Design Thinking for Innovation – Assignment

Challenge & Selection

I work as a management consultant in healthcare, and a large portion of my work focuses on helping  organisations and healthcare providers identify related to the redesign of care pathways in order to  deliver financial and operational improvements as well as improving quality of care delivered and  patient experience. Early in my career, our I was taught to take a strongly analytical approach. We  would analyse activity data, look for internal variation between providers (e.g. length of stay  variation of discharged patients between doctors) and push the design and problem solving back  onto the providers to solve. While incorporating the feedback of the clinicians is and will always  been essential, it often led to combative relationships and took too long to design and implement  effective solutions based on our project timelines.

On the specific project I will be referencing, we took a different approach. We sought to use  visualisation to help redesign the patient journey through drawings, flow charts, and diagrams  developed in a collaborative manner through working sessions with members of the staff (and  patients) from all levels (from front line nurses to Executive Vice Presidents. Our goal to was  redesign the patient pathway through the internal medicine service, but changing the team  structures, escalation protocols, admission and discharge processes. This was no small undertaking  and was so multidimensional, touching the working lives of so many stakeholders, that it needed an  approach that would generate enthusiasm and buy-in in a way that allowed all members to visualise  how the future state would impact them in a positive manner.

Application

Healthcare can be tricky given the high stakes nature of making changes, and consequently, it is  imperative to get the buy-in of everyone possible in order for changes to be made in a safe and  enthusiastic manner. We used three workshops focused on various components of the patient  pathway: admission, the stay in hospital, and discharge (with overlapping components). Rather than  focusing strictly on data tables, graphs and charts, we used a highly visual approach to help every  member visualise the current state and potential future states.

We mapped out the patient journey using post-it notes, process maps for staff at all levels, diagrams  depicting relevant patient areas (e.g. the emergency department, the inpatient ward) and how they  might be restructured to achieve the ultimate goal of reducing length of stay, decreasing costs, and  improving patient experience.

Visualising it in this way helped to garner significant feedback and involvement in the sessions to  identify the pros, cons, challenges of the current state and led to great input that helped informed  the ultimate solution (that was delivered with great enthusiasm and success).

Insight and Approach

One of the key insights gleaned in the work when we visualised the processes from the perspective  of various stakeholder groups (e.g. doctors, nurses, porters, cleaners) was that everyone had a  distinct perception that was ultimately identified as a cause for communication breakdowns that are  so common in the hospital environment. By visualising everything from the patient’s journey in the  emergency department, to the process map of contacting porters to help move patients from the  emergency department to the inpatient ward we were able to achieve a resounding consensus that  would not otherwise have been achievable (in our traditional way of relying mostly on analytics and  disparate conversations).  While we ended up using analytics to help predict the impacts of the

agreed upon model on operational and financial metrics, we found visualising (and to a degree,  storytelling) a far better introduction and base on which the project was delivered. This project truly  helped convert me into a believer of design thinking. The use of visualisation to guide working  sessions allowed me and my colleagues to develop a much greater understanding of the patient and  the healthcare workers for whom this could ultimately be a matter of life and death or at the very  least drastically impact their perceptions of their stay as a patient or their professional life.

Conclusion

This project helped me to understand the power of visualisation in delivering workshops aimed at  developing new processes and pathways. I have subsequently used it to great effect in subsequent  projects and I will never go back.

