Abstract
Service design and service thinking in many industries concentrate on providing a competitive advantage. In healthcare, better service design focused on the patient and provider experience can also improve patient outcomes, for example, by ensuring healthcare regimens are followed. Improving patient care while concurrently minimizing costs requires both big leap and small step design thinking. Healthcare organizations that use service design and service thinking innovations are often touted for big leap, system-wide design innovations. While these types of big leap design change are important, small step design thinking can also help healthcare organizations make service changes with significant results. This chapter will present two case studies illustrating small step design thinking in healthcare. Small step service design focuses on processes that may seem routine or mundane but are integral to improving patient service experience and patient health outcomes. Examples include a patient appointment process that was designed to address research showing a patient is more likely to attend a clinical appointment if that appointment is set before the patient leaves the office of the current clinician visit and a design change at a city fire department that improved access and saved taxpayer dollars. These case studies will show how small step service design thinking can be used to achieve improved patient care and can be used by other healthcare organizations to guide their service thinking.
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References
Cannuscio, C. C., Davis, A. L., Kermis, A. D., Khan, Y., Dupuis, R., & Taylor, J. A. (2016). A strained 9-1-1 system and threats to public health. Journal of Community Health, 41, 658–666. https://doi.org/10.1007/s10900-015-0142-x.
Carmel-Gilfilen, C., & Portillo, M. (2016). Designing with empathy: Humanizing narratives for inspired healthcare experiences. Health Environments Research and Design Journal, 9(2), 130–146.
Center for Care Innovations. (2015). Three SNIN sessions showcase paradigm-shifting partnerships. Center for Care Innovations (Ed). Accessed January 15, 2018, from https://www.careinnovations.org/resources/three-snin-sessions-showcase-paradigm-shifting-partnerships/
Centers for Medicare and Medicaid Services. (2017). HCAHPS: Patients’ perspectives of care survey. Centers for Medicare and Medicaid Services. Accessed January 15, 2018, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS.html
Dam, R., & Siang, T. (2018). 5 stages in the design thinking, process, interaction design foundation. Accessed February 24, 2018, from https://www.interaction-design.org/literature/article/5-stages-in-the-design-thinking-process
de Lisle, K., Litton, T., Brennan, A., & Muhlestein, D. (2017). The 2017 ACO survey: What do current trends tell us about the future of accountable care?. Health Affairs Blog. Accessed January 15, 2018, from https://www.healthaffairs.org/do/10.1377/hblog20171021.165999/full/
Englander, M. (2016). Expanding the LAFD nurse practitioner program. LA City Council District 12. Accessed January 15, 2018, from http://www.cd12.org/expanding_the_lafd_nurse_practitioner_program
Feinberg, D. (2016). Eliminating waiting rooms. LinkedIn Pulse. Accessed January 15, 2018, from https://www.linkedin.com/pulse/eliminating-waiting-rooms-david-feinberg?trk=prof-post
Forrest, C. B., Shadmi, E., Nutting, P. A., & Starfield, B. (2007). Specialty referral completion among primary care patients: Results from the ASPN referral study. Annals of Family Medicine, 5(4), 361–367.
Heath, C., & Heath, D. (2010). Switch: How to change when change is hard. New York: Crown Business.
Interaction Design Foundation. (2017). Service design: Design is not just for products. Interaction Design Foundation. Accessed January 15, 2018, from https://www.interaction-design.org/literature/article/service-design-design-is-not-just-for-products
Interaction Design Foundation. (2018). The basics of user experience (UX) design. Interaction Design Foundation. Accessed January 5, 2018, from https://www.interaction-design.org/
Kheirkhah, P., Feng, Q., Travis, L. M., Tavakoli-Tabasi, S., & Sharafkhaneh, A. (2016). Prevalence, predictors and economic consequences of no-shows. BMC Health Services Research, 16(1), 13.
Kim, S. H., Myers, C. G., & Allen, L. (2017). Health care providers can use design thinking to improve patient experience. Harvard Business Review, 95(5). Boston, MA: Harvard Business Publishing.
