By Dr. Jeffrey Tobias
Can the same design thinking that led to coveted consumer electronics like modern smartphones also improve patient healthcare in hospitals?
That was the question Telstra posed when it engaged us to reimagine healthcare processes at Calvary Mater hospital in Newcastle. Design Thinking is an empathetic approach to problem solving that puts the user or customer at the centre of the project. It learns their needs by involving them in the development process from the start. Design Thinking is especially powerful when used in complex scenarios where the outcome isn’t known at the start of a project.
Telstra and Calvary Health Care were looking for a more efficient and integrated healthcare solution that delivered better outcomes for patients, their families and carers.
The Holy Grail is an integrated system that tracks a patient through the healthcare process. Calvary’s 12,000 staff and volunteers provide services in 15 public and private hospitals, 15 retirement and aged-care facilities and 22 community-care centres in six states and territories. The 21st century challenge is to provide an integrated care model to cut across these boundaries and also link to partners such as primary care providers, says Telstra’s Tanya Felton.
“That’s the problem with healthcare; nothing connects,” says Felton, who is Telstra National General Manager of Health Industry Development. “There’s duplication of data capture, challenges accessing information and none of it focuses on the patient. [Currently], it’s about managing information rather than managing the person.”
Felton says that although healthcare’s measure of success is a good life for the patient, management systems tend to focus on “nuts and bolts” and may ignore the person they’re ostensibly there to serve.
Calvary’s design-thinking journey to integrated patient care
To learn and lead Calvary Health Care and Telstra to a new model for integrated healthcare, we applied a five-step process in Design Thinking:
- EMPATHISE: Clinical practice was observed and recorded in seven integrated care units for later analysis.
- DEFINE: A workshop of diverse stakeholders discussed, defined and prioritised communication problems and needs.
- IDEATE: Internal stakeholders participated in a structured brainstorming session to devise creative and meaningful solutions to identified problems.
- PROTOTYPE: Meaningful, practical solutions were built for testing.
- TEST: Another layer of insight emerged as clinician stakeholders experimented with prototypes in a workshop, sharing their experiences with each other and facilitators.
Timely access to the right information is also critical for efficient and humane care, Felton says. “We saw [clinicians] walking around with two pagers, two DECT [digital cordless] phones and a mobile phone – and in some places none of them worked. And that’s typical of any facility-based care.”
Although some carers preferred paper-based systems, which created access and security issues, hospital buildings often stymied remote access for those who preferred online access to patient records and services. Felton says: “Doctors, nurses, patients and visitors often had to walk to a window and go outside to get a mobile phone signal to access data.”
This had led to workarounds, such as the tech-savvy doctor who set up a wi-fi service for clinicians. Observing this creative “life hack”, the hospital suggested working within existing limitations to designate “Huddle Spots” – favourable areas for data reception. These are signposted as places people can check patient records, make calls and catch up on messages. Telstra is building on the innovation by trialling small-cell wireless access points.
As a result of the study, five key information and communications technologies solutions were identified to improve integrated patient care: in-building mobile coverage; portable patient records; multi-platform integrated messaging for clinicians, patients and carers; multidisciplinary rostering and effective staff utilisation; closed-community social media to link patients and staff.
The Strategy Group’s innovative use of Design Thinking helped Calvary and Telstra untangle a complex knot of problems that will lead to better, integrated patient care.
