L6 handout maher mc carthy are you ready for this

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This is Learning Lab L6 "Design your way to better service" from the Institute for Healthcare Improvement (USA) 25th Annual National Forum on Quality Improvement in Health Care. The workshop, which took place on 8th December 2013 was led by Lynne Maher, Director of Innovation at Ko Awatea, New Zealand and Chris McCarthy, Director of the Innovation Learning Network, Kaiser Permanente. Design methods bring critical new insights and understanding about services and enhance our potential to transform services

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L6 handout maher mc carthy are you ready for this

  1. 1. 12/8/13   Design your way to Innovation Better Services! Skill Building! Are you ready for this? ! (Yes. These slides are slightly different than those you downloaded.)! © 2012 Kaiser Permanente / 2! 1  
  2. 2. 12/8/13   $50.6B operating revenue! 9.1 million members (patients)! 174,000 employees! 16,000 physicians! 600+ medical offices! 38 hospitals! ! ! ! •    ! ! ! ! 3 Chris! Process, IT! Melissa! Interaction Design! Mary! Industrial Design! Scott! Service, Clinic Admin! Mike! Brand Strategy! Nicole! Office Mgmt! Laura! Design Research! Dana! Design Research! Katherine! Architecture! Christi! RN, Hosp Admin! innovation consultancy 2  
  3. 3. 12/8/13   Introducing: Chris McCarthy! Ko Awatea- ʻDawning of the first lightʼ! Sits within the Middlemore Hospital ! Complex and Counties Manukau Health ! System in Auckland ! Comprises –! • Workforce and Leadership Capability! • Quality Improvement and Innovation! • Research, Knowledge and Information Management! • Joint Venture Partnership with The University of Auckland, Manukau Institute of Technology and Auckland University of Technology! ! 3  
  4. 4. 12/8/13   Introducing: Lynne Maher ! Life in health services sometimes it feels like this…! Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.”! " ! A A Milne! ! 8 4  
  5. 5. 12/8/13   Insanity: doing the same thing over & over again and expecting different results. - Albert Einstein © 2012 Kaiser Permanente / 9! How can Design help?
 ! Design- A creative method of problem solving.! It helps individuals and teams to break away from traditional mindsets and think in a fresh, creative way about developing solutions for better health and social care.! ! ! ! 5  
  6. 6. 12/8/13   How do Design methods help? ! Design methodology focuses on really understanding the problem! ! It provides very useful tools and approaches for example;! Ethnography/including observation, deep conversations, listening, enquiring, videoing, mapping, idea generation, simulation, prototyping, testing, reviewing, implementing! @LynneMaher1   Pink and fluffy?! 6  
  7. 7. 12/8/13   Focused and effective………..! Identify the challenge- including baseline data! Review insights and synthesize learning! Generate new ideas and develop concepts! Prototype/ Simulate and refine! Define measures! Test and design implementation! Review! ! There are many slightly different versions of this type of ! structure which have been adapted to suit a local context! Ideo Innovation Process! 7  
  8. 8. 12/8/13   Jeffrey Baumgartner! Artist and ! innovator! Mayo Clinic Design Process! 8  
  9. 9. 12/8/13   ! ! Kaiser Innovation Consultancy ! Understand   Look  for  pa0erns   Ideate   Prototype   Get  feedback   Pilot  &  measure   Innovation is typically the result of a structured process…! Of course it is really more like this...! @LynneMaher1   9  
  10. 10. 12/8/13   What is the problem with giving meds in the hospital?! Case Study - KP MedRite! Nothing, we work hard and get it done. 10  
  11. 11. 12/8/13   Case Study - KP MedRite! 21! Case Study - KP MedRite! 11  
