scheduling department, causing confusion between arrival time and appointment time. »» Many patients are unaware of preparation procedures prior to arrival. Many tests require certain tasks and time that patients do not plan for.

at Registration and are sent to the wrong locations. »» The lack of communication between front desk staff and technicians cause patients to feel anxious when they are not updated on delays. »» The doctor’s order causes many challenges for patients due to inconsistencies in processes and wording on form. »» There are limited activities for patients, especially children. »» Many patients have trouble with the way-finding around the hospital.

Radiology Area: »» There are inconsistencies between doctor’s

»» Some patients are given incorrect information

Registration Area: »» Rotating desk staff can cause confusion for patients during transition. Having one person stationed at the check-in desk could help staff take ownership of that position. »» An alternate system or process for missing doctor’s orders could alleviate patients’ frustration and longer wait times. »» Having only one check-in point causes delays with the volume of patients during certain times of the day. »» There are inconsistencies with the card system, and it is not very informative for the patient. »» Way-finding for the restroom and other parts of the hospital is challenging. »» There are very limited activities in the waiting area. »» Many patients do not know the process, causing confusion when they arrive. »» There are multiple touch points for each patient before their procedure.

METHODOLOGY

STEP 02: DEFINING PROBLEMS Responding to major pain points which were identified, each team entered the second step of the process, problem definition. Each idea was framed into a challenge statement beginning with the phrase “How might we?” Composing a challenge statement is the most important step to reframing the identified problems into opportunities. Thus it enabled us to develop appropriate solutions rooted in reality.

Once the challenge statements were created reflecting the problem areas defined, we began another important process skill called the “WhyWhat’s Stopping” analysis. This analysis allowed us to narrow or broaden our initial challenge statements by asking “Why?” to broaden the challenge or narrow the statement by asking “What’s stopping us from doing that?” The visualization of this process creates a triangle where the broad end of the triangle reflects the “Why” or broader challenge statements, and the narrowed tip of the triangle reflects the more specific or narrowed challenge statements. The outcomes of this process from each of the three groups are shown on the following pages.

Challenge statement mapping

BROADWHY?

communication system to provide a holistic solution.

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According to the patients, much of their experience is based on being informed along the way. Patients felt very strongly about wanting to know what to expect from their procedure, how long they could expect to wait, and how long the procedure would take. Many also said they would like to be kept up-to-date while waiting. Taking all of this into consideration along with the already developed challenge statements, the most appropriate solution was to focus on an integrated

Once the challenge statement maps were completed, a few representatives from the team met with Joy to present the challenge statements and to get input on which areas to focus our efforts on within the given time frame. Joy reviewed all insightful material from each team and recommended not pursuing system level solutions such as the Cerner system or doctor orders. Given this feedback, our design team decided to focus on one challenge statement to maximize our efforts.

NARROWWHATâ&#x20AC;&#x2122;S STOPING

"Why-What's Stopping" analysis. The broad end of the triangle reflects broader challenges; whereas, the narrowed end demonstrates a more narrowed approach.

METHODOLOGY

Registration Area How might weâ&#x20AC;Ś

Design team members: Madison Stevens, Linjun Chen, and Wendy Hsu interviewing Cathy Muse at the Welcome Desk

19 HMW provide supportive facilities for the patient’s wait time? HMW provide an easy and clear way-finding for patients?

HMW develop a service for patient’s that carries or stores personal items during their wait time?

HMW create and provide a variety of options of activities while waiting?

HMW inform patients about the service process?

HMW reduce the redundancy of going to multiple stations?

HMW reduce the ambiguity and confusion of not knowing the priority of service?

HMW help patients to estimate the wait time?

HMW encourage staff and patients to buy-in to the card system?

HMW ensure that the doctor’s staff put orders in the system correctly and on-time? HMW create a better back-up system when the order is missing?

HMW have accurate patient information and authorization prior to check-in?

HMW create more opportunity to develop the staff’s skills as first-point check-in?

HMW have a doctor’s orders and authorizations in the system prior to patient arrival?

