Design as a Change Agent in Care - 2021 presentation

Professor Evonne Miller
Director QUT Design Lab
Faculty of Creative Industries, Education & Social Justice
Design as a Change Agent in Care
@evonnephd

Forging a New Path -
Prof of Design Psychology?
• BA(Hons) & PhD – Psychology (University of Otago, NZ)
• BCom (Marketing)
• QUT – 2004, Centre for Social Change Research
• School of Design, QUT – 2007 – present (14 years)
Human- Centered
Systems Perspective
Change
DESIGN PSYCHOLOGY
Future
Comfortable with
Uncertainty
Creative / Intuition
Engagement
Co-Design
Quantitative – Trad.
not qualitative
Predictive
Hypothesis
Experimental /
Science
LIFE-LONG LEARNER!!!
MARKETING
Creation & Communication of Value
Consumers

CRICOS No.00213J
MANAGEMENT TEAM
Prof Evonne Miller – Centre Director
4 PROGRAMS
• Emerging Technologies
• Dr Jared Donovan
• A/Prof Glenda Caldwell
• Design Robotics & Digital Fabrication
• A/Prof Markus Rittenbruch
• A/Prof Veronica Garcia Hansen
• Designing for Health
• A/Prof Marianella Chamorro-Koc
• Dr Lindy Osborne Burton
• Resilient Communities
• A/Prof Debra Cushing
• A/Prof Sean Maher
“change by design"
QUT Design Lab
We are a collaborative, cross-disciplinary community of
designers, engineers, roboticists, creative thinkers, makers,
artists, health practitioners and innovators, who work
together to speculate, imagine, design, and innovate – to
reimagine and co-create a better future.

use design to solve
complex, wicked problems

How do arts-and design-led methods respond to the complexity of
human experiences, enhance models of care, and promote
healthcare innovation in our post-COVID world—locally,
regionally and globally?
Designing for Health Program
HEAL – The Heathcare
Excellence AcceLerator

https://research.qut.edu.au/heal/

01. Design Thinking, Design Doing, Design Visioning in HEAL

THE ORIGINS: ENGAGING HEALTHCARE
WITH DESIGN - 2019 QUT Design Week
(SAVE THE DATE: 6-9 July - 2021)
2019
1. Immersion in Design Methods & Mindsets
2. Rapid COLLABORATION & Co-Design Pitches

20+ HEAL Projects;
6 HHS ACROSS QLD
INDUSTRIAL DESIGN:
• Paediatric Pain Assessment & PPE,
Interactive CPR Mannequin; Podiatry
Footwear
VISUAL COMMUNICATION & INTERACTION:
• QCH Entertainment Precinct; Project
RedUCE (REDucing Urine Contamination in
Emergency) Cultural Safety;
Telehealth Uptake.
INTERIOR ARCHITECTURE & ARCHITECTURE:
Co-designing a healing environment for
families and staff in the PICU; Birth Suite
Entry and Main Corridor; Emergency
Department Entrances and Exits
DESIGN THINKING: CEQ Fellows’ Design
Thinking Training Program; The Pain Pressure
Cooker; The Rehabilitation Journey
Designers are creative thinkers, makers and
creators, innovators, and agents of change –
comfortable with uncertainty, we traverse
multiple ‘disciplinary edges’ to create
innovative interventions for systemic and
behavioural change

Driving Ideas
Design Thinking
Workshops

PROJECT 1:
Connecting Rehab Services
Across West Moreton
WMH have the fastest growing population
in Queensland – doubling to 587,000 by
2036, with an ageing population – so
models of care need to evolve
THE CHALLENGE - WMH have the fastest growing population in
Queensland – doubling to 587,000 by 2036, with an ageing
population – so models of care need to evolve

Connecting Rehab Services Across West Moreton
Using arts and design methods to raise
awareness, knowledge, and dialogue
about the rehabilitation journey at West
Moreton HHS
1. Co-Design Workshop (March)
2. Photovoice and Rehab Experience
Video (April)
3. Exhibition - Ipswich Hospital (May)
ORG CULTURE ON THE WALLS:
This picture is just outside the patient rehab room
- what do you see?
“Sometimes, we play a little game – and put this picture upside down, until
another staff member notices.. which can take weeks. Look – it’s upside down"