  12. 12. 12/8/13   Case Study - KP MedRite! 1! 2! 3! 1! 23! 4! ✴  No Interruption Sash! ✴  Sacred Zone! ✴  Standardized Process! 23   Nurses  love  it.   Doctors  understand  it.   Pa@ents  appreciate  it.   Family  members  are  relieved  by  it.   Joint  Commission  says  “Good  Prac@ce”     Harvard  Business  Review,  Wall  Street   Journal,  New  York  Times...  Yep!   Pilot  hospitals  are  repor@ng  30  –  60%   reduc@on  in  medica@on  errors.     105%  ROI  in  first  two  years.   12  
  13. 13. 12/8/13   What is the problem with meds at home?! Working with very high intensity users ! 20,000  days   13  
  14. 14. 12/8/13   Readmission-­‐  Agnes  and  Two  Blue  Pills   20,000  days   © 2012 Kaiser Permanente / 27! ! “When developing new products, processes or even businesses most companies are not sufficiently rigorous in defining the problems they are attempting to solve”! ! Spradlin (2012) Harvard Business Review! 14  
  15. 15. 12/8/13   “If I had an hour to save the world, I would spend 59 minutes defining the problem ! and one minute finding solutions”! ! Albert Einstein ! ! 3 Ways we often work ! 1.  Don’t listen very much to our users and we do the !! designing 2. Listen to our users then go off and do the designing 3. Listen to our users and then go off with them to do the designing (Professor Paul Bate 2007) © NHS Institute for Innovation and Improvement 2009 15  
  16. 16. 12/8/13   Learning from Designers! The components of good design! Performance! + Engineering! How well it does the job /is fit for the purpose! How safe, well engineered and reliable it is! Functionality! Safety! + The aesthetics of experience! How the whole interaction with the product/service ʻfeelsʼ/is experienced! Usability! Berkun, 2004 adapted by Bate ! Insights from patients and carers and staff help to design services that better meets the needs of people! 16  
  17. 17. 12/8/13   We need to start with ourselves! “Creative thinking involves breaking out of established patterns (valleys) in order to look at things in a different way.” Edward de Bono The best innovators arenʼt lone geniuses. ! Theyʼre people who can take an idea thatʼs obvious in one context and apply it in not-so-obvious ways to a different context.! ! Harvard Business Review 17  
  18. 18. 12/8/13   This workshop Overview! © 2012 Kaiser Permanente / 35! What you will learn today:! Draw your experience! Writing “How Might We” Questions! Storyboarding! Interview! Fly on the wall! Brainstorming! Video Enactment! Rapid Prototyping! ! © 2012 Kaiser Permanente / 36! 18  
  19. 19. 12/8/13   This workshop…! What this is NOT…. What this is…. A complete soup to nuts training on how to be a designer, ethnographer, or facilitator! An initial introduction to design thinking concepts and techniques! ! An opportunity to try out some practical tools! © 2012 Kaiser Permanente / 37! Understand the Environment! 19  
  20. 20. 12/8/13   © 2012 Kaiser Permanente, Innovation Consultancy! © 2012 Kaiser Permanent / 39! © 2012 Kaiser Permanente / 40! 20  
  21. 21. 12/8/13   Out-of-Context! Cultural 
 Probes! Analogous ! Observations! Trend! Analysis! Fresh 
 Eyes! Secondary! Research! Traditional! Non-Traditional! Grand ! Tour! Draw Your! Experience! Interviewing! Video-! graphy! Fly on! the Wall ! Storytelling! Sessions! Immersion! Sacrificial 
 Concepts! In-Context! 41! Empathize to discover.! 21  
  22. 22. 12/8/13   Look for human factors.! Today’s Challenge You are an executive in a major airline. Youʼve been hearing more and more from the newspapers, TV and your own customer surveys that both business travelers and families are frustrated with the experience of flying with children.! The Problem Statement (for today) You, the airline executive, pose the following challenge to your team: ! Letʼs improve the experience of flying with children within one year. ! © 2012 Kaiser Permanente / 44! 22  