HMW implement a back-up system for when a staff member leaves their post or transitions roles?

HMW reduce the amount of time staff needs to register a patient?

HMW create multiple check-in points rather than one?

HMW have a more concise process for check in?

METHODOLOGY

Radiology Area How might weâ&#x20AC;¦

Design team members: Miley Phillips and Siying Jin interviewing Kenny Hicks

HMW open a line of communication between technician and patients to keep patients up-to-date on status while waiting? HMW develop a system that allows the technician to communicate to desk staff effectively?

HMW decrease patients anxiety by enriching patients’ waiting time? HMW create a positive distraction for patients by adding appropriate activities? HMW implement leisurely activities for patients within the space?

HMW inform patients of the necessary preparation involved and duration of procedure? HMW create an overview of all procedures that includes preparation steps and time involved to inform patients and staff?

HMW create a more free flowing information structure between patients and IU Health North? HMW simplify the technology system to reduce errors and frustration?

HMW make a more concise system to provide doctor’s order forms to departments?

HMW streamline the registration and departments checkin process to limit multiple touchpoints?

HMW collectively gather patients’ necessary information at one touch point to be distributed to departments?

HMW modify the current card system to inform both patients and staff of scheduled appointments?

HMW provide hospital with patients’ necessary information to reduce patients’ tasks?

HMW clearly inform both patients and staff of patients’ scheduled procedures?

HMW limit the amount of steps the patients encounter upon arrival?

METHODOLOGY

Lab Area How might we… HMW reduce the amount of errors around system input? HMW help with better access to data correcting for Lab Staff? HMW give Registration Staff the proper training/tools to input correct data into the system?

HMW make sure the Doctor’s order appear quickly and accurately in the system to avoid delays in patient service? HMW make the “Same Day Pass” process more efficient for patients to avoid delays?

HMW improve the flow of information for the patients? HMW inform First Time patients of Registration/ Check-in protocol before arriving to IUH North? HMW give patients a more accurate wait time based on their specific procedure?

HMW improve interaction between Lab Staff and patients? HMW let patients know that they are waiting for different procedures in the same space?

HMW establish a system for calling patients so that they know even if they aren’t in the Lab wait area?

HMW make the hospital space more user-friendly for patients? HMW improve the hospital way-finding system?

HMW improve the space in the Lab waiting area?

HMW make maps & HMW modify the space signs more available to to entertain the patient patients as they walk in while they wait? to the facility to guide them clearly?

HMW change the functionality of the waiting area to be more comfortable for patient use?

23 HMW establish a better relationship between Lab Services & patients needs?

HMW offer Lab service differently to patients based on their age or physical condition?

HMW improve waiting time by having more staff available in Lab?

HMW implement a system to cover busy days with available internal staff?

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Design team members: Lisa Semidey, Vesta Mohebbi, and Jack Rong interviewing Frank Wimsett

HMW segment Lab space differently to serve patients based on their age/condition? (Ex: Pediatric, wheelchairsâ&#x20AC;Ś)

METHODOLOGY

HOW MIGHT WE

improve the flow of to inform the patient service processes?

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communication of all necessary

SOLUTIONS

SOLUTION FRAMEWORK

Through a rigorous process of problem definition and ideation, our design team

identified eight solutions that could be integrated into a single holistic approach. We first created a persona journey map to shows how each solution would affect the patient at every touchpoint during their hospital experience. We identified three types of patients; the types of patients are the recurring patient, a new patient with a child, and an elderly patient with a family member.

Personas John Smith, age 46 a recurring patient John Is a recurring patient at IU Health North. He visits the hospital twice a year for regular checkups. Most of the time John comes to the hospital for x-rays, and maybe blood work. He has been to each department many times so John knows the procedures and the process of registering for tests. Since he is often there just for quick tests he would like to make his visit as brief as possible and skip the Registration step.

Anna Green, age 37 with her son Jacob, age 4 Anna has never been to IU Health North before and is not aware of the registration procedures. Anna knows she needs to go to Radiology because that is where her son’s test is, but she does not know that she must register her son first.

