This document discusses inclusive design and how what is measured influences what is valued. It argues that design should address mismatches and focus on opportunities at the margins to benefit all. Failure occurs when designers make assumptions without examining their own biases. Inclusive design requires flexibility and examining individual biases. Success is achieving just enough structure with personal control. Design is a way to communicate and improve quality of care, transitions of care, and health outcomes.

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. Who are you?

3. Who am I?

4. Where do we start?
• reduce re-admission
• reduce/eliminate falls
• educate future practitioners
values, mission, desired outcomes

5. what you
measure is what
you value

6. readmissions
falls
education
What you measure is
what you value

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. how can we express just how
critical it is for patient care
that we address those things
that are hard to measure

9. patient outcomes
continuity of care
patient education + clarity
What you measure is
what you value

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. Control
We like structure.
We often fall back on it when we’re most
unsure.

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. 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. WHEN DESIGNS FAIL IT IS OFTEN
BECAUSE THE DESIGNER
STARTS FROM A POINT OF
ASSUMPTIONS — BASED ON
THEIR OWN BIASES,
BEHAVIOURS, OR PLANS…

15. failures

16. Path

17. Chair

18. Ballot

19. Oscar Envelope
2017 | 2018

20. #aodafail
Stairs at Ryerson

22. look for failures to
see opportunities

23. 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?

24. Form &
Function

25. DISABILITY

27. Disability is Mismatch
MISMATCH IS
SOLVABLE
DESIGN CAN SOLVE
MISMATCH
ALL EXPERIENCE
MISMATCH

29. THE MAGIC AT
THE MARGINS
• the edge case and the edge
scenario
• innovation
• benefits the majority
• supports the spectrum
• resiliency

30. 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

31. What is Success then?
Just enough
structure
Personal control

32. how we design matters;
and every decision is a
design decision

33. The role has changed

34. 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.

35. 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%

36. know thyself
Ask, was I brilliant or did I just
perpetuate or further
contribute
to a cycle of exclusion and
bias?

37. 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.

38. 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.

39. 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)

40. Activity
Who isn’t here and should be?
how do we respond and partner as a
system? — across hospitals?

41. Then what are the opportunities in the ICU?
Opportunities in
healthcare
Look to the mismatch to see the opportunities
• Cultural
• Contextual
• Environmental
• Temporary
• Persistent

42. Mismatch
is a design problem
Mismatch
is a design problem, therefore solvable

43. Attending _______________
Resident _______________
Nurse _______________
Care Team

44. 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

45. •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

46. Patient
1
Patient
2

47. Patient
1

48. Patient
1

49. • 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

50. success

51. Gapminder

52. Goalkeepers

53. 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?

54. Rip it off
John Snow image

55. @jesshmitchell