A design thinking framework for healthcare management and innovation
TL;DR: It is shown how design thinking can foster new approaches to complex and persistent healthcare problems through human-centered research, collective and diverse teamwork and rapid prototyping.
About: This article is published in Healthcare.The article was published on 2016-03-01. It has received 303 citations till now. The article focuses on the topics: Critical systems thinking & Teamwork.
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TL;DR: Design Thinking is being used in varied health care settings and conditions, although application varies, and there are methodological and quality limitations.
Abstract: INTRODUCTION Applying Design Thinking to health care could enhance innovation, efficiency, and effectiveness by increasing focus on patient and provider needs. The objective of this review is to determine how Design Thinking has been used in health care and whether it is effective. METHODS We searched online databases (PubMed, Medline, Web of Science, CINAHL, and PyscINFO) for articles published through March 31, 2017, using the terms "health," "health care," or "healthcare"; and "Design Thinking," "design science," "design approach," "user centered design," or "human centered design." Studies were included if they were written in English, were published in a peer-reviewed journal, provided outcome data on a health-related intervention, and used Design Thinking in intervention development, implementation, or both. Data were collected on target users, health conditions, intervention, Design Thinking approach, study design or sample, and health outcomes. Studies were categorized as being successful (all outcomes improved), having mixed success (at least one outcome improved), or being not successful (no outcomes improved). RESULTS Twenty-four studies using Design Thinking were included across 19 physical health conditions, 2 mental health conditions, and 3 systems processes. Twelve were successful, 11 reported mixed success, and one was not successful. All 4 studies comparing Design Thinking interventions to traditional interventions showed greater satisfaction, usability, and effectiveness. CONCLUSION 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.
242 citations
TL;DR: The review aimed to understand why and how HCD can be valuable in the contexts of health related research and how future projects can better integrate design thinking with global health research.
Abstract: Health and wellbeing are determined by a number of complex, interrelated factors. The application of design thinking to questions around health may prove valuable and complement existing approaches. A number of public health projects utilizing human centered design (HCD), or design thinking, have recently emerged, but no synthesis of the literature around these exists. The results of a scoping review of current research on human centered design for health outcomes are presented. The review aimed to understand why and how HCD can be valuable in the contexts of health related research. Results identified pertinent literature as well as gaps in information on the use of HCD for public health research, design, implementation and evaluation. A variety of contexts were identified in which design has been used for health. Global health and design thinking have different underlying conceptual models and terminology, creating some inherent tensions, which could be overcome through clear communication and documentation in collaborative projects. The review concludes with lessons learned from the review on how future projects can better integrate design thinking with global health research.
209 citations
TL;DR: This mixed-methods study identified 5 practices that have the potential to enhance physician presence and meaningful connection with patients in the clinical encounter and combined into a final set of 5 recommendations.
Abstract: Importance Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction. Objective To identify evidence and narrative-based practices that promote clinician presence, a state of awareness, focus, and attention with the intent to understand patients. Evidence Review Preliminary practices were derived through a systematic literature review (from January 1997 to August 2017, with a subsequent bridge search to September 2019) of effective interpersonal interventions; observations of primary care encounters in 3 diverse clinics (n = 27 encounters); and qualitative interviews with physicians (n = 10), patients (n = 27), and nonmedical professionals whose occupations involve intense interpersonal interactions (eg, firefighter, chaplain, social worker; n = 30). After evidence synthesis, promising practices were reviewed in a 3-round modified Delphi process by a panel of 14 researchers, clinicians, patients, caregivers, and health system leaders. Panelists rated each practice using 9-point Likert scales (−4 to +4) that reflected the potential effect on patient and clinician experience and feasibility of implementation; after the third round, panelists selected their “top 5” practices from among those with median ratings of at least +2 for all 3 criteria. Final recommendations incorporate elements from all highly rated practices and emphasize the practices with the greatest number of panelist votes. Findings The systematic literature review (n = 73 studies) and qualitative research activities yielded 31 preliminary practices. Following evidence synthesis, 13 distinct practices were reviewed by the Delphi panel, 8 of which met criteria for inclusion and were combined into a final set of 5 recommendations: (1) prepare with intention (take a moment to prepare and focus before greeting a patient); (2) listen intently and completely (sit down, lean forward, avoid interruptions); (3) agree on what matters most (find out what the patient cares about and incorporate these priorities into the visit agenda); (4) connect with the patient’s story (consider life circumstances that influence the patient’s health; acknowledge positive efforts; celebrate successes); and (5) explore emotional cues (notice, name, and validate the patient’s emotions). Conclusions and Relevance This mixed-methods study identified 5 practices that have the potential to enhance physician presence and meaningful connection with patients in the clinical encounter. Evaluation and validation of the outcomes associated with implementing the 5 practices is needed, along with system-level interventions to create a supportive environment for implementation.