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Todd has been to IU Health North before; however, he is having different procedures done since his last visit. Todd likes to be prepared, but was nervous because he could not find any information online regarding what he needed prior to arrival. He was told to go the Lab area and wait for his name to be called. He feels nervous as he has a hard time hearing. Todd doesn’t play on his phone much but instead prefers to talk with his son Adam when he’s not on his phone. Todd uses a cane and has a hard time standing for long periods of time. He notices that there are no available seats in the Lab wait area.

Todd Sharp, age 72

This is Jacob’s first CT scan. He has had abdominal pain for the last two days. With his situation he is nervous about being at the doctor’s office and the tests they are going to perform. The crowded room makes him feel uncomfortable while he waits.

Colored Floor Markers will be placed throughout the hospital, guiding patients to their destination.

A Wait-Time Board is easily seen by all. One side is for entertainment, the other is to inform patients of their wait.

After the patient arrives in their designated area, they have the option to use the Pager System if they prefer to not wait in the space.

Patients will now be able to spend time in a new space with the Lab Space Re-Design which includes an enclosed area.

The Pager System allows family members and patients the opportunity to walk around during the appointment time.

SOLUTIONS

APPLICATION DESIGN

Concepts The Mobile Application aims to satisfy the

patients greatest concern while waiting, being prepared. Patients stressed that being informed of their wait time and necessary information specific to their procedure would improve their overall experience. Taking these key insights into consideration helped to develop the Connecting Care Application. The design helps to navigate the patients through their journey and customizes the information based on their procedure. Each patient will have access to their approximate wait time, length of procedure, and supplemental materials to prepare them for their appointment.

We have separated the patients based on scheduled and walk-in appointments. The scheduled patients will have access to their journey upon scheduling. The walk-in patients will have the option to select their procedure the day of, and have access to the wait-time board to see how many patients are ahead of them while giving them step-by-step instructions of what to do upon arrival.

Site Map

Interface Prototype

SOLUTIONS

Graphic User Interface

Select status There are two options when patients first launch this App, one is for walk-in patients, the other is for patients who have scheduled their appointment before arrival.

Home page

If You Walk In

If you are a walkin patient, you can find information and estimated wait times, as well as the procedure length of time for the test you are going to have.

Walk in patientsâ&#x20AC;&#x2122; pages

If You Scheduled

Journey pages

If you scheduled your appointment before you arrive at the hospital, you can see your specific procedure on the journey page.

Patients can view messages from the hospital or doctorâ&#x20AC;&#x2122;s notifications on the message page, which is like an inbox and could also add the alert message to the journey.

Message pages

SOLUTIONS

NAVIGATION DESK TRANSITION

Below is a floor plan with two navigation desks added to the north and south entry doors. The center desk will become the first check-in point for registration, a central point in the hospital for patients to easily find.

NAVIGATION DESK

When the patient first arrives they currently struggle to find the registration area, or accidentally go straight to the service area without registering first. We want to prevent this from happening by moving the navigation desk and staff member to be located immediately by the entry doors. The current navigation desk will become the first-point check in station for registration. Patients can give their initial check-in information here with a staff member or they can opt to do the self check-in at the kiosks.

NAVIGATION DESK

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SECOND POINT REGISTRATION CUBICLES

NEW FIRST POINT CHECK-IN FOR REGISTRATION

SOLUTIONS

SELF CHECK-IN KIOSKS

When patients first arrive to the hospital the first step in their journey

is to check-in. For patients who have been through the process before, we wanted to expedite their experience in the registration area. By creating self checkin kiosks the patient can bypass the initial interaction with staff members who would normally ask their name, birth date, service they are receiving, and if they have an appointment. The self check-in kiosks would operate similarly to kiosks you might see at an airline check-in. The patient could input this initial information, and verify any other information already saved in the system, such as insurance and appointments. The patient would still need to be called back to the private cubicles so that a staff member can also verify the correct information and provide a wristband and journey card. The self check-in kiosk will eliminate unnecessary waiting at the initial check-point.

