Shifting Healthcare: Moments of Mediation

patient experience
MOMENTS OF MEDIATION

moment of mediation™ | ˈmōmənt of ˌmēdēˈā sh ən |
noun
The moment of unmediated interaction between the user and
“the system”, which leaves the user feeling drained and or powerless.
e.g. The moment when the caregiver has to explain the entire medical history of the patient from memory or via a
bundle of documents to the doctor from the first incident to the current incident, including drugs given, doctors visited,
procedures done, side effects if any, leaving the caregiver stressed and exhausted worrying if she has left any critical
detail out.
e.g. The moment when the caregiver wants to create a full picture of the patient to the brusque junior doctor or nursing
staff in order to evoke empathy and better but finds herself unable to re-create it leading either to request, pleading or
an escalation.
e.g. The moment when the patient and the caregiver are distressed by the news given to them by the doctor and
without having an option to instantly get a second opinion, or counseling to work through the distressing news,
succumb to the stress.

change the script™ | ch ānj the skript |
verb
The act of envisioning the future conversation with technology
mediation, empowering the end-user and changing the outcome
in her favor
e.g. The caregiver looks up the app which gives the entire case history of her patient to the doctor, who checks
the details, call the previous doctors for confirmations and hands it back to the caregiver, satisfied.
e.g. The caregiver shows the irate doctor or nursing staff a photo log of the best moments in the patients life,
filled with vitality, evoking empathy when they see the current person who is a shadow of their former self.
e.g. The family looks up the most highly rated second opinion, calls him, or is guided to the counselor who helps
them understand the consequences of the choices before them and helps them cope.

the unexpected
HOME HOSPITAL
Symptom
Event
Emergency Care
Transit

I am at a classmate’s place in a
new city. My stomach starts
hurting, and I am in a lot of pain.
But I don’t know him or this city
too well.
Who do I talk to?
“
”
1

My friend had a splitting headache
and fell unconscious.
I need to decide which hospital to
go to.
“
”
2

My grandma has had a cardiac
arrest. My father is not here.
Which hospital do I take her to?
“
”
3

My nani just had a heart attack. I
have to pack for her. But I don’t
know for how long and what is
needed.
What should I pack?
“
”
4

My nani just had a heart attack.
I am busy arranging for her
hospital trip and the ambulance
driver calls up asking for directions
to the house.
Why can’t they take care of these
things?
“
”
5

My friend has suddenly gone
unconscious. We take him to the
nearest hospital. They say they
cannot treat him, and ask us to take
him to another hospital.
Why can’t they just take over from
here?
“
”
6

I go in for a minor accident,
expecting it to be a small thing; but
get told that I need an emergency
surgery.
How do I get it all arranged?
“
”
7

at the doctor’s
CLINIC / HOSPITAL
Waiting Treatment
Screening
Diagnosis

My wife had a fall. We went to the
hospital and they asked us to get an
X-ray. We are waiting for a really
long time, but are not getting called.
What’s wrong? Can’t they see she is
in pain?
“
”
8

I am sitting with the doctor; he
has only a few minutes. But I
have so many silly questions,
and I don’t want to impose.
How can I ask my questions?
“
”
9

I have carefully observed my
symptoms and read up about them.
But the doctor is not paying any
attention to what I am saying.
Why can’t she just hear me out?
“
”
10

My family doctor knows me since
childhood, and always treats me
accordingly.
Why can’t other doctors do the
same?
“
”
11

The doctor is careless while
handling the tongue depressor,
and hurts my 7-month-old
daughter.
Why can’t she be a little more
gentle?
“
”
12

I went in battling a severe asthma
attack. The doctor was very
brusque, and made me walk for 5
minutes to the treatment room.
Didn’t I deserve a little sympathy?
“
”
13

HOSPITAL
the big D
Diagnosis
HOME
Self inform
Understand
Decide

The doctor just recommended that
our 20-year-old daughter get a lump
in her breast removed. I am afraid
how it will affect her marriage
prospects.
Who do I talk to to know that it will
turn out fine?
“
”
14

The doctor just told us that our
8-year-old daughter needs an
appendix surgery. We really
don’t want her to go through it.
Is there any chance he is wrong?
“
”
15

I am scheduled for an eye surgery.
I look up details online and scare
myself completely.
How do I feel reassured?
“
”
16

I have read up a lot about my
condition on the Internet – both
success and horror stories.
Why can’t someone make sense
of it all for me?
“
”
17

I have been having 105 fever for
4 months. A lot of GPs have given
me a lot of medicines. But nothing
has worked.
What is wrong with me?
“
”
18

going under the knife
HOSPITAL
Surgery
Procedure
Preparation

I am in for an elbow surgery. The
nurse asks me to get my entire
body shaved and fully undress for
the surgery, as part of the standard
operating procedure. I don’t think it
is needed.
How do I double check?
“
”
19

