- Sarah Mir, Minahil Rafiq, and Calvin Won
In Conversation with Kim Massicotte: On Human-Centred Design in Healthcare
With the new academic year underway, and in-person gatherings halted to curb the spread of COVID-19, the University of Toronto Chapter of the Institute of Healthcare Improvement (UTIHI) would like to introduce our 2020-21 speaker series initiative.
The goal for this series is to build upon the spirit of both the Interprofessional Education (IPE) Seminar workshops and annual Quality Improvement & Patient Safety (QuIPS) conferences that are normally hosted in-person throughout the year in order to explore diverse topics related to how people experience healthcare. Through a combination of written and video interviews, UTIHI will engage with thought leaders, industry professionals, and students alike to delve deeper into the approaches being used and initiatives taking place in today’s healthcare landscape.
We aim for this series to showcase a holistic approach where the topics included are not solely concerned with direct patient care but also include those areas that intersect with the planning and delivery of care, such as enabling technologies for greater effectiveness or novel grass-roots organizations promoting best practices. If you have any ideas for topics you would like to be explored, please email us at email@example.com or reach out to our team via our social media platforms.
With this, please enjoy the first installment in our 2020-21 speaker series.
Kim is a graduate of the Masters in Design for Health program at OCAD University. Focusing her career on quality improvement, patient safety, and health process redesign, Kim has over 10 years experience driving improvement culture within large academic hospitals.
Kim is currently an Improvement Specialist at Unity Health Toronto and has received national and international recognition for her work in patient safety, innovation, and quality design.
Initially, Kim was going to lead an Interprofessional Education Seminar workshop on applying co-design methods to develop psychological support for healthcare professionals. Due to the pandemic, we have changed this workshop to a Speaker Series Interview for this year.
What motivated you to pursue the role of design in healthcare, and what do you find to be the most empowering part of it?
Healthcare is an incredible place to be a designer, or a design thinker. There is no shortage of problems to solve, it’s complex in nature, and the aim is to make things better for people; whether you are providing healthcare or receiving it, you’d want to have a good experience.
Design in healthcare is about creating spaces and services that are user-friendly, efficient, effective, and as pleasant as one can expect them to be.
Design in healthcare is about creating spaces and services that are user-friendly, efficient, effective, and as pleasant as one can expect them to be. I came from a career grounded in quality improvement science where we have many of the same goals for efficiency and operational excellence; design was a natural progression for me as I wanted to be able to look beyond the treatment processes and better understand user needs by layering the traditional QI methods with empathy and human experience mapping, resulting in more impactful innovation and problem-solving solutions.
How was the system of support for healthcare workers designed using co-design methods?
The goal of this research project was to answer the question: what are the user and usability requirements to design a practical and effective service to respond to and support staff, physicians, trainees, and volunteers at the Hospital following a traumatic experience resulting from an adverse patient event or encounter?
The pre-design phase was used to gather a quantitative and qualitative gap-analysis through the use of an anonymous and voluntary survey distributed to all Hospital staff, physicians, trainees, and volunteers. The purpose of this survey was to better understand system access narratives from users, based on our understanding of current available programs and services.
During the design phase, I worked with Hospital physician and non-physician staff to conduct a series of three, 3-hour co-design workshops to 1. define and validate the current state, 2. establish the unique needs of the Hospital, and 3. design a new system for accessing support following a traumatic patient safety event.
How can you use practical design tools and methods to embed the user experience?
To help us really understand this unique topic, and in order to design a relevant and scalable solution, the team was facilitated through several foundational design research tools. One of the first being a Stakeholder Empathy Map. Within this map, the team had to carefully consider and articulate the following:
Who is affected by this problem (primary & secondary users)?
Who are the decision makers (influencers, holders of power)?
What are the needs of each stakeholder group to be addressed?
What are the potential issues or barriers for each stakeholder group?
Starting out with this very human-centred view of the issue encouraged the team to focus on the point of view of the end-users and more practically set out an aim statement that clearly defined, 1. what are we going to do? 2. who are we doing it for? And 3. what are we trying to change?
This small switch of perspective freed the team up to ideate solutions that they themselves would be willing to access and recommend to their peers. This also gave the team permission to create something new rather than focusing on trying to improve on something we might already have or have seen elsewhere.
1. What are we going to do? 2. Who are we doing it for? 3. What are we trying to change?
How can video prototyping and design be used as part of the integrative approach to design for health?
Video prototyping is a tool, used by Interaction Designers, to better present an entire concept, and it invites prospective users to participate in the experience. Think of a television commercial where a product is being introduced. The details of the product are shown but there is usually a narrative illustrating the experience that is superimposed onto the technical details. This is done in order to help individuals connect emotionally with the product.
In the case of this project where we were designing a service, we set out to rapidly prototype a two-minute video that could illustrate the details of our concept solution, and demonstrate how users would access and interact with the proposed service.
This was a very useful experience for the teams because they were able to present their concepts in a rapid, low-tech manner. The videos were shot on smartphones and were immediately available for presentation and to help the teams further ideate and iterate their work. This is a very accessible technique and a very effective one for communicating complex ideas in an easy-to-digest way. Perfectly suited to healthcare!
Do you foresee any beneficial or necessary changes to the system to support this approach over the next few years? If so, how?
Building things is easier than designing things.
A beneficial and necessary change to the system would be to continue to embrace a diversity of ideas and disciplines to help ask the right questions and solve problems in a meaningful way for people.
In healthcare we build a lot of things but that isn’t the same as building the right thing. Healthcare improvement has absolutely come a long way and continues to evolve all the time. Ongoing and enhanced partnerships with patients, family members, advocates, advisors, designers, and external industry will strengthen efforts toward human-centred healthcare design and innovation.
How has your work been impacted by the current Pandemic? What measures are you taking to ensure the quality of your work is not compromised?
The pandemic has impacted a lot of the previous operationally-based improvement work. Understandably, the current focus has shifted primarily to pandemic-related initiatives. The quality of the work remains the same, and thankfully, has not been compromised. If anything, the pandemic has shown us that there is even more utility for these methods in healthcare when approaching unprecedented areas for design and innovation in healthcare.