Kizer, K. W., Shore, K., & Moulin, A. (2013). Community paramedicine: A promising model for integrating emergency and primary care. UC Davis Institute for Population Health Improvement. Accessed January 5, 2018, from https://www.ucdmc.ucdavis.edu/iphi/publications/reports/resources/IPHI_CommunityParamedicineReport_Final%20070913.pdf
Los Angeles Fire Commission. (2016). Memo on public-private partnership to create an additional nurse practitioner response unit. Los Angeles Fire Commission. Accessed February 2, 2018, from http://clkrep.lacity.org/onlinedocs/2016/16-0857_rpt_FC_08-04-2016.pdf
Los Angeles Fire Department. (2015). Memo on nurse practitioner response unit. Los Angeles Fire Department. Accessed February 2, 2018, from http://ens.lacity.org/lafd/lafdreportarchv/lafdlafdreport186498079_08252015.pdf
Los Angeles Fire Department. (2018). Welcome to the Los Angeles Fire Department. Los Angeles Fire Department. Accessed January 5, 2018, from http://www.lafd.org/about/about-lafd
Martin, C., Perfect, T., & Mantle, G. (2005). Non-attendance in primary care: The views of patients and practices on its causes, impact and solutions. Family Practice, 22(6), 638–643.
McLean, S. M., Booth, A., Gee, M., Salway, S., Cobb, M., Bhanbhro, S., et al. (2016). Appointment reminder systems are effective but not optimal: Results of a systematic review and evidence synthesis employing realist principles. Patient Preference and Adherence, 2016(10), 479–499.
Network for Excellence in Health Innovation. (2011). Improving patient medication adherence: A $290 billion opportunity. Network for Excellence in Health Innovation. Accessed January 5, 2018, from https://www.nehi.net/bendthecurve/sup/documents/Medication_Adherence_Brief.pdf
Paudyal, V., MacLure, K., Buchanan, C., Wilson, L., Macleod, J., & Stewart, D. (2017). When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night: Behavioural determinants of homeless patients’ adherence to prescribed medicines. Public Health, 148, 1–8.
Petersen, M., & Hempler, N. F. (2017). Development and testing of a mobile application to support diabetes self-management for people with newly diagnosed type 2 diabetes: A design thinking case study. BMC Medical Informatics and Decision Making, 17(1), 91.
Plattner, H. (2018). An introduction to design thinking, process guide. Institute of Design at Stanford. Accessed January 5, 2018, from https://dschool-old.stanford.edu/sandbox/groups/designresources/wiki/36873/attachments/74b3d/ModeGuideBOOTCAMP2010L.pdf
Porter, M. (2012). Value-based health care delivery. Harvard Business School Institute for Strategy and Competitiveness Redefining Health Care. Harvard Business School. Accessed January 15, 2018, from http://www.hbs.edu/rhc/index.html.
Porter, M., & Teisberg, E. (2006). Redefining health care: Creating value-based competition on results. Watertown, MA: Harvard Business Review Press.
Pyatak, E. A., Florindez, D., & Weigensberg, M. J. (2013). Adherence decision making in the everyday lives of emerging adults with type 1 diabetes. Patient Preference and Adherence, 7, 709–718.
Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for healthcare management and innovation. Healthcare, 4, 11–14.
Sanko, S., Ito, T., Guggenheim, A., & Eckstein, M. (2017). Nurse practitioner response unit launched in Los Angeles. Journal of Emergency Medicine, 42(2).
Shostack, G. L. (1984). Designing services that deliver. Harvard Business Review, 62(84115), 133–139. Accessed January 15, 2018, from http://www.lcis.com.tw/paper_store/paper_store/servicesThatDeliver-20141291771178.pdf
Steelcase. (2018). New insight into the patient experience. Steelcase. Accessed January 5, 2018, from https://www.steelcase.com/research/articles/topics/healthcare/new-insight-into-the-patient-experience/
Sviokla, J., Schroeder, B., & Weakland, T. (2010). How behavioral economics can help cure the health care crisis. Harvard Business Review, 88(3). Boston, MA: Harvard Business Publishing.
Tadros, A. S., Castillo, E. M., Chan, T. C., Jensen, A. M., Patel, E., Watts, K., et al. (2012). Effects of an emergency medical services-based resource access program on frequent users of health services. Prehospital Emergency Care, 16(4), 541–547.
Thies, A. (2015). On the value of design thinking for innovation in complex contexts: A case from healthcare. Interaction Design and Architecture Journal, 27, 159–171.
Acknowledgment
Thanks to Cal Bowman and the president and CMO of a large ACO for participating in interviews that informed this book chapter.
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Gleason, B., Bohn, J. (2019). Using Small Step Service Design Thinking to Create and Implement Services that Improve Patient Care. In: Pfannstiel, M.A., Rasche, C. (eds) Service Design and Service Thinking in Healthcare and Hospital Management. Springer, Cham. https://doi.org/10.1007/978-3-030-00749-2_3
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