Challenge    I have recently been inves2ga2ng the processes involved in my workﬂow in an outpa2ent

healthcare se;ng. Some2mes the appointment schedule does not run on its expected 2meline due to  spending more 2me with a pa2ent: either because of the complexity of a pa2ent’s care, the 2me taken  to communicate, or other limi2ng factors. In other cases, the schedule gets behind because of the  variable check-in 2mes of pa2ents: late check-ins leading to a later start, and thus later ﬁnishing 2mes  for their appointments. I wanted to look into the factors that lead to late check-in 2mes and see if there  were any solu2ons for this aspect within our current system.

Selec2on    I selected the visualiza2on tool, as I wanted to start tackling this problem from the beginning in

the design thinking process. I hoped this may help me think a liFle more crea2vely at the onset of this  process. This visualiza2on could help me think from a pa2ent-centered perspec2ve: what was involved in  their journey to the arrival to their appointment.

Applica2on    I drew a ﬂow chart from a pa2ent’s perspec2ve including the steps involved from ini2al

no2ﬁca2on of the appointment to being called to the exam room (see ﬁgure 1). The process starts with  an appointment postcard usually sent two weeks before the appointment and then moves on to involve  driving 2me and traﬃc, ﬁnding a parking spot, wai2ng in line to check in, and taking a seat in the wai2ng  room. Wri2ng out these steps is one way to describe the experience, but the diagram and drawings  helped magnify how some of these steps can be stressful to someone experiencing them. Visualizing this  process also demonstrated how, when one of these steps takes extra 2me, all the other downstream  steps are delayed. I also think that by using visualiza2on, I was more aware of small details that are a  part of this journey; now, each step can be given aFen2on when seeking solu2ons to the challenge.

Insight    Moving through this journey using the ﬂow chart allowed me to see that there are mul2ple

points within this 2meline that could cause the pa2ent to arrive later than the appointment 2me  scheduled. Not only that, but drawing some of these images helps to express that these situa2ons may  be frustra2ng for the pa2ent to experience. Visualizing the challenge this way allowed me to pause and  to brainstorm the factors that are involved in the end result.

Approach    Evalua2ng the factors involved in the journey to arrive to an appointment by visualizing the

concept of the problem as I did in this exercise certainly helped me to have empathy for the pa2ent  experience. Someone’s late arrival may be due to factors beyond their control. They may arrive to the  appointment already frustrated by their earlier journey. The visualiza2on technique used at the start of  this process could be elaborated upon in a later step of the design thinking process in the mind mapping  steps. Then, stakeholders like pa2ents and members of the healthcare team could contribute their  insights and experiences. Adding others’ opinions to this process would add depth in the process of  thinking about possible solu2ons: how some of these more stressful or 2me-consuming steps might be  streamlined, or somehow accounted for elsewhere in the adjustment of the clinical schedule.

Figure 1. Visualiza2on of pa2ent journey to appointment check-in

