service design of care - ocadu workshop

Copyright © 2015, Peter Jones

Designing Inspirationfor Community Health

Service Design for Health Movements

Peter JonesOCAD University, Toronto

Service Design for Healthwith Dr. Rick Botelho

April 21, 2015


Design’s emerging role in complex domains


Where is health located?

In the individual?

Where they live?


Care occurs in-place, in a communitywe share with others.

Caring requires knowing, trust, patience, humility,honesty, & the primacy of life’s rhythms.

“… there must also be developmental change onthe other as a result of what I do; I must actuallyhelp the other grow.” M Mayerhoff


Design for “new value demand”Less for failure demand

• From systems perspective,disease focus is an intervention.

• Patient context is temporary• How to motivate prevention,

adherence, & continuity?


WHAT IS HEALTH SEEKING ?


All people are health-seekers

A health-seeking journey occurs over a lifetime, a continuitythat proceeds through youth, adulthood, & older age.


3 ORDERS OF HEALTH FEEDBACK

Dubberly.com & Design for Care

Copyright © 2015, Peter Jones Dubberly.com & Design for Care

STAGES OF INTRA-PERSONALHEALTH SEEKING


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


How does identity change when a patient?Are we disempowering self-care?


Today, services are discrete events


Functional unit of service provision

Can connect services across system levels


Functional unit of service

Connecting closer to the health-seeker

Coordinated services across systems


A Service Design process

Human ResearchDesign Research

Prototype Testing


Basic service concepts.


A simple service experience map.


Framing Coaching as a Service

• Service for “who in a community”• Frames are reflective responses to a desired action.

There is always a “prior pattern”• Our “initial appreciation” has huge leverage!• Avoiding jargon & default ways of thinking

• What are the affordances in communities?• How do movements (or contagions?) form?


“Frames not only simplify and create alternative views of aproblematic situation; they also evoke particular outcome spacesthat afford a range of responses.”

Paton & Dorst (2011). Briefing and reframing: A situated practice. Design Studies.

Language Co-Creation with yourstakeholders

Releasing fixation from prior frames

Considering “users” & their preferredvalues, taste regimes


Framing exercise.• Develop a framing concept for coaching in your

contexts, using handout.

• How might coaching / peer exchange take hold inyour network or situation?

• How would it be understood by others as a value tobe co-created?

• How would coaching be valued and understood?

Individually: Consider & enter responses in formPairs: Share concepts, identify similar / differing


Debrief

• What frames for coaching / movements / did you co-create?

• What are the affordances in communities?

• How do movements (or contagions?) form?

• What’s the analogue today?


Today’s New Design Domains

Complexity increases at each .0

Number of stakeholders >Need for collaboration >Multi-tech, multi-design, multi-disciplinary

Future healthcare services will require all 4levels of skill & knowledge.

But design skills do not transfer up.Mixed teams always a necessity.


• Integrating clinical & community services• Interventions for social determinants• Community health promotion

• Redesigning services for new business models• Design & research for care innovation• Clinical teams communication & coordination

• Patient-health experience of service• Redesign EHR / information as workflow• Patient self-service in local clinics• Patient information across care journeys

• Innovative & usable wayfinding• Interior space infection control

Healthcare design across 4 domains


Demand Side Innovation (Bottom-up)• Human experience – What are real concerns:

Student resilience in their first year of university• Mapping out journey of “ups & downs”• Identify key transition points• Top of map - Campus service systems

Human-Centred Systems


A Service Design process

Human ResearchDesign Research

Prototype Testing


Demand Side Innovation (Bottom-up)• Patient side - Human-centred concerns:

Mental wellness responsive to students.• People don’t know what services are offered• Fear or stigma associated with therapy• Care complicated by other conditions, life situations• Case study: OCADU Campus Mental Wellness

• Research modes: Ethnography, Dialogue, Public workshops• Design methods: Service analysis, Blueprint, Journey, Mapping

Human-Centred Service Design


OCADU Health & Wellness Centre – Service Flow

Current Service Blueprint


As re-envisioned to enable early student self-care

Oikonen, Starkman, Jones, Yip. (2014).


Distributing health care resourcesamong different points of care:

• Person-Family• Person-Community• Patient-Patient• Patient-Providers• Providers-Community


Co-creating care in our communities


Extending our communities to largernetworks.