I was put through the painful and
embarrassing rituals of surgery. I
was expected to be as passive as
possible.
How do I have a voice through it
all?
“
”
20

I have checked into hospital. I have
been rushed to the OT table, and
asked to undress in the presence
of a man.
How do I not feel ashamed?
Helpless?
“
”
21

They rushed me into the
operation theater. I just got a
hurried glimpse of my mother.
Why can’t I take a few minutes
to be with them before I enter?
“
”
22

My nani is undergoing surgery for
4 hours. I have no clue what is
happening with her.
How do I know that she is fine?
“
”
23

Tense & Intense(ive)
HOSPITAL
The ICU Caregivers outside ICU

My mother was in the ICU with
liver cirrhosis. Right till the end,
the hospital kept saying that she
will be fine. We never really knew
how serious her condition was.
Why couldn’t they just tell us what
was happening with her?
“
”
24

My mother was in the ICU for 6
days before she passed away. All I
got was the mandatory, 2 minute
robotic update by the doctor.
Why can’t they just talk to us?
“
”
25

The doctor came back and told me
‘your mum is on the ventilator’. I
didn’t realize he meant she is not
going to be back.
Why can’t someone tell me what it
means?
“
”
26

I am in the ICU after surgery. My
doctor has asked me to be back
in the room by 2 pm. But the ICU
nurse refuses to let me go.
How do I get out of here?
“
”
27

My nani is in the ICU. She tells me
that she is not being taken care of
properly. The nurse says she is
fine.
How do I ensure she feels cared
for like at home?
“
”
28

I wanted to feed my mum-in-law
in the ICU myself. The nurse
refused. She passed away soon
after.
I really really regret I couldn’t.
“
”
29

My mother was in the ICU. I asked
the hospital staff if I could go home
for a shower and change. They told
me to go…and I missed her by 10
minutes.
I wish I didn’t have to leave…
“
”
30

My father is 71 years old, and is
attending to his wife outside the
ICU. He is required to be there 24x7,
but has no place to rest and sleep.
Why doesn’t anyone think about
the caregiver?
“
”
31

panic attack
HOSPITAL
Scary Moments

It is 5 in the morning. My
mum-in-law has had a cardiac
arrest. The hospital says I need
to get blood. I am alone, its dark
and I am really scared to step out.
Who can I reach out to?
“
”
32

My mother is in a lot of pain. Her
doctor is not here until morning,
and the duty doctor doesn’t know
much about her condition.
Who should I turn to for help?
“
”
33

to do or not to do…
HOSPITAL
Moments of Uncertainty

The hospital just told me that they
will need blood, but not right now.
They will inform me when.
What am I supposed to do?
“
”
34

I am hooked to the IV. The doctor
asks me to report if I get a rash. I can
see a rash developing, but the nurse
says it is nothing.
How do I raise the alarm safely?
“
”
35

My wife developed an allergic
reaction to anesthesia and went
into coma. She is better now, and I
really want to get her operated in
another hospital. But the doctors
here are convincing me to stay.
Why can’t someone help me decide
if I should stay or go?
“
”
36

After 2 days of inducing labor, they
told me ‘we will operate on her’.
They put me in a spot where I had
no choice.
Why couldn’t they tell me the full
story earlier, so that I could take a
decision?
“
”
37

the patient routine
HOSPITAL
Inside the
hospital room

I am in for a stomach infection and
have to spend about 10-12 days here
at the hospital.
How do I pass my time in here ?
“
”
38

The doctor comes in everyday, and
takes an inventory of my bodily
functions – how I sleep, eat, poo…
Why can’t someone take an
inventory of my interests and get
to know me?
“
”
39

Every time the nurses change
shifts, they mess up my
medication dosage.
Why can’t they just get it right?
“
”
40

The nurses keep coming in and
doing a lot of tests. But they don’t
tell me about the test results unless
I ask them multiple times.
Why can’t they just keep me
informed?
“
”
41

Every time I ask the nurses about
my test results or correct their
mistakes, they feel I am intruding
and get defensive.
How do I get proper care and
information?
“
”
42

2000 miles away
HOSPITAL
Patients & Caregivers
away from home

I am in a hospital far away from
home, with my aunt attending
to me. I really want to be cared
for, but I don’t want to impose.
Who can I be a child with?
“
”
43

Our son is in the ICU. The doctors
say he is brain dead. We are far
away from home with no family
here. We don’t even understand
the language.
How do we get help?
“
”
44

Our son just passed away in the
ICU. We don’t know this city and
have no family here. We don’t
even understand the language.
How do we make arrangements?
“
”
45

losing the battle
HOSPITAL
Death at hospital

The doctor curtly told us that it is
better we don’t see our mother in
the ICU in that state. As consolation,
they told us that since she was in
coma, she didn’t feel any pain when
her heart stopped.
Why couldn’t they be a little more
sensitive?
“
”
46

