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What is our tolerance for failure (in healthcare)

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A presentation given at the Sunnybrook Hospital Interprofessional Partnership summit

Published in: Design
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What is our tolerance for failure (in healthcare)

  1. 1. Nothing is Neutral Jess Mitchell Sr. Mgr. Research + Design Inclusive Design Research Centre OCAD University @jesshmitchell inclusive design thinking, healthcare outcomes, and the best way to open a door
  2. 2. Who are you?
  3. 3. Who am I?
  4. 4. Where do we start? • reduce re-admission • reduce/eliminate falls • educate future practitioners values, mission, desired outcomes
  5. 5. what you measure is what you value
  6. 6. readmissions falls education What you measure is what you value
  7. 7. Strong leaders teach the hard stuff.- Vala Afshar @ValaAfshar sense of urgency critical thinking creativity patient empathy team commitment humility unselfish giving judgement grace and dignity positivity optimism bias towards results active listening communication do you measure?
  8. 8. how can we express just how critical it is for patient care that we address those things that are hard to measure
  9. 9. patient outcomes continuity of care patient education + clarity What you measure is what you value
  10. 10. Misconceptions: If we just explore something (a person or a problem) from all possible angles we can know it, predict it and control it we can FIX it—we can design for it thinking & logic
  11. 11. Control We like structure. We often fall back on it when we’re most unsure.
  12. 12. What is Failure Adherence to the rule is success; deviation from the rule is failure. With this: • We fail to go anywhere. • We often fall back on the way it has always been • comfortable ruts of thinking and doing
  13. 13. What is Failure Adherence to the rule is success; deviation from the rule is failure. Who is making the rules? Are the rules revisited as culture, humans, the economy, health, the context, the environment change? Do the rules flex for edge or special cases that they don’t fit?
  14. 14. WHEN DESIGNS FAIL IT IS OFTEN BECAUSE THE DESIGNER STARTS FROM A POINT OF ASSUMPTIONS — BASED ON THEIR OWN BIASES, BEHAVIOURS, OR PLANS…
  15. 15. failures
  16. 16. Path
  17. 17. Chair
  18. 18. Ballot
  19. 19. Oscar Envelope 2017 | 2018
  20. 20. #aodafail Stairs at Ryerson
  21. 21. look for failures to see opportunities
  22. 22. Where are opportunities? • Where things break down • Where things can be done better • Where things go wrong • Where things are confusing and complicated Where are Opportunities?
  23. 23. Form & Function
  24. 24. DISABILITY
  25. 25. Disability is Mismatch MISMATCH IS SOLVABLE DESIGN CAN SOLVE MISMATCH ALL EXPERIENCE MISMATCH
  26. 26. THE MAGIC AT THE MARGINS • the edge case and the edge scenario • innovation • benefits the majority • supports the spectrum • resiliency
  27. 27. Design has a unique ability to dignify. It can make people feel valued, respected, honoured, and seen. And this is both the opportunity and responsibility of design. - John Cary, architect
  28. 28. What is Success then? Just enough structure Personal control
  29. 29. how we design matters; and every decision is a design decision
  30. 30. The role has changed
  31. 31. What does it mean to do inclusive or accessible design? Inclusive design is fundamentally flexible in all aspects of person interfacing that can result in match or mis-match with the person’s needs, expectations, preferences, inferences.
  32. 32. nuggets Don’t solve right away… THINK Do the opposite of what feels good/natural/easy Lateral thinking – look at the problem from another angle, from relaxed attention, from the edge Don’t’ focus on the 80%, solve for the 20%
  33. 33. know thyself Ask, was I brilliant or did I just perpetuate or further contribute to a cycle of exclusion and bias?
  34. 34. nuggets Reflect on what you’re doing and why – question assumptions and ask yourself why you feel or react the way you do Change doesn’t happen over night – it will take some time to change the way you think and the way you do things. There is no fixed, predictable timeline for this – transformation is dynamic.
  35. 35. one more thing… Inclusively designing anything fundamentally gets at issues of equity, diversity, and inclusion. It requires us to not only change our methodological approach, but also examine our own individual biases.
  36. 36. Success • Instead of focusing on brilliant policies • ASK • Who stands to advance? succeed? achieve with the way we’ve set up (work, culture, measures of success)
  37. 37. Activity Who isn’t here and should be? how do we respond and partner as a system? — across hospitals?
  38. 38. Then what are the opportunities in the ICU? Opportunities in healthcare Look to the mismatch to see the opportunities • Cultural • Contextual • Environmental • Temporary • Persistent
  39. 39. Mismatch is a design problem Mismatch is a design problem, therefore solvable
  40. 40. Attending _______________ Resident _______________ Nurse _______________ Care Team
  41. 41. It’s a scary time It’s an intense time It’s a complicated time It’s a confusing time The big picture is missing The Big Picture
  42. 42. •This person is a person first •This person is a patient temporarily •This person is unique •What do you need to know to care for her? Personal Narratives Matter
  43. 43. Patient 1 Patient 2
  44. 44. Patient 1
  45. 45. Patient 1
  46. 46. • Design is communication • Good Communication = Quality of Care • Quality of Care = Good Transitions • Good Transitions = Good OUTCOMES • Good OUTCOMES Readmissions Design matters in MedicineDesign matters in Medicine
  47. 47. success
  48. 48. Gapminder
  49. 49. Goalkeepers
  50. 50. Where are opportunities? • Where things break down • Where things can be done better • Where things go wrong • Where things are confusing and complicated Where are Opportunities?
  51. 51. Rip it off John Snow image
  52. 52. @jesshmitchell

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