Be Like Water: Strategies for Infusing Design in Healthcare Organizations

Be Like Water
Strategies for Infusing Design in
Healthcare Organizations
@jeremybeaudry + @katiemccurdy
interaction17 | February 7, 2017

BE LIKE WATER: Strategies for infusing design in healthcare organizations | @jeremybeaudry + @katiemccurdy
We’re designers

We work at The University of Vermont Medical Center

We work at The University of Vermont Medical Center
Over 7,600 employees
A million patient encounters annually
Building an expanding network health system
with aﬃliate hospitals across Vermont and
northern New York

Where we work also looks like this

It’s a big, old institution with a speciﬁc culture

BE LIKE WATER: Strategies for infusing design in healthcare organizations | @jeremybeaudry + @katiemccurdy interaction17 | February 7, 2017
That’s just the way things get done
around here.”

Amazing, committed people work here

People are very nice, people are very polite

BE LIKE WATER: Strategies for infusing design in healthcare organizations | @jeremybeaudry + @katiemccurdy interaction17 | February 7, 2017

Meetings where people sit and talk

Lots of consensus

Limited idea of “participation”

Lots of hierarchy

People feel helpless — “that’s above my pay grade”

Uneven power dynamics

Strict project management protocols

Skewed sense of how long things should take

People hide out in their oﬃces, working alone

Emailing, emailing, emailing

Passing around Word docs with “track changes” on

Like it’s 2004

If this is the organization

Here’s us – new, strange, scarce

Modeling a new way of working

We want to tell you how we’re like water

Flowing through this place

Picking up people and information as we go

Increasing collaboration and connectedness

We think you can do this too
Build connections Co-create Model a diﬀerent
kind of “work”

We work on all kinds of projects
After Visit Summary
Bill Redesign
Cancer Patient Welcome Guide
Children’s Hospital Guide
Culture of Quiet
Future of Nursing
hiCOlab Innovation Lab
Hospitalist Calling Cards
Patient Portal Website
Patient Flow (ED Admissions)
Patient Referral Process
Pediatrics Transitions of Care
Progress Note Redesign (EHR)
Proxy Access (EHR)
Public Website Redesign
Wayﬁnding
Conversations
Relationships
Interactions
Print materials
Websites
Mobile apps
Services
Environments
Systems
Processes
Strategy
Culture

CASE STUDY 01
Helping people navigate our space

We know we have a problem

“We need an app.”

“No, we need to do our research.”

Exhaustive audit of our facilities

Interviews with front-line staﬀ

We discovered where the breakdowns are

Walk-through with leaders

Workshops with patients and staﬀ

Workshop with registration staﬀ

Synthesis as a team

We created ﬁndings and principles cards

Yeah, we have problems with our signs

We also lack a clear and cohesive organizing system

At this point, we needed a design sprint

We sketched ideas and prototyped the best one

A nature-themed zone system

Testing our prototype

It worked
I love this.” –Patient
I find it calming.” –Staff member
The simplicity is good.” –Staff member
I could have used this yesterday. I needed a
GPS.” –Visitor
It makes me feel like: I can do this.” –Patient
Anyone can use it. Even if you can’t read
you can get there.” –Visitor

Be like water
Our ethnographic research methods and design
sprints introduced many people to our process
and how we work.
We shared diﬀerent methods and tools with our
partners, and they began to use them conﬁdently
on their own.
We carried people with us, building excitement
and momentum for the project across multiple
departments.

Being like water helped us
Build connections Co-create Model a diﬀerent
kind of “work”

CASE STUDY 02
Supporting parents staying 
with their children

Problem

Problem
After leaving the hospital, parents say that they
didn’t know what resources were available to
them.

Visual storytelling session

WTF is glycogen storage disorder?

Apprehensive, powerless, not kept in the loop

Insights
We heard a lot about communication breakdowns
and transparency issues.
We realized we also needed fresher experiences
and tips from parents who are currently in the
hospital.

Traveling, shadowing, learning

What do parents see?

What is it like to stay at the hospital?

