Design Thinking
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Everything you wanted to know about design thinking but were afraid to ask.
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Design Thinking
- 1. Everything you wanted to know but were afraid to ask.
- 3. RESOURCES • Empathy map exercise http://bit.ly/2Blm5A6 • Liberatory Design Cards http://bit.ly/2i0sol9 • Partner exercise worksheet http://bit.ly/2up1U5n • How might we… instructions http://bit.ly/2j3fALx • d.school @Stanford website resources ttps://dschool.stanford.edu/resources/ • Google ventures library https://library.gv.com/ • Follow us on Twitter @Design4AHS
- 4. Poll: What is design thinking? a) Design thinking is how designers work. b) Design thinking is an approach to solve problems. c) Design thinking merges what is possible, what is doable, and what is wanted. UNDERSTAND
- 5. www.ideo.com
- 18. PONDER What would prevent you from applying design thinking in your work?
- 22. QUESTIONS
- 23. MARY EXAMPLES
- 24. EXAMPLES
- 27. Home Care Design Day • 0830-0900: Registration • 0900-1030: Design Work • 1030-1100: Coffee Break • 1100-1215: Design Work • 1215-1300: Lunch • 1300-1630: Design Work
- 30. What could Home Care do to improve your care?
- 32. Goal 2: Ensure Joyce receives quality support service options. Why Change? Concerns about current state: • Fragmented care • Inconsistent and confusing • Processes dictated by mandates rather than clients • Duplicated effort • Unmanageable workload Frazzled Fran Who was involved? • Clients: 81 clients interviewed; 5 clients at Design Day • Staff: 1300 comments through chats with Barb; 16 staff at Design Day • Managers: 21 managers at Design Day • Stakeholders: 2 Provincial Continuing and Primary Care Partners at Design Day How will we get there? • Approaches to initiatives will vary; generally, we will do small tests of change, measure impact and celebrate and spread successes. • Individual initiatives will be tracked through Home Care Council. Check out the tracking spreadsheet on the IHC Quality site on Insite. • Ongoing communication will take place through e-Blasts and your manager. • We need ongoing participation from Clients and Staff members. Want to get involved? Talk to your manager. Goal 1: Partner with Joyce’s Primary Care Team. Integrated Home Care Design Day Goals 2017 Design Target: Support Joyce to Thrive in Her Community Goal 4: Build stable care teams with case manager as specialist with “Joyce.” Goal 3: Enable staff to provide Joyce with only value-added service. • Enhance case management practice • Review specialty team service delivery model • Distribute workload equitably • Reduce transition points within Home Care • Reduce number of individuals going into Joyce’s home • Get Joyce the right care • Build a mechanism to notify primary physician when Home Care is involved • Enhance collaboration between case managers and physicians • Engage, improve role clarity and reduce duplication between Home Care and Primary Care • Engage in micro-improvement initiatives with PCNs • Enhance and expand contracted services financial auditing and quality monitoring • Improve shared accountability • Enhance bounded-choice and control; consider voucher system • Consistently review and stop program activities that do not add value to Joyce • Reduce duplication in documentation • Reduce non-admits to the program • Inform Paris 6 roll-out • Fully adopt technology • Collaborate for legible complete orders • Determine Joyce’s goals early on • Review professional service hours Purpose? Identify program goals, optimize program design, and prioritize program initiatives. Draft: June 21, 2017
- 34. QUESTIONS
- 35. Patients in rural communities aren’t taking advantage of virtual opportunities to connect with a physician. Children under the age of 6 are experiencing abnormally high adverse reactions to this year’s flu vaccine. Physicians are sending shot-gun referrals in the hopes that their patients might better access specialist care. Vulnerable members of the community are accessing the ED when they are experiencing pain due to a lack of oral hygiene and access to a dentist. QUIZ
- 36. Human centred Little available data Many unknowns No clear problem RIGHT FIT
- 37. Don’t isolate your thinking. Don’t be a perfectionist. Don’t kill your ideas. Do gamify to maximize your teaching capabilities. Don’t use design thinking as a quick fix. Do keep asking “why?” Don’t assume you know the problem. Do get comfortable with being uncomfortable. Do find your superpower. Do look outside of health care for inspiration. Don’t forget the user. DO’S & DON’TS
- 39. QUESTIONS
Editor's Notes
- Design thinking has become a bit of a buzz word around AHS, so I’m really excited to have the opportunity to talk about what it is, what it isn’t, how to use design thinking in your work and why it’s important to do so.
