Purpose: To utilize an interdisciplinary user-centered design process to co-create experience improvement strategies on a medical inpatient unit.
Description: We conducted a 1-day, interdisciplinary experience improvement design session focused on a 24-bed medical unit. Participants included 4 attending hospitalists, 1 medical student, 8 nurses, 1 nurse manager, 1 pharmacist, 1 case manager, 1 social worker, 1 certified nursing assistant, and 1 process improvement specialist. The purpose was to design 4 human experience “Always Events” to be implemented by January 2017.
Significant background work on the unit included a review of HCAHPS data, multiple real-time patient interviews, and over 20 hours of patient and care team observation. In addition, a series of interdisciplinary focus groups were completed to evaluate baseline provider experience. The background work identified 4 critical experience areas that became the focus for the design session: (1) Patient admission and onboarding, (2) Patient discharge, (3) Interdisciplinary communication, and (4) the question: “What would the unit look like if 100% of people working on the unit were proud to work here?”
The first half of the design session focused on creative brainstorming in 5-person teams around the focus areas. Ideas were collated into related groups and nominal group technique was used to select 4 “big ideas.” Participants were then re-grouped into different teams and engaged in two 1-hour design cycles with the goal of prototyping “Always Events” around the 4 big ideas. After the first design cycle, teams received constructive feedback from the larger group that was incorporated into a second design cycle. Finally, teams presented their refined initiatives to executive stakeholders, who similarly provided feedback and support. The group developed 4 “Always Event” prototypes: (1) Twice monthly physician-nursing education sessions on the unit called the “Smash Up!” (2) An admission “time-out” conducted by the nurse and physician at the bedside, (3) An “appreciation” section of the nursing huddles at shift change, and (4) A discharge progress section of the patient whiteboard.
100% (n = 16) of surveyed participants found the design session to be effective at creating collaboration across disciplines and all found the session to be effective at promoting strategies for improving the experience of care. 3 of the 4 “Always Events” have been implemented on the unit with an early upward trend in patient experience scores (HCAHPS).
Conclusions: Interdisciplinary experience design sessions can be effective at promoting healthcare experience design and engaging providers around creative reconnection to professional purpose. While these approaches may seem resource intensive, they are more likely to promote whole-unit engagement around shared goals when compared to traditional top-down improvement efforts.