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Experience Design A Framework for Patient Care presented by Art Frohwerk Clearpath, LLC in collaboration w/ Quantum at Meeting of the Minds Toronto June.

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Presentation on theme: "Experience Design A Framework for Patient Care presented by Art Frohwerk Clearpath, LLC in collaboration w/ Quantum at Meeting of the Minds Toronto June."— Presentation transcript:

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2 Experience Design A Framework for Patient Care presented by Art Frohwerk Clearpath, LLC in collaboration w/ Quantum at Meeting of the Minds Toronto June 23, 2010

3 Useful Tools & Systems Transformational Strategies Creating Meaningful Stories Relevant Processes Comfortable Places Engaging People Its About Connections ! Appropriate Measures Challenging Vision

4 Context …a whole system approach The Environment of Trends & Opportunities Roadmap to sequence Implementati on Experience Design Principles Strategy Management System Strategic Purpose & Commitment Vision, Mission, Values Strategic Imperatives Culture Design based on Values Influencing People Governance & Policies Experience Design Framework

5 Big Picture Framework Storyboard Fundamentals

6 Master Process to orchestrate The Organizations Way to best do business

7 Desired Outcomes Core Process Master Process to orchestrate The Organizations Way to best do business Info. & Support Processes Inputs Opportunities Roles Moments of Truth Support Systems Measures

8 Community-scale Master Process

9 Master Process connecting the parts àCore Process Customer-focused value chain àSupport, Relationship, & Information Processes Integrated with Core àSystems Tools, Places leverage human factors and processes àMoments of Truth Proactive: shows we care, makes efficient, avoids waste vs. reactive àDesired Outcomes and Inputs Driven-by and linked-to strategy, environmental reality àRoles Show how each person contributes and recognizes personal styles àMeasures Measure new things, esp. soft Balanced scorecard – lead, lag

10 Storyboard to understand & design the Stories

11 IntroductionRegistrationService EncounterDischargePost-Discharge ArriveRegisterTreatLabDispositionCheck-out Storyboard to understand & design the Stories Chapter / Scene Stage Patient Needs Our Intent Impressions Physical Elements Behaviors Mechanisms Check-inEducateRoomTherapyFollow-upPlan