PART ONE
Understanding the System
ACTIVITY ONE: Individual “Exceptional Moments”
10 mins
1. Sketch a Moment of Exceptional Practice (4 mins)
Recall a special moment of exceptional practice when you were really engaged,
excited, & proud of your work. Take 4 mins to remember & draw this experience. Add
a title, key descriptors (dot points) & your name (optional)
2. Table Share (3 mins)
Share your exceptional experience with the group: what were the common themes?
Pick one story that illustrates the shared themes.
3. Joint Analysis (3 mins): Each table shares one story to the other groups. As a table
respond to the question - What does a great rehab experience look like? - Write it
down on a sheet for the research team to collect with your drawings to pin to the walls.
End of Activity: Project Team - Stick Activity Sheets to the Walls.

Critical Step
of Design
Thinking:
Empathize
We must understand
the rehab experience
from the perspective
of our patients, and
their families –
enter -
Don & Ruby
and Clara

PART ONE
Understanding the System
ACTIVITY TWO: Empathy Journey Mapping through Storyboard
30 mins
1. Create a Comic (~ 20 mins) – on Don/Ruby or Clara’s Rehab Journey:
what do they THINK / FEEL / DO / SAY (THEIR PAINS/ GAINS)
As a group select one of the two personas (or develop your own) to develop into a patient journey of
transitioning between facilities through the medium of a comic strip.
Spend 5-10 mins developing a storyline which considers journey of chosen persona:
- best case / worst case scenario (or combination); and
- the different stages of engaging with rehab system (Before, During, After)
Spend 10 mins creating and drawing storyboard/comic. Create name & pin-up
2. Gallery (10 mins): Using callout cards - add scenes or comments to other groups
Components of
a Comic Strip:
Sequence of
Scenes
● i.e. moments in
a story.
Narration
Captions
● Thought Clouds
● Speech Bubbles
OMG - a lion!!!
Pete! There’s a lion
chasing me - run!
Looks like a house
cat to me...
Adam takes himself for a
leisurely stroll
around his neighbourhood.

SYSTEM ANALYSIS
Surfacing Hopes,
Fears, Myths & Legends –
from staff & patient
perspective

PROJECT 2: Virtual Outpatient Integration for
Chronic Disease (VOICeD)
Allows patients with chronic disease to see multiple healthcare
providers at one appointment via telehealth – while telehealth is
increasingly common, this is the first-time patients could
virtually see multiple specialists (Diabetes–Renal–Cardiac) in
one multi-specialist virtual cliinc - true care integration.
- journey mapping of the experience
- co-design workshop with potential users in Cairns
- tested the tele-health experience with these users,
- advised on process & design of communication materials
(eg booking letter)
TEAM: Dr Gaurav Puri (Cairns & Hinterland
HHS), Jessica Cheers, Prof Evonne Miller

DREAM BIG FESTIVAL: One-hour rapid design workshop - the Pain Pressure Cooker

2. Driving
Innovation
Design DOING

Driving Innovation
- Design Doing
Personal Protective Equipment (PPE) has become ubiquitous in 2020
due to COVID-19 - but PPE can be scary, unfriendly, and confronting
for children. Working with Sunshine Coast University Hospital
and Queensland Children’s Hospital, this project aims to develop less
frightening PPE for the staff to wear, so that the children they interact
with are less afraid.
INDUSTRIAL DESIGN - A/Prof Marianella Chamorro-Koc

QCH:
Playful Placemaking
& Wayfinding –
Level 6
Entertainment
Precinct
Driving Innovation
- Design Doing
QUT LED: Dr Jen Seevinck, Interaction
Design & Visual Communication

Driving Innovation
- Design Doing
QCH: Playful Placemaking & Wayfinding.
Level 6 Entertainment Precinct
QUT LED: Dr Jen Seevinck,
Interaction Design & Visual Communication

QCH:
Playful
Placemaking &
Wayfinding.
Level 6
Entertainment
Precinct

• Site Audit & Observation
• Parent and Staff Engagement & Storytelling
Patient/Staff Foyer Interactive Static Display Station
Shadow Safaris/Day-in-the-Life
Parent Pack (Videos, Photovoice, etc)
Co-Design Workshop with Staff & Past Parents
• 3) Interior Redesign Concept Proposal
• 4) Placemaking & Wayfinding Redesign Concept Proposal
PICU - Co-designing a healing
environment for families and staff
QUT LED: Dr Natalie Wright
Interior Design

Animating Cultural Safety - working
with the Aboriginal and Torres Strait
Islander Leadership Team at Metro
North Hospital and Health
Service to create a series of short,
provocative animated videos on
cultural safety for clinicians –
cultural awareness, cultural
sensitivity and cultural safety
QUT LED: Dr Manuela Taboada
Visual Communication

3. Driving
Innovation
Design
Visioning

Miller, E & Polson, D.
(2019). Apps, Avatars,
and Robots: The
Future of Mental
Healthcare. Issues in
Mental Health Nursing,
40(3), 208-214.