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During the initial implementation, a staff member may need to be assigned near the kiosks to aid in any questions patients have with usability. Once the kiosks have been in place for awhile patients will understand their purpose and use more and more, and less assistance will be needed. Patients will also be able to draw on their experience at airports, car rentals, ticket booths, etc. to understand how the kiosks operate.

The self check-in kiosks will also alleviate the initial staff memberâ&#x20AC;&#x2122;s role, opening up more time for them to focus on new patients, or other portions of the patientâ&#x20AC;&#x2122;s experience. The self check-in will allow patients that do not have any conflicts with doctors orders to move steadily through the process. If someone uses the self check-in and does not have their doctorâ&#x20AC;&#x2122;s order in the system, this will alert the staff, allowing them to focus on aiding that patient, but still allowing other patients to check themselves in. This will eliminate the bottleneck that exists now.

The self check-in kiosks will expedite the initial checkin process for patients and eliminate the bottleneck that occurs now at the first point of check-in.

SOLUTIONS

CARE CARD

Once the patient has used the self checkin system they will be called to a cubicle where a

staff member will verify the patientâ&#x20AC;&#x2122;s information and provide them with a color-coded wristband and care card.

The care card will combine all of the cards currently being used into one. It will list all of the service areas and services being provided in each area. Based on feedback from staff and patients it was important to include the services that are provided in each area to reduce confusion. We also included a place to write in the name of the staff member that is located in each area to help guide the patients to know who they need to check-in with. This will eliminate the problem of patients not checking in properly once they reach the service area.

Based on feedback, we included a map to help guide the patient to the correct service area. The color on the wristband, care card, map and way-finding will all correlate to the service area, helping to connect care.

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The front side of the Care Card will include services listed in each area; the back side of the card is a map.

SOLUTIONS Staff:

Thanks for your patience and confirming all of your information with us.

Staff:

Patient: No problem. Staff:

Please give me your hand, Iâ&#x20AC;&#x2122;ll put this wristband on for you.

Patient: Okay. (Sticks out his hand)

Staff:

All the colored spots mean different areas you will visit. You will be able to see the color at each area.

And here is a care card for you. You will need to keep this card with you before you finish all of your tests today. You are having more than one test today, so I have circled all the tests you will have at each area. The color of the area matches your wrist band too. (Finger pointed to all the circles)

Patient: I see. Staff:

I also wrote down the staffâ&#x20AC;&#x2122;s name you need to check in with at each area. You will show them the card when you check in.

(Looks closer to the map)

Staff:

After having the test here, you will make a turn here to the next destination (draws another line from point A to point B)

45 Patient:

Please keep this card with you as a reminder for both staff and yourself. After you check in with your last test, the staff will take this card from you.

(Flips the card and picks up a pen) Now we are here (marks the registration area on the map). When you leave from this door, you will go here first (draws a line from registration area to destination).

Staff:

Patient: Great! Thank you! Staff:

You are all set.

Staff:

Patient: Okay.

are so many tests, which one should I do first? And where are they located?

Patient: (Takes the card and browses) Wow! There

SOLUTIONS

COLOR SYSTEM

Way-finding What we are calling the â&#x20AC;&#x153;Color Systemâ&#x20AC;?

was first introduced by IU Health North via the original card system used for patients. Our solution integrates that system further to the hospital surroundings and way-finding system to create a unified, communicative system. The extension of the system is two-fold, first into the existing signage, and secondly into floor graphics that will direct patients to the service areas.

is placed could be cut using the corresponding color in the system. Brands like Rowmark offer a variety of colored acrylic sheets perfect for both phases of the implementation. We suggest using floor graphics to lead patients from Registration to the service areas. These floor graphics could be extended further into the lobby if necessary. 3M fabricates high-traffic, anti-slip material ideal for this use called ScotchCal.

For the existing signage, there are two possibilities. First is the addition of a laser-cut acrylic piece in the corresponding color of the service area on the existing signs. To take it a step further, the acrylic backing where the type

The Color System is intended to help more selfsufficient patients find their way to the correct service areas. The staff will still play an important role in directing patients that need a little more guidance in accordance with the core maxims.