12 Experience Design STORYBOARD Hospital System ON-STAGE MECHANISMS CHAPTER SCENE Recovery Area Plan. & Coord. Home, Work, Hospital (They call us or we call them.) Check-in Pre-op Holding Business Follow-up Home or Work Check-out Exit Route RegistrationService EncounterDischargePost DischargeIntroduction Behavior Physical Cues Intent Process People Tools Place Know who I am, have my info : Know & contact my key contacts, my Physician, the plan. Information/ logistics needed to prepare : Learn date, time, when/where, parking, arrival. Pre-admission testing? What to bring. Length of stay. Know where Family goes. Impact on Family. What should I do with my usual medication routine? Confirm schedule, timing, what to bring. Answer last-minute questions. What I should bring : How much to pay, when. Insurance coverage. Pre-register info. Define team : Select Physician. Team coordinated? Role of Family? Comfort of Interaction : Easy of access. Empathy. Save time. Find way easily : Get to ER when ER needed. Travel, find, park. Physically able to get inside. Surface parking close to the entrance for high-priority Patients – wound care, handicapped, D&T Know where my Family, friends go and how to contact them. Security of hospital. Know who I am. Treated as an individual. Dont get lost, delayed. Aleve worries. No unexpected waits, distractions, embarrassment. Sense that people, info. is well- coordinated. Attentiveness : Responsive. Staff is coordinated with Physicians, Nurses, other Staff. Learn and Explain progress. Expected changes. Keep me informed about my baby, the purpose of his/her tests, & how he/she is doing. Comfort, Safety : No distractions, embarrassment, pain. Care & Competence show empathy, explain. Personalized – Access to my medical record. Explain next steps. Estimate when I can leave, what I will have, need. When there is a death, how do I handle it? What are all the details? Who do I call? When am I leaving today? Physicians coordinated & timely. Comfort, Safety : No unexpected waits, distractions, embarrassment, pain. May I talk with a Chaplain? Ready to go. Ask final questions. Anything else Seton can do? Provide what I will need. Escort : Offer how to get there. Assure who to talk to, who will know me. Get needed materials. Understand when I will get my bill and who to call if I have questions. How many bills will I get & from who? Comfort, Safety : No unexpected waits, distractions, embarrassment, pain. Do I understand what I need to continue & complete the healing process? Am I confident to heal – mind, body, spirit? What should I do if I have a problem? a question? Who to call? Am I going to be able to control my pain? How? Describe how to get around, who takes care of dependents. When am I ready to go? Coordinate with others and get what I need – meds, equip, helpers, instructions, Family. Am I really OK to go to next level of care? Learn what will happen next – on my own. Understand instructions. Cant read or interpret (Post acute care big need work being done w/ unfunded Patients). What do I do if I lost info or instructions? What to do if deviation? Who to call? Supplies available & understood. Manage meds. Not forgotten. Called, gave contact info. Is it working? Anything needed? How do I feel? Follow-up call if needed. What will I get? Understand my bill. Arrive Entrance: Parking or Curb Check-in, Register Desk: Main, Womens, ED, Patient floor (after Main) Lab Endo, Cath, Pulmo. Func, Echovascular Labs (short duration) ED ER OR Suite / Day Surgery Sleep LabOut PatientImaging (In-Patient, Out-Pt, Day Surgery) Educate Patient Room Discharge Disposition Patient Room Clinical Follow-up Home or Work Experience Follow-up Home or Work Rehab / Diagnosis & Therapy Patient RoomC SectionNursery NICU Transitions / Hand-offs Hallways Know who I am: Be confidential. Treated as individual. Personalized. Know who I am : Be confidential. Treated as individual. Personalized – Access to my information. How was the experience? Listen and clarify. What are the details? Not forgotten. Called, gave contact info. Anything needed? How do I feel? Follow-up call if needed. Labor & Delivery The Phase Activity or Purpose on a given Stage (place) Info. Exchange Outside the Hospital (Call, Internet, Physician, Media, Friends) Info. Exchange In the Hospital Experiential Bundles: Scene-specific procedures and behaviors, using predetermined tools, in a given place (Stage), carried-out by specific roles to create an intended experience. Grounds : Valet Parking Golf Cart (Shuttle) Safety Code Blue Stations In Parking Lot Covered Entrance Water Feature Strategically Placed Benches – Parking Lot, To Entrance Inner Courtyard Labyrinth Treatment Areas: Sub Waiting Areas With Comfortable And Bariatric Seating Consultation Rooms For Private Conversations With Physician/Healthcare Team Lobby And Public Areas: Water Feature Simplistic, Intuitive Layout Of Public Areas Wayfinding Strategies (Universal Signage, Central Admitting/Registration) Chapel And Meditation Room Learning Center Use Of Natural Design Elements (Wood Accents, Stonework) Comfortable And Bariatric Seating Player Piano And Coffee Bar In Lobby Wireless Internet Access Room Service With High Quality Foods (Self Regulated Diet) Concierge Service Staff Experience Design Elements: Tranquility Rooms Team Rooms Dual Clean/Dirty Utility Rooms Provision Of Linen In Each Room Dedicated Staff Entrance Comfortable Break Rooms Experience Immersion During Orientation And Beyond Innovation / Improvement process Time In Motion Strategies Dual Omnicells Provision Of Routine Equipment In Each Room (E.G. NIBP, Lift Equip) Concierge Service Physician Design Elements: Covered Parking Parking Additionally Located Adjacent To ED Comfortable Physician Lounge With Amenities (Off Courtyard) Child Care Onsite MOB With Covered Walkway Inpatient Rooms: Daybeds For Family In Med/Surg And ICU Recessed Rooms From Hallway Double (Double Size Or Two Beds?) Day Beds For Family In Post- partum Interactive TV (Includes Many Options) Larger Rooms For Family Space Additional Storage Space For Patient/Family Valuables Lift Equipment Re-transcribe typed prescriptions resulting in disastrous errors. Didnt attempt to validate correctness. Could not alter permissions form to indicate no student Physicians. Need to know what to eat/not to eat before surgery … Connecting not easy- played phone tag …………………… Place and way to indicate special information. Overheard concerns. Discomfort; Wait; Charging to park; we're the only hospital that does that Large useful signs. Helpful person along the way. Easy parking; Roving volunteers give attention (even at night). Cluttered spaces. Distracting; Disconnected; Shadows; Glare; Confusing layout Noise: loud TV, distractions, food channel; Muffled; Cold. Hard; Too Hot; Too Cold; Drafty. Free-for-all, individualistic; Disconnected: no one sees you sitting; Confusing; Wait; Wonder. Left me to 'chase things down; Complained about problems; Distracted: Told to 'sit (when it hurt); Waited w/o explanation. Acted bored; No rush in ED – treated as routine. Machines looked cold. Cold x-ray; Hard surface; "It hurts" Surprise; Told "no problem" when there was. Rude - acted like no 'big deal' not open after. 