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Whereas in industry, where an innovation designer may prioritize customers’ preferences to maximize profits, in health care a balance must be struck between creating interventions that are effective and sufficiently palatable and feasible so that they will be used by providers and patients. Design Thinking is an approach that prioritizes developing empathy for users, working in collaborative multidisciplinary teams, and using “action-oriented rapid prototyping” of solutions (2,6). It is an iterative process, with innovation emerging only after cycling through several rounds of ideation, prototyping, and testing, which distinguishes it from the traditional linear and often top-down approach to health intervention design (Figure 1) (1,2,4). Design Thinking has been used across sectors to solve complex problems, including the redesign of an elementary school curriculum to enhance student engagement (7), and in domains such as aviation (8) that, like health care, have high levels of risk. Design Thinking is similar to both “user-centered design” and “human-centered design,” which are both referred to as “Design Thinking” in this article.
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As health care systems around the globe struggle to expand access, improve outcomes, and control costs, Health Design Thinking offers a new approach for designing dynamic, responsive health care products and services. Health Design Thinking is authored by Bon Ku, physician and founder of the innovative Health Design Lab at Thomas Jefferson University, and Ellen Lupton, award-winning designer, author, and curator at Cooper Hewitt, Smithsonian Design Museum, with contributions from experts in design and medicine. This practice-based guide applies design thinking to real-world health care challenges. Health care systems require continuous innovation to meet the needs of patients and providers (1,2). However, these stakeholders are not always considered when new interventions or system processes are designed, which results in products that remain unused because they do not account for human context, need, or fallibility (3,4). This approach also likely contributes to the decades-long gaps between intervention development and implementation (5).
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Occupancy of a new or renovated health care space triggers immediate regulatory and safety requirements including location of emergency shut-off valves, accurate inventory counts, preventive maintenance procedures for equipment, and updated and accurate life safety drawings. As an industry, we have seen an increase in the inclusion of end-users in the design process, however, transition to operations is an area where increased collaboration with facilities can yield greater results and improved safety. Josh will share his experiences as a facilities professional and will offer ideas and suggestions for improving the transition process. This section outlines several innovative design strategies borne out of a need to address challenges faced by aging populations. However, each model incorporates universal design principles and should be considered for the health and well-being benefits for any person at any age.
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Stay current on the latest health design topics with these educational resources that will inform and improve your design projects. We’re reshaping healthcare through creative, user-first design solutions and reimagining the way that healthcare facilities are designed and built, to better serve patients, medical personnel and the greater community. Design Thinking is being used in varied health care settings and conditions, although application varies. Design Thinking may result in usable, acceptable, and effective interventions, although there are methodological and quality limitations. More research is needed, including studies to isolate critical components of Design Thinking and compare Design Thinking–based interventions with traditionally developed interventions.
One inspiring example is an intergenerational program in Seattle, where residents of Providence Mount St. Vincent senior care community share the facility with 125 children attending daycare (Jansen, 2016). The hallways and vacant rooms double as the children’s playground, and the common spaces serve as a dance floor for all ages. As people grow older and move into retirement, they tend to have fewer social networks, and the risk of loneliness and isolation is heightened.
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In rural communities, more people may work outdoors, and cooling access may be more limited as compared to urban areas. Where the design is key, there are many deliverables from compliance and coordination that need to be managed to ensure projects get completed timely and according to the design intent. GDG helps manage projects from conceptual design thru completion by tracking all milestones and closing the loop on all coordinated efforts.
It should also be noted that this process required significant time and energy from stakeholders. This study highlights the importance of staying true to the user-centered nature of Design Thinking throughout the process — from development to implementation — to maximize implementation success. Teams using Design Thinking should be prepared for a more intensive process than traditional, less iterative and user-centered methods. Twenty-four studies using Design Thinking were included across 19 physical health conditions, 2 mental health conditions, and 3 systems processes. All 4 studies comparing Design Thinking interventions to traditional interventions showed greater satisfaction, usability, and effectiveness.
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A practicing emergency medicine physician, he is also the Director of the Health Design Lab and created the first design thinking program at a medical school. His innovative program tackles healthcare inequalities as a form of social justice and teaches future physicians to apply human-centered design to healthcare challenges. His work towards designing better health has been featured in The New York Times, CNBC, Fortune and Wired. Dr. Ku is the recipient of the Cambridge Health Alliance Art of Healing Award and healthcare innovation awards from The Philadelphia Inquirer and the Philadelphia Business Journal.