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These prototypes were created in order to demonstrate the function of the idea. If IU Health North decides to move forward, their design will be re-visited.

SOLUTIONS

Wristbands As an additional extension to the color system, we are recommending using Colored Wristbands. This solution will have a longer recognition phase for the patient. Initially the purpose may not register with the patients, but eventually it will help the patients distinguish between the types of services being provided, and the different wait times of those services. This will help the patients to understand that when other patients get called, it may be for a different service. We propose using a silicone band to match the card/ color system that will carry one of the many stickers with the barcode affixed to it. If the patient has multiple stops during their visit, stickers with the other corresponding areas may be used to prevent the patient having to carry many bands. As an initial prototype, we suggest printing color stickers that can be affixed to the current paper band in use. These same stickers could also be used in conjunction with the silicone bands.

In areas like the LAB where various services are performed (PAT, Express Diagnostic and Lab) some patients feel they are getting skipped or forgotten. The color bands will also give staff a visible cue when they come to look for a patient to look for the corresponding band/ sticker.

Wait-Time Board + TV For the Lab Waiting Area, we suggest

including a TV screen to keep patients entertained while they wait. As an added information feature for the patients, we suggest using a system that permits segmenting the screen into four parts. One is the TV feed, and the other three show queues for the service areas (Lab, PAT, and Express Diagnostics). Some patients need to coordinate pick-up by other members of the family or need to make other appointments in the same day so this system allows patients to be informed and use their time as they see best. Patients will be put into the queue system once they check in with the unit secretary upon arrival. This solution could also be implemented in the Radiology Area.

SOLUTIONS

LAB SPACE RE-DESIGN

Waiting Area We are suggesting a re-design of the Lab space to create a waiting area that

is more segmented from the hospital lobby to give patients a cozier feeling while waiting. This spatial re-design will also lessen the amount of patients that stop by the Lab check-in desk prior to visiting the Registration desk because we created a single entrance to the space. The new design separates the area into two equal spaces that could allow staff to guide patients to sit on one side or another depending on the procedure they are receiving that day. Additional seating has also been provided by using benches instead of individual chairs. Some of the benches are higher, like the current seats available in the space to allow for comfort of getting in and out of the seats for older patients. “Tech tables” have been integrated to provide patients with the possibility to entertain themselves with tablets or plug in and use the table if they brought their own tablets or computers. If patients want to sit outside because of health concerns, we have provided more bench seating around the exterior of the waiting space. There is an integrated speaker system in the exterior wall to inform patients of their turn if the patient is called and the phlebotomists receive no response from the interior waiting room.

It is currently presented as a solid wood structure following the materials used throughout the hospital design. If creating a dark space is a concern, we suggest using materials from 3-Form. This company uses a technique that allows them to press natural materials in a translucent resin panel that will still match the look and feel of the current design but will allow light to shine through keeping that bright lighting provided in the atrium.

Re-Design Highlights »» Tech

tables »» Segmented space for better temperature control/ patient guidance based on procedure »» Additional seating »» Space for hanging coats »» Single entrance »» Exterior speakers for patients to hear names being called

SOLUTIONS

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Overall space view including Tech Tables, WaitTime Board. Movable arm rests are located throughout the space on the back of the seating to be lowered if patients need support getting up or want more privacy.

Samples swatches from 3-Form Varia Ecoresin Wood palette:

CONCLUSION

SUMMARY

During our research practice we have learned about the patient’s journey, the IU Health North system, and the services offered to patients. We had the opportunity to work with wonderful staff and patients to better understand the activities, time, actors (perception), objects, goals, feelings and space that form the holistic patient waiting experience. Through analysis and synthesis of that data we were able to determine key pain points, or challenges, that both the patient and the staff face during the patient’s time at IU Health North. Our solutions were derived directly from these pain points and the data. All of our solutions relate to improving the flow of communication across the various service areas, and in turn “Connecting Care” throughout IU Health North. By having a better understanding of the patient experience, IU Health North can provide their patients with the most appropriate solutions that will truly make a difference in the patient’s visit. The “Connecting Care” solutions will create a comfortable place for patients to enjoy their stay and communicate productively with the staff while they receive services at IU Health North.