METHODS / TOOLS - one new approach
THEORY – STORMING IN PARTICIPATORY WORKSHOPS
Cushing, D.& Miller, E. (2020). Creating Great Places: Evidence-
based urban design for health and wellbeing. Routledge.

Inspired by de Bono’s Six Thinking Hats
How can we make engaging with theory – evidence-based design – fun?

Theory-Storming in Action – ‘Design a Utopian Place’
QLD DEPART. OF HOUSING, HOMELESSNESS & SPORT (HHS)

Theory-Storming Innovative, Health-Promoting Places
Miller, E. & Cushing, D. (in press). Theory-Storming in the Urban Realm: Using Nudge Theory to inform the design of health-
promoting places for all ages. The Journal of Design Strategies.

02. Arts-based research is memorable storytelling
Arts-Based Research (ABR) is the process of
integrating creative arts into research

Shocking revelations in the media about abuse and neglect of
vulnerable older people living in aged care triggered a 2019
Royal Commission into Aged Care Quality and Safety. Interim
Report Neglect states: ”As a nation, Australia has drifted into an
ageist mindset that undervalues older people…. Left out of sight and
out of mind, these important services (aged care) are floundering. …
All to often, they are unsafe and seemingly uncaring. This must change”
Mandate for Rapid Change: 2019-2021. Royal Commission into Aged Care Quality and Safety

AGED CARE DURING COVID-19
a period of isolation with parallels to living in aged care

PROJECT 1. Inside Aged Care 2013-17
Australian Research Council Linkage
Project (LP130100036) & Ballycara
Chief Investigators: Prof Evonne Miller,
Prof Laurie Buys & Nicole Devlin.
Research Fellow: Geraldine Donoghue
Photographer/PhD Student: Tricia King
Research Team: Dr Lorraine Bell;
Dr Deborah Oxlade; Dr Kirralie Houghton
insideagedcareproject.wordpress.com
nsight & empathy via my P3 method: photovoice, documentary photography & research poetry

Method
INTERVIEWS
OBSERVATION
PHOTOVOICE
POETIC INQUIRY
FOCUS GROUPS
WORKSHOPS / ARTS DAY
Includes in-situ interviews
combination of repeated in-depth
semi structured and open ended
Cohort
RESIDENTIAL (NURSING HOME)
RESIDENTIAL WITH DEMENTIA
RETIREMENT VILLAGE
RESPITE CARE
COMMUNITY
FAMILY
STAFF
THE “INSIDE AGED CARE” PROJECT - QUALITATIVE CASE STUDY
180+ formal & informal interviews and photovoice meetings
6 PV workshops & 150 hours observation

powerful combination of photovoice & research poetry
WHY PARTICIPATORY CREATIVE ARTS-BASED RESEARCH METHODS?
THEIR POWER, IMPACT, COMMUNATIVE & PARTICIPATORY PROCESSES

Poetic Inquiry – creating poem-like prose
from interview transcripts

You could scream the place down
My family said
I was too old
to be on my own,
that I needed organizing.
You lose everything
you lose everything
to come in here.
You only have the barest minimum
there’s not much here.
It is not nice, not nice at all.
It is not good for me.
I can’t get out.
That’s what you lose, when you come in.
All your independence is taken away from you.
I’m not able to do it myself.
That’s very hard to take,
you get so frustrated at times
you could scream the place down
‘Scream the place down’

The Power of a Photograph – Pearl’s Room

“Oh it’s a mess, but I know
where everything is. I’ve
got all my secrets in here”
Pearl

ARC DISCOVERY GRANT – 2021-2023
Amplifying voices from the Royal Commission into Aged Care

Idris Mootee (2013).. Design Thinking for Strategic Innovation : What They
Can't Teach You at Business or Design School. John Wiley & Sons. p.95.

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