While searching for a suitable practical methodology for this research project, I came across a scientific paper for a Design Research Society conference in 2018, written by Dr. Erez Nusem, University of Sydney. The paper gives an overview of different design approaches for healthcare, which can be applied not only to UX and interaction design, but also to industrial and social design.
When bringing research into project work, these approaches can help to define the relationship between the prescribed outcome and the constrained context, as well as the extent to which design can or should have an impact when talking to stakeholders.
Design as an human-centered approach
Healthcare systems are becoming increasingly conscious of the quality of care delivered, nevertheless the majority of innovation in the realm of healthcare has been focused on products and services. These technology-driven innovations treat medical staff as the primary stakeholder and do little in the way of improving the quality of care for patients. As a human-centered approach, design offers a method for holistically exploring problems, meeting stakeholder needs, and has been established as a means of driving innovation.
Systematization
The author categorizes four design approaches and places them on a coordinate system that shows the relationship between the amount of prescribed and constrained context. This emphasizes the impact of designing for healthcare, where precise boundary conditions do exist.
Design approaches
Result-centered design (simple)
Description
Design follows ‘the rules of the game’, concentrating on design conventions, customs and habits, and the set ways of working within a field (e.g. concentrating on the user and designing from their perspective).
Example
As articulated directly by the staff, previous ultrasonic scanners were very immobile and heavy. Philips designed a machine which could easily be moved around a patient. The process based on observation and analysis of current devices in use.
Requirements
- Basic understanding of design.
- Problems are easy to identify and articulate.
- A deep sense of empathy is not required.
Suitable design scenarios
- No consideration of workflow and processes in newly designed environments.
- Lack of standardised procedure for training and use of equipment.
- Lack of standardised platform in hospital for collecting and storing patient data.
Situation-centered design (complicated)
Description
Design follows ‘the rules of the game’, concentrating on design conventions, customs and habits, and the set ways of working within a field (e.g. concentrating on the user and designing from their perspective).
Example
A group of designers worked on improving the information exchange between nurses in shift changes, which has been incomplete and resulted in unsatisfied patients. As a result nurses were advised to share information in front of patients, which increased quality of information transfer between all stakeholders and shorter preparation time for nurses.
Requirements
- High design competency required, since design criteria can be difficult to define.
- Context needs to be explored holistically.
Suitable design scenarios
- Patients with undiagnosed conditions which are discovered through unrelated treatment.
- Outdated workflows that have evolved over time, with no deliberate design.
- Suboptimal experience in waiting rooms with issues around long wait times for patients.
Subject-led design (complex)
Description
Design is concerned with the process and development of new ways of working which are imposed upon a problem (e.g. reframing the design problem to develop something new).
Example
CT scanners require patients to remain still for as long as the lengthy exposure takes. Instead of increasing the imaging source‘s power, causing a higher dose of radiation, designers came up achieving a more enjoyable experience while scanning through changing the hospital‘s environment.
Requirements
- Being open-minded to undefined outcomes.
- High degree of empathy and understanding of stakeholders and challenges.
Suitable design scenarios
- Staffing issues (e.g., understaffed due to low retention), meaning patients often need a return visit following diagnosis.
- Patients with visible medical products are self- conscious.
- Prolonged stay in sterile environments, with minimal interaction with other humans.
Design for innovation (chaotic)
Description
Design is revolutionary and disruptive, where the designer explicitly aims to redefine the field (e.g. the entire problem and solution are reconceptualised).
Example
Medicial errors are often caused of incorrect usage of medical devices due to a technological design focus. Designers who consider users and usage scenarios are able to achieve a seamless user experience, which benefits ease of use and shortens learning time for medical staff.
Requirements
- Being open-minded to leave conventional paths and practices.
- Being open-minded to undefined outcomes.
- Overall holistic perspective required.
- Masterful design competency, facing ambiguity without pre-existing solutions.
Suitable design scenarios
- Lack of channels for patients both pre and post-care (e.g. initiating care and discharge) to be engaged in their care.
- Desensitised staff which see patients cases rather than individuals.
- Services are not value-driven and do little in the way of ensuring optimal patient outcomes.
Insights
Regarding my research, I’d like to classify my research project between situation-centred design and design for innovation regarding the following aspects:
Situation-centered design
- The context needs to be explored holistically, as it is emergency relevant, it must work for different contexts.
- The solution can be narrowly prescriptive, optimizing the few existing solutions.
Design for innovation
- There is a lack of existing solutions.
- Given new technologies and devices, the outcome could be anything.
- A holistic approach to users and context of use, as suggested by the authors, is needed: Taking into account the attribution of epilepsy stigma, such as the visibility of seizures and cultural perceptions, as well as the different symptoms of epilepsy, as people with epilepsy often experience different individual and social challenges depending on the severity of their symptoms.
Resources
Nusem, E. (2018) Design in Healthcare: challenges and opportunities, in Storni, C., Leahy, K., McMahon, M., Lloyd, P. and Bohemia, E. (eds.), Design as a catalyst for change – DRS International Conference 2018, 25-28 June, Limerick, Ireland. https://doi.org/10.21606/drs.2018.318