We enjoyed this collaborative, learning experience and look forward to continuing the partnership with IU Health.

APPENDIX

APPENDIX 60

DESIGN TEAM

Linjun Chen

Hsueh-Fen “Wendy” Hsu

Linjun Chen got a bachelor‘s degree in Art and Design from Beijing Normal University, in 2013. She built a visual art studio to do space design and corporate design in Beijing in 2009. She went to Baidu, Inc. to work and learn, focusing on websites and app design. Her professional experience includes graphic design, space design, and painting. She thinks design is not merely a job, but a way of life.

Wendy comes to Herron with a hybrid of communication and leadership development experience and plans to integrate her skill-set into design thinking and creative leadership. Most recently, Wendy was a learning & development provider and a facilitator at the Indianapolis Neighborhood Resource Center. She was named as one of Indianapolis’ ‘125 Leaders’ by Citizen Energy Group in 2013 for her leadership projects for community engagement.

Siying Jin

Vesta Mohebbi

Sisi was born in China, and achieved her undergraduate degree in Graphic Design at Capital Normal University. Her focus was on information visualization during her undergraduate study and she also did a lot of works outside of her major. Right after graduation, she began working at CBS Interactive China as a web interface designer. The VCD program offered a new challenge for her to view design in a higher perspective.

Vesta was born in March 1989 in Tehran, Iran. She has been active in numerous fields of art and design. Presently, one of her favorite activities is sitting by her laptop and focusing on digital painting and character design. She holds a bachelor in Industrial design from Tehran University of Art. She also passed courses to fulfill the requirements of Master of CIW (Web Design) from Tehran Institute of Technology.

Miley Phillips

Jiacheng Rong

Miley attended The Ohio State University with a degree in Nutrition and Community Health Education. After designing corporate wellness initiatives with the City of Dublin, she changed her focus to Marketing. User experience is what helped drive her creativity working in form design, developing client applications, product brochures, and installment pieces for companies such as Guggenheim Life and Annuity and State Farm.

Jack grew up in Shanghai and received his undergraduate degree in Optoelectronics Engineering from Shanghai University of Electric Power. He started to learn design at undergraduate by himself, he designed posters and magazines in the Student Union. Then he worked as a designer in Shanghai In-Vision Advertising Design Co. He participated in visual identity design, branding, package design and magazine design.

Lisa Semidey

Ed Sieferd

Lisa attended Syracuse University, where she got a Bachelor’s degree in Graphic Arts from the Newhouse School of Public Communications. Right after graduation, she began working at one of the largest advertising agencies in Puerto Rico, her hometown. She is interested in learning how Design Thinking and research can intersect with her design background to create truly innovative solutions in areas like healthcare, way-finding, experience design and product development.

A lifelong Hoosier, Ed is self-described as “livin’ off luck, coffee, hyperactivity and just enough craziness to be creative.” He was first turned on to design through volunteering at nonprofits in Richmond, Indiana where he began with layout design for web and print. He would go on to earn a BFA in Visual Communication at Ball State University. After learning about design and communication, he wanted to know more about how design can be used to facilitate people-centered solutions.

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Madison worked as an in-house graphic designer for a Fortune 500 real estate firm. After spending three years in the corporate world, Madison realized she wanted to develop her skills of communication to better utilize design thinking in business. She has had the privilege of traveling to many places around the world. Madison’s interactions with people while traveling gives her a unique perspective on collaboration that she hopes to apply to her work.

Madison Stevens

APPENDIX

RESEARCH ACTION PLAN OBJECTIVE Our partnership with IU Health North is geared towards examining and enhancing the patient waiting experience. Through our research we will be able to identify Challenges, Concerns, and Opportunities related to the waiting experience.