- But first, let’s do a quick visual so we can see where we’re all calling in from. If you hover and select the marker on the left of your screen, you can make a mark on the map of your location. [Whiteboard: place a dot to indicate where you’re from.] [take a moment to acknowledge where people are from]
- So I’ve put together a list of resources that you’ll find helpful after the webinar, and this list contains not only links to all of the tools that I’ll be showing you, but also good websites that have loads of reading and resources that are all open-share. In particular, if you’re interested in learning more about design thinking, I’d hit up the d.school @Stanford as they have probably the most comprehensive amount of information about design thinking, and it’s a great place to start.
- [All answers are true.] To get started, let’s do a quick poll – Sue, could you pull the poll onto the screen? So what is design thinking? So it turns out that you’re all right, design thinking is all of these things. And even though it’s a buzz word now, design thinking isn’t new – it’s been around as a concept since the 1960’s. It was borrowed from design, but the approach has been adapted – most recently by Google Ventures when they created the step-by-step process of a design sprint.
- At the beginning, though, it was an attempt to develop a science out of the field of design. It made it’s progression through various fields of specialization over time, and then when IDEO was formed in the early ‘90’s, they really brought design thinking to the mainstream. The guy you see in the centre of this picture is David Kelley, who is kind of considered the father of modern design thinking. He is one of the founders of IDEO, and a professor at Stanford University. If you’d like to know more about IDEO, their website is fantastic and has loads of information about the evolution of design thinking and the key players involved. They also have incredible resources, case studies, and open-sharing tools.
- While earlier strategies of design thinking focused mostly on product development – one of it’s early results were the Apple mouse - it has evolved to embrace not only creating things but also solving problems, making decisions, devising strategies, and producing services. What HAS remained the same is that it is a human-centred approach, it is measured by how well it fulfills the user’s needs, and it prioritizes rapid experimentation and testing.
- There are core tenants to design thinking. First, as I mentioned, it is human centred. Also, design thinking never assumes that the problem is certain, and it requires the work of diverse, empowered teams with a strong bias toward action. Finally, design thinking prioritizes FAILING QUICKLY over LENGTHY PLANNING.
- As scary as it sounds, failing quickly is the most efficient way to find out what works, and what doesn’t. At AHS we are experts at planning, we are experts at capturing and demonstrating the value of our plans, our pilots, and our projects. Even when the plan or project or pilot has failed miserably, we are invested in demonstrating it’s value, because we’ve already invested so much time and money in the planning and piloting stages.
- In design culture, failure is seen as a step in the right direction. If we know what isn’t working, and we learn that quickly, we can regroup – rework – and retest. This process makes it possible to rapidly tweak the solution over and over again until value is created. So, remember I mentioned that design thinking was originally an attempt to scientize design? Well, here’s the formula. Empathize Define Ideate Prototype Test
- These are the five stages of design thinking but they are non-linear. Because, remember, design thinking is a cycle, it’s not a one-off. You’re meant to build upon your learning, reiterating and generating new ideas – identifying new problems – and throughout each cycle gaining a deeper understanding of the user. In health services, the end user is usually either the patient, or front-line staff.
- The human experience is at the centre of design thinking and empathy is the place to start. When you start with empathy, you throw out any assumptions that you’ve made about your end user. You get out to the front lines, you put yourself in their shoes. You don’t assume to know what your end user needs, you are there to research what they think and feel. There are many ways to get to know your user – surveys, observation, interviews – this is the research part of design thinking.
- The insight that you’ve gained for your end user will help you identify and define the problem. And the problem isn’t always what you may have thought it was. Suppose a hospital routinely has long wait times in its emergency room. Patients have been complaining and the problem may be misdiagnosed as lack of staff or lack of funding. This is the problem from the perspective of the hospital. However, from the patient’s perspective, the problem might appear very different. It might be the number of people to whom they need to repeatedly explain their situation, or the multiple forms they have to fill out while also caring for their restless and tired children. What the hospital assumed was a problem with the long wait times was actually a problem with what happened WHILE the patient was waiting. Assuming knowledge of the problem can get you off to a false start very early in the game, and set you on the path of “fixing” the wrong problem. However, using the insights you’ve gained from researching your user gives you a more targeted approach to making sure you’re working on the right problem.
- After the problem is defined, design thinking uses ideation to find as many solutions to the problem as possible. Ideation is the messy, creative bit of design thinking, where you generate as many possible ideas as you can. It often makes people feel uncomfortable, and I’ve heard it referred to as “the fluffy bits”. And yet this is where the genius happens! Let me be clear – you don’t have to know how to draw, you don’t have to consider yourself a “creative type”, and you don’t have to like group hugs and patchouli in order to come up with a great idea. Creativity breeds, it’s like a virus. When you give a group of people license to be creative without judgement, to get messy with ideas and over-the-top with solutions, you’d be surprised at what emerges.
