design for community care
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Copyright © 2012, Peter Jones
Designing for Community as the Source of Care Co-creating Care where it happens
Peter Jones Redesign Research
OCAD University, Toronto
Copyright © 2012, Peter Jones
Practices Redesign redesignresearch.com Dialogic Design designwithdialogue.com
Publications Papers / Blog designdialogues.com Research sLab.ocad.ca Healthcare designforcare.com
Products Cdling.com Clinical Key Procedures Consult ScienceDirect
designforcare.com
Peter Jones, Ph.D. @redesign Senior Fellow, Strategic Innovation Lab Faculty of Design, Strategic Foresight & Innovation
Copyright © 2012, Peter Jones
“What if Design was designed as a care profession?” And if … Healthcare as systems of services Enabling those who serve people seeking care: Health practice & care organizations. • People not patients. • Systemic, touches every sector • Cases, Methods, Experiences
Rethinking Care 1. Design as Caregiving 2. Co-Creating Care 3. Seeking Health
Rethinking Patients 4. Design for Patient Agency 5. Patient-Centered Care Service Rethinking Care Systems 6. Innovating Points of Care 7. Designing Healthy Information Technology 8. Systemic Design in Healthcare Innovation 9. Futures in Service Innovation
designforcare.com @designforcare
Design for Care: Innovations in Healthcare Experience
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Real care occurs in-place, a community we share with others.
Caring requires knowing, trust, patience, humility, honesty, & the primacy of life’s rhythms. “… there must also be developmental change on the other as a result of what I do; I must actually help the other grow.” M Mayerhoff
Copyright © 2012, Peter Jones
Schools of Design Thinking in Healthcare
• User Experience / IxD / IA
• Service Design
• Evidence-Based Design
• Environmental Design
• Participatory Design
• Generative Design
• Radical Innovation
• We tend to forget – Sociotechnical systems
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Copyright © 2012, Peter Jones 8
SERVICE
Copyright © 2012, Peter Jones
A Healthcare Revolution?
Two trends are preparing ux for what’s next :
• Tech - Mobile & Health 2.0
• Social - ePatient & patient-centered
• Our investment matters The way we design for care now defines our field
Copyright © 2012, Peter Jones
What’s your Possibility?
• Choose your Context Consumer Health Care Practice Healthcare Organizations Education, Policy & Institutions
• From designing services to co-creating care
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
People are health-seekers
A health-seeking journey occurs over a lifetime, a continuity that proceeds through youth, adulthood, & older age.
Copyright © 2012, Peter Jones
Design more for value demand
Less for failure demand
• From systems perspective, disease focus is intervention
• Patient context is temporary
• Prevention, adherence, & continuity
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Where does Health Live?
Copyright © 2012, Peter Jones
Where does Health Live?
Dis-eases emerge from so many factors …
Can we design for:
• Home conditions
• Connectedness - Friends & family circles -
• Autonomy, mobility & communications
• Neighborhood, safety, food supply
• = community
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
How does identity change as a patient?
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Can we distribute care resources
among different points of connection?
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
• Person-Family
• Person-Community
• Patient-Patient
• Patient-Providers
• Providers-Community
Copyright © 2012, Peter Jones
Design skillsets in healthcare
Community “All 4 at once” D3.0 & 4.0 require power tools of systems & collaboration. Transfer down: - Sensemaking mindset - Stakeholders - Reframing power - Adjacency
Adapted from Humantific with permission
Copyright © 2012, Peter Jones
D3.0 & 4.0 “Changemaking” Power tools are necessary:
- Systemic design approaches.
- Multi-stakeholder collaboration. - Participatory research. - Strategic innovation. - Design of practice & service.
Healthcare Design Contexts in …
Clinical practices for complex care New organizational modes Redesigning business models Service systems Clinical education
Community engagement Healthcare networks Public health - Prevention Policy development Transforming education
Copyright © 2012, Peter Jones
Atrial Fibrillation Care Many health services treat chronic & complex illness as exceptions. Patients fall between the cracks & are shuttled around, getting fragmented care. By not adapting to the changing reality of the chronic demographic, costs rise as hospitals increase their exception cases.
Morra, et al (2010). Reconnecting the pieces to optimize care in Atrial Fibrillation in Ontario.
D3 & D4
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Atrial Fibrillation Aftercare Pathway (Service design is not inherently systemic.)
Copyright © 2012, Peter Jones 30
Atrial Fibrillation System Redesign The improvement of individual experience is an effect in healthcare. Nice but not systemic. Redesign institutional practices & business models.
Copyright © 2012, Peter Jones
If 90% of U.S. babies were breastfed for 6 months, save $13 billion /year
The United States has one of the lowest rates of breastfeeding of any country in the developed world.
Only 13% of children are exclusively breastfed for the first 6 months.
Correlated with fewer infections, illnesses, & diseases, such as asthma, diabetes and obesity.
1st place Rotman Design Challenge Mayo Clinic
Copyright © 2012, Peter Jones
• P2P network & service
• Simple & decentralized
• Enduring connections
MDes Strategic Foresight & Innovation
Living communities are co-creative.
Copyright © 2012, Peter Jones
Understanding the design moment
The Experience of Breastfeeding
Human-centered Intervention
Understanding phase Expert interviews Lactation Consultant Child Life Specialist Anthropologist
Moms & Dads In-depth interviews
Research Design Research Design
Expert interviews Midwife
Sociologist
Moms In-depth interviews with mothers focused on the
moment of intervention.
“The Latch” Moment of
Wellness
Copyright © 2012, Peter Jones MDes Strategic Foresight & Innovation
Prepare a mother for the emotional and physical challenges ahead to ensure ingoing assumption is not that “it comes naturally”
Offer safe, unbiased, emotional support and positive reinforcement during the “latch
experience” when it is needed most
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MAYO MOM
NEW MOM
Facilitate Connection
Connection
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How do we design for healthy communities?
D4.0 design
research skills
Co-creative for
Social Systems
Complex – all 4
Trans-disciplinary
Not-radical Innovation
Copyright © 2012, Peter Jones 37
Accessibility of Family Physicians in Ontario Josina Vink, Jessica Mills, Phouphet Sihavong Social Systems project, Strategic Foresight & Innovation, OCAD U The average age of family physicians in Ontario is 52 years old. 9.8% of family physicians in Ontario practice in rural communities, where as 13% of Ontarians live in rural communities. One third of physicians in Canada practice family medicine, but to meet the need, it should be closer to one half of all physicians.
Copyright © 2012, Peter Jones
OCAD University Mills, Sivavong, & Vink, 2011 Positive Systems Change In Rural Communities Without A Family Physician: A Case Study
Copyright © 2012, Peter Jones
Service design for caregiver community
Copyright © 2012, Peter Jones
“How can the community of Thessalon First Nation meet and exceed their primary health care needs?”
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
How do we design for healthy communities?
D4.0 design
research skills
Co-creative for
Social Systems
Complex – all 4
Trans-disciplinary
Not-radical Innovation
Copyright © 2012, Peter Jones
Copyright © 2012, Peter Jones
Thank you.
@redesign @designforcare designforcare.com designdialogues.com redesignresearch.com Strategic Innovation Lab OCAD University Toronto Strategic Foresight & Innovation