25 min before evaluated. Too busy; Don't notice; "Never a Triage Nurse. No rush – routine, Wonder; Bad measurement Noise: loud and crowded; Cold room; More blankets Long wait before surgery Didnt pay attention to patient info. provided No one owning bad behavior. "Nothing we can do until Monday" Exposed in gown -need more privacy No accommodations for family members. Machines looked cold and hard. Cold x- ray; Hard surface; "It hurts" Phys therapist telling patient how they should feel about wearing robe. No clear indication of when patient would be in room. Trash cans too full, housekeeping not coming around. Interior courtyards not all that pleasant to look at. TV remotes don't work. Pharmacy not on site. No beds for family to sleep No privacy in gown Plastic charts on metal racks make a lot of noise. Unappetizing food - wretched. Uncomfortable chairs Room type, furniture No accommodations for family members. When JCAHO was here, did not see anyone for a long time - they took priority Family wait for patient to arrive in room, not know when. Improper fit: bandage, sling. Ortho told me to get films- "I have to drive around!" Memorabilia & ceremony is important!! Post name of care giver. Deal w/ all kinds of calls, bills, advice, etc. because Hospital could not work with three insurance coverage's to resolve payment. Lab work billed incorrectly because Dr. doesn't provide proper insurance info Build Partner relationships-Outpatient Hall Monitors; Online Experience Providers; Fire Departments; Churches, Community Groups; Walgreens-In house; Food Delivery; Alternative Medicine; Health Club, 24 Hour Fitness; Wal- Mart-Diapers; Pet- Care; Support Groups; Spa, Massage to Patients Room; Education; Techno. support - outside of Hospital Cost Estimate Need: Friendly, understanding, listen & follow-up. Info ready; No financial pressure; Flexible if info not available. Immediately ready (initiation);<5 min. effort; Immediately go to next steps Routine but engaged w/ present person & situation. Responsive. Fresh air. Live plants. Seek guidance : Discuss symptoms, potential need, Physician options, second opinion. Learn : Whats available? Whats the process? How long it takes? Info. needed to provide. Check on info : My pre-registration, schedule. Directions to hospital & where to park. Physician background. My financial responsibility : Understand what will be covered by insurance (In? Out?) Comfort of interaction : Manage fear, grief, denial, anger, depression, acceptance. Courtesy, efficient, competent, empowered. Welcoming, calming : Treated well. Aleve fears/worries. Courteous prepayment process. Ready : for my arrival. Know who I am, why Im here. Coordinate care/info./Physician. Accurate data & verification. Remember me from previous visits – esp. repetitive lab, therapy, wound care. Avoid long waits, repetition Use what I brought. Understand : what Im signing. Remind me where to go. Easy way-finding, understand process & flow. Estimate length of stay (physician at PreAdmit) & cost. Sense Competence of Staff. Aleve worries. Trust other to make decision for me when I cant. Safety See/ talk with my Physician. Be checked-on. Get an explanation of the procedure. No unexpected waits, distractions, embarrassment. Sense that people are competent & well-coordinated. Know who I am : Be confidential. Treated as individual. Comfort & Aleve worries. Answer questions. Be checked- on. Keep me warm & comfortable. Safety Coordinated with my Physician. Sense that people are competent & well-coordinated. Let me know what to expect. No unexpected waits, distractions, embarrassment. When will my results be available to my Physician and when will I hear about them? Learn how I am doing. Know how long it will take. Explain progress. Expected feelings. Explain purpose of what is going on. Know who is coming to see me. Provide secondary diagnosis (e.g. Diabetes diagnosis in hospital). Provide diagnosis-specific process / flow (e.g. Cancer). Physicians are coordinated with other Physicians, Nurses, Staff, etc. Describe medications/therapies needed, available. Goals expected. Comfort : No unexpected waits, distractions, embarrassment, pain. How can this be easier on my family? Acknowledge the uncertainty & discuss how to ask questions. Who do we contact if there is a question? who is on-call? Know who I am : Be confidential. Treated as individual. Personalized Physicians are coordinated with other Physicians, Nurses, Staff, etc. Learn how I am doing. Explain progress. Expected feelings. Describe medications/therapies needed, available. Comfort, Safety : No unexpected waits, distractions, embarrassment, pain. Care show empathy, explain. Not forgotten. Let me know what I should expect. Someone is connected to me. Theyve focused on me. Attentive. Responsive. Assess my condition. Verify history. Get ready for treatment. Learn what happens. Care to listen, show empathy, discuss, explain. Not forgotten. Attentive. Responsive. Courteous. Comfort & safety. How can I keep from catching something? What do I do if Im hungry, thirsty, cold, etc.? How do you maintain cleanliness? Get treated. Someone is connected to me. Theyve focused on me. Attentive. Responsive. Learn what it feels like. Know when we will start. Why am I not the priority? What is the system to keep me informed about my wait time (i.e. Now calling number X…)? How will I communicate (bilingual, multicultural, hearing impaired)?