  23. 23. 12/8/13   Out-of-Context! Cultural 
 Probes! Analogous ! Observations! Trend! Analysis! Fresh 
 Eyes! Secondary! Research! Traditional! Non-Traditional! Grand ! Tour! Draw Your! Experience! Interviewing! Video storytelling! Fly on! the Wall ! Storytelling! Sessions! Immersion! Sacrificial 
 Concepts! In-Context! 45! WHAT IS DRAW YOUR EXPERIENCE?! Ask participants to visualize an experience through drawings and diagrams. Then, dedicate time to debriefing the drawing with the participant. ! © 2012 Kaiser Permanente / 46! 23  
  24. 24. 12/8/13   Your turn! ! Think for a moment about your worst/best plane trip. What images pop in your mind? What colors come to mind?! ! Grab a piece a paper draw and draw!! ! © 2012 Kaiser Permanente / 47! Your turn! ! Pair up, and debrief each other about the drawings. Dig Deep!! ! What do the symbols mean? Why those colors?! ! © 2012 Kaiser Permanente / 48! 24  
  25. 25. 12/8/13   Out-of-Context! Cultural 
 Probes! Analogous ! Observations! Trend! Analysis! Fresh 
 Eyes! Secondary! Research! Traditional! Non-Traditional! Grand ! Tour! Draw Your! Experience! Interviewing! Video storytelling! Fly on! the Wall ! Storytelling! Sessions! Immersion! Sacrificial 
 Concepts! In-Context! 49! Question types! Naïve Outsider Perspective 
 “Iʼm not a nurse, tell me about this 
 medication thing”.! Peer Comparison 
 “Do other clinicians handle situations 
 this way, or differently?”! Quantity 
 “How many of your colleagues fall 
 into that category?”! Projection 
 “What do you think would happen if…”! Changes Over Time 
 “How are things different than they 
 were a year ago?”! Sequence 
 “Walk me through a typical day…”
 
 Native Language 
 “Why do you call this room ʻthe war roomʼ?”! Clarification 
 “…and when you say ʻthe principals will 
 eat you alive,ʼ what do you mean exactly?”! ! Specific Examples — 
 “Let's take yesterday for example, 
 which meetings did you attend?”! ! © 2012 Kaiser Permanente / 50! 25  
  26. 26. 12/8/13   Video ! © 2012 Kaiser Permanente / 51! Choose one! Naïve Outsider Perspective 
 “Iʼm not a nurse, tell me about this 
 medication thing”.! Peer Comparison 
 “Do other clinicians handle situations 
 this way, or differently?”! Quantity 
 “How many of your colleagues fall 
 into that category?”! Projection 
 “What do you think would happen if…”! Changes Over Time 
 “How are things different than they 
 were a year ago?”! Sequence 
 “Walk me through a typical day…”
 
 Native Language 
 “Why do you call this room ʻthe war roomʼ?”! Clarification 
 “…and when you say ʻthe principals will 
 eat you alive,ʼ what do you mean exactly?”! ! Specific Examples — 
 “Let's take yesterday for example, 
 which meetings did you attend?”! ! © 2012 Kaiser Permanente / 52! 26  
  27. 27. 12/8/13   Your turn! ! Pick a new partner. Using your assigned question type, interview your partner about their drawing.! ! Switch after 3 minutes.! ! © 2012 Kaiser Permanente / 53! Out-of-Context! Cultural 
 Probes! Analogous ! Observations! Trend! Analysis! Fresh 
 Eyes! Secondary! Research! Traditional! Non-Traditional! Grand ! Tour! Draw Your! Experience! Interviewing! Video storytelling! Fly on! the Wall ! Storytelling! Sessions! Immersion! Sacrificial 
 Concepts! In-Context! 54! 27  
  28. 28. 12/8/13   Video © 2012 Kaiser Permanente, Innovation Consultancy! © 2012 Kaiser Permanente / 55! Your turn! ! Each table will view the video from a different lens. ! ! Table 1: Observe Space! Table 2: Observe Tools! Table 3: Observe People! Table 4: Observe the conversation! ! © 2012 Kaiser Permanente / 56! 28  
  29. 29. 12/8/13   Video © 2012 Kaiser Permanente, Innovation Consultancy! © 2012 Kaiser Permanente / 57! Your turn! ! Whatʼd ya see? ! ! Table 1: Space! Table 2: Tools! Table 3: People! Table 4: Conversation! ! © 2012 Kaiser Permanente / 58! 29  