- After going through many possible solutions to the problem, you choose one that has the biggest wow. It’s true that it might fail spectacularly, but that’s what you’re testing for. And now it’s time to prototype. The key words here are MVP: minimum viable product. For example, the people in this picture were prototyping an app for Sesame Street – what they’ve captured in this photo happened as they were virtually testing the prototype with children. The group created a poster-board frame and demonstrated the app with a real person who was pretending to be in the app. This prototype was a last-minute idea and yet remained true to the questions this group wanted to answer: would children respond positively to a human instead of a puppet? The moral of the story - Prototype cheaply Prototype quickly Don’t forget the question you’re trying to answer And remember to build your prototype for the end user, not for the product.
- Testing your product is where you gain valuable feedback, whether positive or negative. You don’t have to survey a thousand people to find out if your idea works. Usually, five test subjects are enough. Most importantly, test in the real world, with real people. That’s a lesson that the project managers behind New Coke learned the hard way. See, when they tested their product with a customer group, they did so in these tiny little sample cups with people who had been brought into the lab. But people don’t drink soda pop out of tiny little cups in a lab, they drink full glasses of the stuff, and usually in a social setting. Turns out that when New Coke was launched, people hated it because it was just too sweet – something the project managers never could have discovered with their itty bitty little sample cups.
- Another way to view design thinking is to see it as an overlap of what is possible, what is wanted, and what is valuable. And I’d just like to point out that this is NOT how my daughter comes up with her Christmas list – just saying.
- Keep in mind that real change takes place in real work – nothing has really changed if we aren’t doing the real work differently. Design thinking requires a shift from our traditional and ingrained ways of solving problems, but once you try it and see how easily and quickly you can bring about real change, you’ll be hooked!
- WHITEBOARD
- I’d like to show you some of my favourite tools that can get you started with design thinking. At the heart of design thinking is the user, and understanding your user is the most important part of the process. Gathering ethnographic evidence can be done a myriad of ways – surveys, questionnaires, sample groups… but I am particularly fond of the empathy map. This tool is something we use at the Design Lab for nearly every workshop – it’s even how we organize our annual report! Whenever we do this exercise with another group, they are astounded at how effective it is at identifying with your user. It really does offer extraordinary insight. It’s even better if you can have your user with you as you are creating an empathy map. Sometimes we’ve gathered insight when creating a map with the user that even the user wasn’t aware of! It’s THAT good of a tool. Empathy Mapping Who is your “user”? Create a persona
- The second exercise I’d like to share is a fun way to dive into the process, and quite relevant considering the season. It’s an exercise to design a better gift-giving experience. This exercise takes the design thinking process and turns it into a quick one-hour activity that you can do with ANYONE – a colleague, a friend, a partner… even your kid. The structure is all there, and every step reinforces not only the formula for design thinking but the importance of using feedback to reiterate your idea – a process that can continually generate better and better prototypes. If you’re dying to try design thinking but don’t know where to start, I’d start with this worksheet. Personal development Partner exercise: Design a better gift-giving experience
- How-Might-We questions are essential to the design thinking process as they can take a problem or an insight and turn it into an opportunity. The HMW format suggests that a solution is possible and that there is a variety of possibilities that might work. Consider the difference between these two examples: Kevin knew that there wouldn’t be funds available to send him to the management conference in Rome. Kevin wondered, HMW raise funds to send him to the management conference in Rome. You can see how just rephrasing the statement to a how-might-we question opens it up to possible solutions. They both state the fact that there just isn’t enough money to send poor, deserving Kevin to Rome – but only the second statement opens the possibility that there are other ways to get him there. Reframe your Mindset How Might We…?
- Before we get to Abram’s discussion about using design thinking in Home Care, I’d like to just touch on a couple of other examples where design thinking helped improve the patient experience. My first example is Mary. Mary had a painful chronic condition and required special treatments but kept missing her regular appointments. Despite reminders by mail and by phone, Mary continued to miss appointment after appointment. Finally, the clerk who scheduled Mary’s appointments decided to call her at home and ask her about her experience. Was there an issue with transportation? Did she need additional reminders? Slowly, Mary began to reveal the reasons why she never made it to her appointments. For starters, her painful physical condition required her to arrange door-to-door assistance and special transportation. She found coordinating the logistics quite stressful. And then, once she was at the hospital, she was expected to travel long distances between services and worried that she wouldn’t find someone to push her wheelchair, or that she might get lost. Simply thinking about the various hurdles of this journey made Mary anxious to the point of talking herself out of going at all. In Mary’s case, she couldn’t explain her concerns through the standard patient experience survey, which is initiated after an appointment and which mostly asks general questions focused on the medical visit. Were it not for the clerk’s initiative to ask Mary what was going on, her concerns may have gone both unnoticed and unaddressed.