Insight: many parents are ‘stuck’ in the room for days
When you come in here you’re not
thinking of yourself. You’re thinking of
[your child], and doing everything you can
to help them. Then you get here and
realize you need things like clothes.” 
—A mom
They oﬀered to do a tour when I ﬁrst got
here, but I didn’t want to leave him.” 
—Another mom

Temporary tip board installation

Add a tip or put a sticker on another person’s tip

The board ﬁlled up quickly (and it’s still there, a year later)

Insight: parents often gave moral support

End result: pocket guide (paper & web)

frequently if you need to step out.
The Ronald McDonald Family Room, located on the unit (see the
map on page 3,) is also a great place for familes to take a break in a
comfortable, living room-like setting. It offers amenities like laundry
and showering facilities, coffee, other food and beverages, a small
kitchen, and computer access. You can learn more about the room on
page 27.
STAFF TIPS
• Take family and friends up on their offers to help.
• Do not feel like you’re a “bad” parent if you need to spend a night
or two away from the hospital.
• If you need to keep family and friends updated, the CaringBridge
site or Facebook’s group messaging can be helpful.
– PARENT TIP
“Don’t feel guilty for getting outside for a walk every
now and then to keep your sanity. Have a volunteer sit
with your child. It will make such a difference!”
PARENT TIP
Informed directly by parents

The team experienced new ways of working together

Parent council felt sense of pride and ownership

Ripple eﬀect
The same team hired another UX designer to
create materials for parents whose children are
seen at the outpatient specialty center.

End result: an eﬀective product
I notice when parents don't get [the guide]
— they seem more lost. They didn't know
they could get a meal tray. They didn't
know what questions they could ask.”
—Lisa, Nurse Manager

Be like water
We traveled through the physical space of the
pediatric unit, asking questions and observing,
leaving no corner untouched.
We followed leads, which led us to meet more
people and gather more complete information.
We seeped into the culture of the advisory
council.

CASE STUDY 03
Improving transitions of care
for kids with chronic illnesses

Moving from pediatric to adult health care is hard

We asked kids and parents about their experiences

We created a tool for patients to map their journey

Insight: the relationships in pediatrics run deep

Insight: the child-parent dynamic is complex

We also interviewed doctors, nurses, other clinical staﬀ

We are learning a lot about what kids need

We need to support meaningful conversations
that visualize the entire transitions journey and
help families navigate it.
The tool should connect kids and parents with
existing transition resources appropriate to their
age and illness.
We must create a clinical system that facilitates a
“warm handoﬀ” between pediatrics and adult
specialty clinics.
So that we can create a toolkit just for them

Be like water
Our action-oriented, iterative approach is a
motivating force for our project partners.
They also see how important it is to focus on
learning from end users.
As we talk to people across the organization, we
are consolidating multiple, isolated eﬀorts around
transition of care and forging new collaborations.

What helps us do what we do?

Champions who let us be

Our amazing little space

Our teams’ willingness to collaborate diﬀerently

Our unique access to people — patients and staﬀ

We love the work

It draws people to us

They say nice things
There's a lot of action when we're working on a
project or exploring an idea. We typically
aren't sitting down, there are visuals - and
often Post-It Notes - and it feels like topics are
discussed and next steps and decisions are
made quickly.” 
—Communications team member

You are focused on ﬁxing problems with the
input and assistance of the people aﬀected by
the problem. Most other teams just do what
they think will work.” 
—Anonymous

Clone yourselves!”

Being like water helps us  
change culture

FROM: hierarchical decision making

TO: more user-centered decision making

FROM: uneven power dynamics

TO: conversation & relationships

FROM: long, rigid projects

TO: quick iteration

FROM: hiding out

TO: getting out

FROM: sitting & talking meetings

TO: visual collaboration

FROM: “that’s above my pay grade”

TO: “I can make things better”

TO: “we can do this”

Build connections
Show up in-person.
Follow the leads, and believe that every person
you meet is an opportunity to learn something
new.
Understand the organizational culture so you
can ﬂow through the paths of least resistance.

Co-create
Facilitate participatory design workshops.
Use tools that support visual ways of gathering
information and input.
Get out of your oﬃce (and oﬀ devices) and talk
to end users, ask for their suggestions.

Model a diﬀerent kind of “work”
Make meetings visual — always, no excuses.
Don’t be afraid to be the weird one doing
things diﬀerently.
Pull non-designer team members into design
and synthesis exercises.
Show people how much more fun you have
than they do.

Healthcare system designers: join us on Slack
hsxdesign.herokuapp.com

Be Like Water: Strategies for Infusing Design in Healthcare Organizations

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