OUR METHODOLOGY We will be using the Simplex Creative Process to accomplish our challenge. Simplex is a creative problem solving process. Different from other problem solving processes, Simplex is a design thinking approach that helps generate ideas and creative solutions. This process consists of three stages: finding problems; developing creative solutions; and implementing your solutions. Each stages requires a different kind of creativity, and all three stages are necessary to allow creativity to work. These three stages can be divided into eight separate steps that make up the sections of the Simplex Wheel. The eight steps include problem finding, fact finding, problem defining, idea finding, evaluating and selecting, action planning, gaining acceptance, and taking action. This process provides a framework for using various tools and methods.

RESEARCH TEAM STRUCTURE

RESEARCH FOCUS AREA

For the Fact Finding stage, our group of nine graduate students will be divided into three groups of three to focus our interviews and observations on three main areas we have identified for the waiting experience:

In order to better understand the waiting experience as a whole, we are looking at the experience from two specific perspectives. We will examine three specific criteria in the problem space through the eyes of:

• Registration Waiting Area

• The Patient

• Radiology Waiting Area • Labs Waiting Area

• The Staff » Feelings » Expectations » Interactions

We have included our proposed interview guidelines later in the document.

» Feelings » Expectations » Interactions

OBJECTIVE Our partnership with IU Health North is geared towards examining and enhancing the patient waiting experience. Through our research we will be able to identify Challenges, Concerns, and Opportunities related to the waiting experience.

INTERVIEW GUIDELINE OUR METHODOLOGY

8.• Radiology What do they wait most for? Waiting Area 9. What do they wait least for?

• Labs Waiting Area

10. Do patients know the order they are waiting in? We have included our proposed interview guidelines 11. Do patients complain about waiting time? later in the document. 12. What is the busiest time of day in this area?

Actors (Perception) 13. What can you control in relation to the patients wait time and what can you not?

24. What other information on the cards would be helpful to you? 25. Do patients lose the cards? What happens then? 26. Do you need to replace the cards often?

Goal 27. Is the Card System successful? 28. Do you have a set goal that you have to meet in terms of time for serving patients?

RESEARCH FOCUS AREA

Feeling

29. How do you feel when you see a patient wait too long? 30. What time of the day do you feel tired or overwhelmed In order to better understand the waiting experience as a when working? whole, we are looking at the experience from two specific 31. What makes you feel tired (or other emotion)? perspectives. We will examine three specific criteria in 32. any space interactions with theHave problem through thepatients eyes of: triggered any strong emotions or feelings from you?

• The Patient Space » Feelings

33. »From where you sit, can you see all the patients who Expectations waiting? »are Interactions 34. Do any patients complain about the space setup? • The Staff noise, seating, set up, distribution, signage?) »(About Feelings 35. »IsExpectations everything accesible to you in your work station? » Interactions

WHAT COULD BE... Activity

15. What percent of the patients are easy to interact with?

36. Do you think there are too many touch points for the patients before they see their doctor? How would you improve this?

16. Do you adjust turns if the patients are elderly, mom with small child?

Actors (Perception)

14. How do you deal with anxious patients?

17. What do enjoy about your work? 18. Do patients get lost on their way to the lab? 19. Do patients know this is the lab? 20. What do you see patients doing while they wait in this space?

entries affect waitour times? Forthese the Fact Finding stage, group of nine graduate students will be divided into three groups of three to Time ourlong interviews and observations onlongest three main 6.focus How is the quickest test and the test? areas we have identified for the waiting experience: 7. What is the typical wait time for patients in this waiting area? Waiting Area • Registration

23. How does the card system work?

37. What do you wish you could control that you can’t control now?

RESEARCH TEAM 5.STRUCTURE What entries must you make in the system? How do

Object

4. If a patient leaves this area for a few minutes and he missed you calling him, what would exactly happen to his turn?

22. Does anybody help you at the busy time of day?

Object 38. Are there any tools you don’t have right now that you think could improve your work process?

you arrange the schedule between patients with appointments and without appointments?