- The Mayo Clinic, Kaiser Permanente, and John Hopkins Medicine have all installed design thinking labs into their research facilities. At the Mayo Clinic, design thinking has been responsible for increasing their dermatology practice from 35 to 65 patients a day, treating more patients in pediatric ENT, improving treatment compliance in diabetes patients, bringing in an eConsult program and redesigning the exam room so that patients are better able to retain information about their health records and exam results. __________________________ Hear some examples of how design thinking has improved health care Mayo Clinic Dermatology practice redesign: CFI designers worked with Mayo’s dermatology practice to enable each function to work at the top of their license; as a result, the practice increased its business from 35 to 65 patients a day. Pediatric ENT practice redesign: The CFI helped the pediatric ENT unit to more effectively treat sick children by improving communication with their parents. Diabetes education cards: Mayo’s endocrinology practice, in collaboration with the CFI, found that patients who used new diabetes education cards were more knowledgeable about the side effects of their medicines and more likely to be compliant with their treatment plans. eConsults: A new electronic communication system helps physicians to communicate more efficiently with each other and with faraway patients. Exam room redesign: A new exam room designed by the CFI enables patients to better retain information about their health records and exam results.
- We’re also using design thinking at AHS to improve the patient experience and redesign how our teams work. I’d like to introduce Abram Gutscher, who is a program manager with Home Care and took part in a design thinking workshop earlier this year.
- NOTE: WHITEBOARD Have participants put themselves inside or outside square. I am a blue square. Include quote for Insights Leadership description. Project Charter, Policy Lens, literature review, data, manager input. Are you a blue square?
- Mindset “Keep Joyce in mind”; empathy map
- Survey; interview
- Co-Design
- Careful of over production
- Placemat: http://insite.albertahealthservices.ca/assets/sh/tms-sh-cal-homecare-placemat-final.pdf QI page: http://insite.albertahealthservices.ca/16512.asp Prioritization tool
- Whiteboard
- Let’s do a little quiz. Here are four problem statements, each one concerning health care. Place a mark on any of the problem statements that you think would be suitable for design thinking. It looks like most of you are picking up what I’m putting down. All these problems EXCEPT B are ripe for design thinking. The reason B isn’t suitable is because it’s not a human-focused problem, it’s a problem with the vaccine.
- Design thinking is not magic, and it’s not a quick fix. It’s a mind set, but there is a right and a wrong time to use it. At the Design Lab, we use four questions to determine if your problem is the right fit: Is this problem human centered? Design thinking is appropriate if a deep understanding of the actual people or users involved is essential. Linear analytic methods may be better if there are few human beings involved in the problem or the solution. What's the level of uncertainty? If there are many unknowns, both large and small, and past data is unlikely to help us, design thinking is appropriate. If, on the other hand, the data that you've got on the past is a pretty good predictor of the future, analysis works. How clearly do you understand the problem? If we need to explore and perhaps build agreement even around the definition of the problem, design thinking is an appropriate method. On the other hand if we understand the problem clearly and are sure that we're solving the right one, linear methods may work better. What data is already available to you? If there's very little relevant existing data, then design thinking is appropriate. If, on the other hand, there are several clear sources of analogous data, linear analytic methods may work better.
- Now I’m going to let you guys decide what you’d like to know more about. This list of do’s and don’ts is fairly straight forward but if you’d like me to expand on some of these statements, just type the statement you’d like to hear more about in the comment box. Design thinking Do’s and Don’ts Don’t isolate your thinking. “Silo thinking” describes the typical mindset that most physicians and mathematicians use to solve a multifaceted problem by splitting it up into many other smaller problems. While silo thinking might be effective when used to develop solutions that solve small, isolated problems, it falls short when it comes to developing more comprehensive solutions that require a more holistic view. Furthermore, silo thinking allows solutions to be developed while forgetting the users. Don’t be a perfectionist. Don’t create products for a perfect world, because it is not a perfect world we live in. Everything is Beta. Don’t kill your ideas. refrain from saying the words “but” and “try” and do not let “problems” become the center of attention when trying to innovate. The best ways to kill an idea is to discuss it to pieces, to focus on too many details, try to benchmark it and to overanalyze it. Do gamify to maximize your teaching capabilities.
- The AHS Design Lab is available to any team within AHS, depending on the appropriateness of your problem. We’ve led workshops, trained personnel, advised on strategy, consulted on development, launched social movements, co-designed services, designed websites, guest-hosted projects and generally caused a ruckus wherever we go. If you think you have a problem and that we can help, go to our website and click on “explore with us”. If we can help you, we will. If we can’t help you, we’ll try to find someone who can. Know what the AHS Design Lab does and how to use it Process Webpage Services
- Whiteboard So that’s it for me, folks. Thank you for listening – I hope I’ve piqued your interest in design thinking enough so that you’ll find a way to bring it into your own work. I’m happy to take any more questions you might have, or if you prefer you can email me at erin.rohl@ahs.ca.