We specifically asked them to make
sure my father-in-law doesn’t go
hooked to the machines. In the
rush to revive him, it was forgotten.
We just wanted him to go in peace.
“
”
47

My mother just passed away in the
hospital. My father is completely
shattered.
Is there someone who can talk to
him?
“
”
48

the paperwork
HOSPITAL
Leaving the
hospital

I am ready to be discharged, but
the hospital staff says they will
take time to prepare the reports,
discharge summary and bills.
I want to go home now!
“
”
49

They made a mistake in my
discharge certificate because of
some miscommunication
between the doctors and OT staff.
“
”
50

I am running out of time to submit
my bills for insurance claim. The
hospital didn’t send me the bills
for a long time, and now they send
me a wrong bill.
“
”
51

no cure in sight
HOME HOSPITAL
Dealing with Chronic,
Progressive, or
Terminal Conditions

My mother was unwell with liver
cirrhosis. We didn’t know how
serious her condition really was.
I wish there was someone to guide
us through the disease.
“
”
52

My father-in-law has advanced
cancer. The senior doctors are
hopeful. But the junior doctors
always come in and say he has
weeks to live.
Why are they constantly telling
us about the worst case?
“
”
53

the pillar of strength
HOME HOSPITAL
Caregiving

I am 13 years old. My mother met
with an accident. Now I have to be
the mother and care for her.
Am I the only one in such a
situation?
“
”
54

My husband just took care of his
father and now has to take care of
me. I know he is very stressed.
How do I give him a break from all
the caregiving?
“
”
55

My husband just lost his father to
cancer. Now I am unwell and he is
afraid he will lose me.
How do I reassure him?
“
”
56

I have been caring for my mother
since I was 13. I have no constant
friend with whom I can talk about
my life and my feelings.
Why can’t someone follow up with
me?
“
”
57

My mother has to undergo surgery
every year. Ever since I was 13, I
look after her and the house really
well. But at times I don’t feel like
doing it.
Am I selfish or does everyone feel
this way? I want to know!
“
”
58

My mother has been ill for many
years now. I take good care of her,
but I feel like she is hogging all
attention. I don’t feel wanted. I don’t
feel recognized for my efforts.
How do I deal with my conflicting
emotions?
“
”
59

My mother had an accident and has
to undergo a surgery every year.
Each time, I am afraid of losing her.
How do I hold on to whatever little I
have?
“
”
60

I hate hospitals because the power
is in their hands…NOT YOURS

They come in with a stoic face
and treat you like a
ROBOTIC MACHINE

ICU is like a
BLACK BOX
once your loved one goes in, there is no
way you can know what is happening
inside.

It is like you have shattered a bit and are
trying to put the pieces together.
But how do you put pieces together when
you don’t have INFORMATION?

Even if you can walk,
they will put you in a wheelchair and
make you feel MISERABLE

As a doctor, you understand the
disease…
But not my experience!
Unless you have had cancer,
Unless you have
been in my shoes,
you will never understand what I am
going through...

For my mom, it was the first time in 63
years that she was hospitalized. I thank
god that this was also her last time. It
crushes me to think of the 6 days she spent
alone in the morbid ICU.

Why is
more care in the ICU =
only medical care?

I have been a patient 10 years ago,
and as recently as a few weeks back.
But what they make you
go through at the hospital has
not changed at all…

If you are not alert,
you can be there
FOREVER!

Hospitals are
places of TRANSITION.
There is something to someone
holding your hand and telling you –
you’ll be alright, here or later…helping
you make the transition.

You are a Patient.
You need Medicine.
Do Not EXPECT
Love, Care and Happiness.

As my mother was wheeled into the
ICU she sighed “I will not come out
alive!” Such was her disdain for
hospitals that true to her word, she
came out dead…

First Responder by Luis Prado from The Noun Project
Waiting Room by Luis Prado from The Noun Project
Programmer by Hadi Davodpour from The Noun Project
Scale by Veronika Karenina from The Noun Project
Patient by Wilson Joseph from The Noun Project
Doctor by Diego Naive from The Noun Project
Surgical Scissors by Mister Pixel from The Noun Project
Sad by Juan Pablo Bravo from The Noun Project
Laundry by Luis Prado from The Noun Project
Headache by Sebastian Langer from The Noun Project
Question by Thomas Le Bas from The Noun Project
icon credits
Injection by Luis Prado from The Noun Project
Patient by TypePlus from The Noun Project
Suitcase by Diego Naive from The Noun Project
House by Pham Thi Dieu Linh from The Noun Project
Speech Bubble by Anna Stam from The Noun Project
Wheelchair by Dmitry Mirolyubov from The Noun Project
Document by Brian Gonzalez from The Noun Project
Front Desk by João Miranda from The Noun Project
Sitting by Nithin Viswanathan from The Noun Project
Window by Juan Pablo Bravo from The Noun Project

Shifting Healthcare: Moments of Mediation

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