21. Have any patients come in asking if this is the coffee shop?

We Staff will be using theat Simplex Creative Process to The memebers each area have direct contact accomplish our challenge. Simplex is a creative problem with the patients and facilitate the process for them, so solving Different from otherdirectly problemrelated solvingto they are process. key to getting some insights processes, a design thinking approach that the patientsSimplex waiting is experience. helps generate ideas and creative solutions. This process consists of three stages: finding problems; developing STAFF: creative solutions; and implementing your solutions. WHAT IS... Each stages requires a different kind of creativity, and all three stages are necessary to allow creativity to work. Activity 1.These What arestages the typical people come three can betests divided into eightfor? separate thatare make the tasks sections Simplex Wheel. 2.steps What theup exact youofdothe since a patient comes Thetoeight problemuntil finding, fact finding, yoursteps desk?include (The process you notify the patient problem finding, selecting, for thedefining, test) ORidea What are theevaluating steps youand go over with the action planning, and taking action. patient beforegaining they sitacceptance, down to wait? process a frameworkfor fortheir usingtest various 3.This Do peopleprovides make appointments or you tools doand the methods. test without appointments too? If so how do

APPENDIX

INTERVIEW GUIDELINE The patients are central to this study. By speaking with them we can gather insights directly from the source. We will try and be respectful of the patients’ time and space and only engage those that are willing to participate.

PATIENT: WHAT IS... Is this your first time at IU North? If YES… Activity 1.

What area did you visit before coming to ____ section?

Time 17. Do you notice a difference in your wait time from visit to visit? 18. How do your visits affect your normal routine? 19. Where do you feel you wait more, here or Registration?

Actors (Perception)

Time

20. Have you ever faced problem in hearing the clerk calling your name? What are some other communication challenges you’ve faced?

3. How long have you been waiting in this area since you gave your test documents to the attendant?

21. What is the main reason you return to this hospital to do this service?

4. Where do you feel you waited more, in the Registration area or here (any other stops before getting here)?

22. How was your interaction with the staff?

2. How have you spent your waiting time so far?

5. How does this appointment affect your normal routine?

23. Have you talked with others in the area today? If yes, can you describe your conversations?

6. Did anyone in the registration area tell you how long your wait would be?

Object

Actors (Perception) 7.

Have you talked with others in the area today? If yes, can you describe your conversations?

8. How was your interaction with the staff?

24. What information would you like to know while waiting?

Feeling 25. How do you feel during your waiting experience?

Object

26. How do you feel about waiting at registration area compared with waiting here?

9. What information would you like to know while waiting?

Space

10. Would knowing your spot in the queue make your waiting experience better?

28. Do you feel comfortable in this area?

27. How do you feel about this waiting area?

Feeling

WHAT COULD BE...

11. How do you feel during your waiting experience?

Activity

Space

29. What would be valuable for you during your waiting time here?

12. Did you find this area easily? 13. How do you feel about this waiting area? 14. Do you feel comfortable in this area?

Is this your first time at IU North? If NO… Activity 15. What area did you visit before coming to the Lab section? 16. What have you done during your waiting experience in previous visits? Is that different from today?

30. What are some activities you do while waiting in other places?

Goal 31. Was there anything about this visit that you wished you would have known before coming today? 32. Do you have any other suggestions to improve the waiting experience?

Space 33. Would you want to change anything in this waiting area?

65 Time

Time

Actors (Perception)

Object

Goal

Feeling

Space

WHAT COULD BE...

Activity

Time

Actors (Perception)

Object

Goal

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ZOOM IN DESCRIPTION

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Specific to Users

System Level / Overall

“Look carefully at what people are using and doing. You may find that certain elements of a product, service, or experience are especially ripe for a redesign, elimination, or upgrade.”

“Look beyond your existing set of products, services, and experiences to consider a broader swath of possibilities. Identify a broad range of variables and then choose some to emphasize as you imagine possible solutions.”

- Bryan Richards, Adjunct Instructor at IUPUI

Activity

ZOOM OUT WHAT IS...

ZOOM IN WHAT IS...

OBSERVATION GUIDELINE

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