  30. 30. 12/8/13   Out-of-Context! Cultural 
 Probes! Analogous ! Observations! Trend! Analysis! Fresh 
 Eyes! Secondary! Research! Traditional! Non-Traditional! Grand ! Tour! Draw Your! Experience! Interviewing! Video storytelling! Fly on! the Wall ! Immersion! Storytelling! Sessions! Sacrificial 
 Concepts! In-Context! 59!                                     Additional Resources Understand Environment! © 2012 Kaiser Permanente / 60! 30  
  31. 31. 12/8/13   Imagine ! Possibilities! Tigers and Bears! ! Purpose: Getting people to come up with lots of ideas!! ! 1.  Pair up! 2.  One person choose tigers, one person choose bears.! 3.  Tigers go first- you have 1 minute to think of all the reasons Tigers are great.. “Tigers are great because…”! 4.  Your partner will tally all of the ideas you have. Go for quantity!! 5.  Repeat, with Bears! ! © 2012 Kaiser Permanente / 62! 31  
  32. 32. 12/8/13   WHAT IS BRAINSTORMING?! Brainstorming is a group creativity technique designed to generate a large number of ideas for the solution of a problem.! © 2012 Kaiser Permanente / 63! “The best way to have a good idea, is to have lots of ideas….” –Linus Pauling © 2012 Kaiser Permanente / 64! 32  
  33. 33. 12/8/13   © 2012 Kaiser Permanente / 65! “The best innovators aren’t lone geniuses. They’re people who can take an idea that’s obvious in one context and apply it in not-soobvious ways to a different context.” Harvard  Business  Review   © 2012 Kaiser Permanente / 66! 33  
  34. 34. 12/8/13   Your turn! ! “How Might We”! ! ! ! ! ! © 2012 Kaiser Permanente / 67! © 2012 Kaiser Permanente / 68! 34  
  35. 35. 12/8/13   Defer! judgment. © 2012 Kaiser Permanente / 69! Encourage! wild ideas. © 2012 Kaiser Permanente / 70! 35  
  36. 36. 12/8/13   Build on the ! ideas of others. © 2012 Kaiser Permanente / 71! Stay focused ! on the topic. © 2012 Kaiser Permanente / 72! 36  
  37. 37. 12/8/13   One conversation at a time. © 2012 Kaiser Permanente / 73! Be visual better good best © 2012 Kaiser Permanente / 74! 37  
  38. 38. 12/8/13   Your turn! ! Designate a facilitator. Brainstorm the question, “How might we enable toddlers and adults to enjoy long flights together?” ! ! Start with a silent brainstorm, then as a group brainstorm.
 ! Remember the rules!! ! ! ! ! ! © 2012 Kaiser Permanente / 75! Your turn! ! Cluster your ideas. Select 2-3 criteria to help participants focus their attention. ! ! e.g.: Can do quickly, will achieve the greatest impact in safety, will engage most staff……! ! Set your voting rules. How many voting dots (it equals the number of ideas divided by 3). Can you top load?! ! Vote!! ! ! ! ! ! © 2012 Kaiser Permanente / 76! 38  
  39. 39. 12/8/13   Prototype! Ideas! WHAT IS A PROTOTYPE?! © 2012 Kaiser Permanente / 78! 39  
  40. 40. 12/8/13   WE PROTOTYPE TO…! Fail safely, quickly, and inexpensively! To collaborate around! To allow concepts to be experienced! To get early feedback! To communicate a vision! To inspire! © 2012 Kaiser Permanente / 79! PROTOTYPE SUPPLIES! © 2012 Kaiser Permanente / 80! 40  
  41. 41. 12/8/13   Storyboards! Rapid Mock-Ups! Enactments! DONʼT OVERTHINK IT…! 10 dollars.! 10 minutes.! © 2012 Kaiser Permanente / 82! 41  
  42. 42. 12/8/13   10 min 10 min Your turn! ! ! Storyboard Prototyping 10 min Act It Out 10 min Filming © 2012 Kaiser Permanente / 83! Prototype! Ideas! 42  
  43. 43. 12/8/13   Keep in touch! KPʼs Innovation Consultancy
 Twitter: @KPInnovation
 Web: http://www.kpinnovation.org/! Chris McCarthy 
 Twitter: @McCarthyChris
 Blog: http://mccarthychris.com/! ! ! Ko Awatea
 Twitter: @KoAwatea
 Web: http://koawatea.co.nz/! Lynne Maher
 Tiwtter: @LynneMaher1! ! © 2012 Kaiser Permanente / 85! 43  

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