This document discusses experience-based design in healthcare improvement. It defines touchpoints as moments of interaction between patients and healthcare services. Emotional touchpoints are moments that patients recall feeling touched emotionally or cognitively. Various methods are presented for eliciting patients' emotional experiences at different touchpoints, including storytelling, hearing patients' stories using touchpoint cards, and experience questionnaires. A four-step approach is outlined for using patient experience data to improve services: capture experiences, understand experiences by identifying emotions and mapping them to touchpoints, improve experiences through co-design, and measure the impact of improvements.

1. EXPERIENCE BASED DESIGN
IN HEALTHCARE
IMPROVEMENT
DR LEE OI WAH
MD (UKM) CMIA(NIOSH)

2. DEFINITIONS
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3. HEALTHCARE PERSPECTIVE
 ‘A touchpoint is any moment where a user interacts in
some way with the service’
(NHS Institute Innovation and Improvement, 2009).
Eg : # arriving at the ward/counter
# talking to the nurse /HCP
# waking up after surgery
# mealtimes
# on discharge
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4. HEALTHCARE PERSPECTIVE
 Emotional touchpoints ‘are the moments where the person
recalls being touched emotionally (feelings) or cognitively
(deep and lasting memories)’
(Scottish Health Council website)
.
 They can be 'big moments' in a patient’s contact with a
service or 'small acts' that have a huge impact on an
individual whilst maybe not seeming significant to others.
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8. THE CARE JOURNEY
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9. METHODS TO ELICIT EMOTIONAL
TOUCHPOINTS
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10. STORY TELLING
 Touchpoints and emotion words (both positive and
negative) can be used to help patients and/or staff to talk
about their experiences of receiving or giving care or a
service – to tell their story.
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11. STORY TELLING
STEP ACTIVITY REMARKS
STEP1 A set of possible touchpoints is
developed comprising the key
pointsof contact with service (as
laminated cards)
Eg arrival to ward, meal
times,visiting times ,
procedure times etc
STEP 2 Create a set of positive and less
positive emotion words on smaller
laminated card.
Can be fixed with
magnetic tape before
laminated.
STEP 3 Identify point of contact to be
discussed and give emotion cards
to the story teller.
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12. STORY TELLING
STEP ACTIVITY REMARKS
STEP 4 The story teller is asked to select
emotion cards that best sum up
how the experience felt
STEP 5 The story teller is encouraged to
tell the story and invited to say
why he or she felt this way
STEP 6 The storyteller is invited to say
what could have been different, if
appropriate.
STEP 7 The storyteller is ideally given the
typed story to review and change
as required and asked for
permission to share the story to
the care team. 8/10/2019PATRICIA LEE12

13. HEARING THE STORY USING
TOUCHPOINTS
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16. PROS
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17. PROS
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18. CONS
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19. CHALLENGES
 Who do we ask to hear the story from ?
 Hearing the negative
 Knowing how to react when people discuss aspects of
their life or care that are distressing
 Emotional investment
 Prioritizing time
 Valuing the process alongside other measures of
effectiveness.
 Sharing the story with others
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20. EXPERIENCE BASED APPROACH
FOR SERVICE IMPROVEMENT
 4 key steps
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23. CAPTURE THE EXPERIENCE
Tools available :
Experience questionaire
Patient and staff esperience log
Interview (with voice /audio recording)
Interview (with film recording)
Observation (for understanding or inspiration)
CONSENT MUST BE OBTAINED PRIOR TO ALL INTERVIEW WITH
PATIENTS
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24. PATIENT EXPERIENCE
QUESTIONAIRE
 A tool to gather people’s feelings/emotions at certain points of the process of
care.
 To celebrate the positives and identify area of improvement.
 To identify the ideal emotions to evoke at each point while designing patient’s
pathway or journey. 8/10/2019PATRICIA LEE24

25. CAPTURING STAFF EXPERIENCE
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26. THE SERVICE JOURNEY
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27. PATIENT & STAFF EXPERIENCE
LOG
 A tool used to capture experiences of staffs and patients
while delivering and receiving care.
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29. UNDERSTAND THE EXPERIENCE
 The principles are :
a) Identify emotions
b) Find the touchpoints
c) Map the emotions to the touchpoints
d) Identify priority
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30. EMOTIONAL MAPPING
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31. EMOTIONAL MAPPING
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33. IMPROVE THE EXPERIENCE
 Using co-design method to generate a shared
understanding between patients , carers and staffs to
obtain different perspective on the service and
improvements that could be made.
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34. EXPERIENCE IMPROVEMENT
SHEET
 A sheet on which changes to
the service can be recorded
and tracked against
experiences.
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35. INDIVIDUAL ACTION CARD
 A simple card to record
individual’s responsibilities in
the improvement project.
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37. MEASURE THE IMPROVEMENT
 Subjective outcome
# patient’s experience (story telling,questionaire etc)
 Objective outcome
# reduced waiting time
# reduced critical event
# improved performance, safety and reliability
 Proxy measurement of patient experience
# number of incidents reported
# Thank You letters
# Sickness and absences
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