13 Fundamentals of Experience Design àBe Relevant àEngage àFlow àAdapt

14 Fundamentals of Design: Be Relevant Include the soft with the hard: –Understand Patients needs & expectations vs. Our intent –Close the gap q Seek to understand each Patient & Family member as if standing in their shoes q Anticipate & act on the needs & concerns of each Patient & Family member, if possible, before they are voiced. Photo: Seton Family of Hospitals

15 Fundamentals of Design: Engage Trigger: –Impressions Concepts Symbols –Physical elements The five senses Memorabilia –Behaviors What Who Where When q Use the 3 key mechanisms to deliver the experience: - People - Tools - Places q Address positive & negative cues & the 5 senses that form impressions q Recognize what should be on-stage & when things should be off- stage.

16 Fundamentals of Design: Flow Build meaningful stories: –Chapter –Scene –Stage –Transitions q Connect the Patient & their Care Team to the next: - Procedure - Service - Time - Place …so that the Patient never becomes lost & we never drop the ball in any hand-off. q Work as a Healing Team by sharing & accepting, modeling leadership, & living the 4 Cs: - Communication - Collaboration - Caring - Cooperation.

17 Fundamental: Adapt Learn whats important in the Story: –Understand –Discuss & Plan –Try –Report q Experiment q Be opportunistic q Pilot q Share learning q Innovate q Constantly improve.

18 Context …a whole system approach The Environment of Trends & Opportunities Roadmap to sequence Implementati on Experience Design Principles Strategy Management System Strategic Purpose & Commitment Vision, Mission, Values Strategic Imperatives Culture Design based on Values Influencing People Governance & Policies Fundament als Storyboard Master Process

19 Principles New Paradigms for implementing Experience Design 1.Bring the Strategy out and alive 2.Get good at Connecting 3.Engage the Soft with the Hard 4.Build meaningful Stories 5.Learn whats important in the Story 6.Adapt the role of leadership –Bring clarity and focus to vision, values –Build self-confidence –Coach and reinforce –Have faith.

20 Discussion Experience Design: A Framework for Patient Care Photo: Seton Family of Hospitals

21 Experience Design: A Framework for Patient Care Storyboard q Chapter q Scene q Stage q Transitions Master Process q Moments of Truth q Core Process q Support & Information Processes q Systems & Tools q Desired Outcomes & Inputs q Roles q Measures Fundamentals q Be Relevant q Engage q Flow q Adapt


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