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This review suggests that Design Thinking may result in more usable, acceptable, and effective interventions compared with traditional expert-driven methods. However, there is inconsistent use of the methodology and significant limitations inherent in the studies, which limits our ability to draw conclusions about this approach. Future studies may benefit from focusing on comparing interventions developed using Design Thinking methods with traditionally developed interventions, including those with RCT designs, and identifying the most useful components of Design Thinking methods. Given the varied outcomes included in the review and the inconsistent reporting of qualitative outcomes it was difficult to make comparisons across studies. The range of study types and limited number of large scale RCTs testing intervention effects also made it difficult to draw definitive conclusions about effectiveness.
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Design Thinking is also similar to other techniques, such as plan-do-study-act cycles and formative evaluations. We considered the emphasis on empathizing with the user and the use of low-fidelity prototyping to be key distinguishing features of Design Thinking, so only articles that explicitly indicate their use of these approaches were included. Initial screening was completed for all selected abstracts, and a second round of screening was completed on eligible full-text articles. While there are several cases of innovative strides toward more universal design, in many cases the basic needs of aging individuals are still not being met. Most buildings and public environments fail to support anything beyond the needs at the lower end of Maslow’s pyramid (Sinclair & Watson, 2014).
This webinar will describe the team’s approach to adaptive reuse, repurposing vacant retail space to provide direct health benefits for the patients, families and staff who access the facility and live within the neighborhood. Presenters will share their toolset to gather community input regarding needs and culture and offer considerations for projects seeking to become a Federally Qualified Health Center. With state-of-the-art capabilities such as electronic health record systems, robotic surgeries, remote video connections, and medication safety systems, organizations can increase diagnostic and treatment efforts and enhance patient outcomes in exciting ways. These advancements can support cost-effective and efficient patient-centered care, all of which should be thoughtfully integrated into layout and design details. Individualized care within a patient-centered medical home is provided in a culturally and linguistically appropriate manner. As people live longer and longer, managing the needs of the aging population is more important than ever.
Universal design aims to make products, environments, and content accessible to everyone. Human-centered design explores people’s needs and wants in order to enhance well-being. Over time, Cooper Hewitt, Smithsonian Design Museum has documented design for better health through a range of exhibitions, publications, collections, and educational programs.
It will be an essential volume for health care providers, educators, patients, and designers who seek to create better experiences and improved health outcomes for individuals and communities. This book offers a practice-based guide to applying the principles of human-centered design to real-world health challenges that range from drug packaging to breast cancer detection. Written by pioneers in the field—Bon Ku, a physician leader in innovative health design, and Ellen Lupton, an award-winning graphic designer—the book outlines the fundamentals of design thinking and highlights important products, prototypes, and research in health design. This revised and expanded edition describes innovations developed in response to the COVID-19 crisis, including an intensive care unit in a shipping container, a rolling cart with intubation equipment, and a mask brace that gives a surgical mask a tighter seal. When healthcare facilities do not have adequate staff to maintain operations, consequences can include lost revenue, high turnover of existing staff, and compromised patient outcomes.
A truly patient-centered model means considering how patient recovery extends beyond the walls of the healthcare facility. The “Hospital at Home” model offers patients who are sick enough to be hospitalized but stable enough to be treated at home the latter option (Klein, Hostetter, & McCarthy, 2016). Under the right circumstances (health status and accessible home design), this approach can produce better health outcomes at a lower cost than hospital care (Klein et al., 2016). Many of the studies did not use low-fidelity prototyping or multiple rapid iterations, perhaps because of this tension.
The Design Thinking intervention resulted in improved detection of changes in patient states and greater ease of use, usefulness, satisfaction, and support of understanding, but no differences in workload for nurses (26). Another study using an experimental crossover design compared 2 computer interfaces designed to display drug interaction alerts, one developed using Design Thinking and one using traditional software (17,18). Whereas the design of the traditional software was not described, the traditional display included only basic text information.
At the same time, given that there was only one study with a null result, there was likely publication bias, which may have led to overestimation of the effectiveness of Design Thinking. It is also possible that investigators used methods but did not report them (eg, prototyping). In addition, we did not assess the use of Design Thinking in other health care areas where it may be beneficial, such as the design of physical spaces. Finally, Design Thinking–based health care innovations that were developed and implemented outside research contexts may exist and are thus not reported in the literature. To overcome this tension, the team involved additional stakeholders to develop a more user-centered process for the implementation of their Design Thinking innovation, after which they successfully implemented the innovation across 125 nursing units in 14 hospitals over 2 years (16). This study highlights the importance of understanding the context of the setting and users, both when developing and implementing an intervention using a Design Thinking approach.
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