136 citations
TL;DR: This paper contextualizes how the design discipline differs from conventional approaches to research and innovation in global health, by emphasizing craft skills and iterative methods that reframe the relationship between design and implementation in human-centered design.
Abstract: As digital technologies play a growing role in healthcare, human-centered design is gaining traction in global health. Amid concern that this trend offers little more than buzzwords, our paper clarifies how human-centered design matters for global health equity. First, we contextualize how the design discipline differs from conventional approaches to research and innovation in global health, by emphasizing craft skills and iterative methods that reframe the relationship between design and implementation. Second, while there is no definitive agreement about what the 'human' part means, it often implies stakeholder participation, augmenting human skills, and attention to human values. Finally, we consider the practical relevance of human-centered design by reflecting on our experiences accompanying health workers through over seventy digital health initiatives. In light of this material, we describe human-centered design as a flexible yet disciplined approach to innovation that prioritizes people's needs and concrete experiences in the design of complex systems.
110 citations
TL;DR: After decades of research and policy initiatives, the advice to use evidence-based practices has become a mantra for improving clinical care, but research indicates that these interventions are used infrequently and inconsistently and that most efforts to implement them are unsuccessful, dramatically limiting their potential for promoting well-being.
Abstract: After decades of research and policy initiatives, the advice to use evidence-based practices has become a mantra for improving clinical care. In behavioral health, most evidence-based practices are psychosocial interventions: interpersonal or informational strategies to reduce symptoms and improve functioning. Hundreds of evidence-based psychosocial interventions now exist, and research shows that their use in real-world systems can confer demonstrable effects on communitylevel outcomes.1 Nevertheless, research also indicates that these interventions are used infrequently and inconsistently and that most efforts to implement them are unsuccessful,2 dramatically limiting their potential for promoting well-being.
71 citations
References
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TL;DR: Burnout is more common among physicians than among other US workers, and Physicians in specialties at the front line of care access seem to be at greatest risk.
Abstract: Methods: We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. Results: Of 27276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8%ofphysiciansreportedatleast1symptomofburnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internalmedicine,andemergencymedicine).Comparedwith a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with worklife balance (40.2% vs 23.2%) (P.001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Comparedwithhighschoolgraduates,individualswithanMD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P.001), whereas individuals with a bachelor’sdegree(OR,0.80;P=.048),master’sdegree(OR, 0.71;P=.01),orprofessionalordoctoraldegreeotherthan an MD or DO degree (OR, 0.64; P=.04) were at lower risk for burnout. Conclusions: Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
2,546 citations
Book•
18 May 1990
TL;DR: How Designers Think as discussed by the authors is based on Bryan Lawson's many observations of designers at work, interviews with designers and their clients and collaborators, and is the culmination of twenty-five years' research and shows the author's belief that we all can learn to design better.
Abstract: How Designers Think is based on Bryan Lawson's many observations of designers at work, interviews with designers and their clients and collaborators. This extended work is the culmination of twenty-five years' research and shows the author's belief that we all can learn to design better. The creative mind continues to have power to surprise and this book aims to nurture and extend this creativity. This book is not intended as an authoritative description of how designers should think but to provide helpful advice on how to develop an understanding of design. 'How Designers Think' will be of great interest, not only to designers seeking a greater insight into their own thought processes, but also to students of design in general from undergraduate level upward.
1,996 citations
"A design thinking framework for hea..." refers background in this paper
...Research into how scientists and designers solve problems has shown that the former put more emphasis on analysis of pre-formed hypotheses or theory-driven solution approaches, while the latter put more emphasis on synthesizing information and ideas from many different sources, in search of new and unconventional solutions.(4) In this way, design thinking can be an important new approach and toolset for complex problems in which existing practice paradigms do not work well, requiring whole new approaches to a problem....
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TL;DR: The concept of design thinking has been introduced by as mentioned in this paper to improve the look and functionality of products and to provide low-cost health care in the world, and businesses have started to adopt it.
Abstract: DESIGNERS HAVE TRADIIONALLY FOCUSED ON ENHANCING THE LOOK AND FUNCTIONALITY OF PRODUCTS. RECENTLY, THEY HAVE BEGUN USING DESIGN TOOLS TO TACKLE MORE COMPLEX PROBLEMS, SUCH AS FINDING WAYS TO PROVIDE LOW-COST HEALTH CARE THROUGHOUT THE WORLD. BUSINESSES WERE FIRST TO EMBRACE THIS NEW APPROACH—CALLED DESIGN THINKING—NOW NONPROFITS ARE BEGINNING TO ADOPT IT TOO.
1,107 citations
"A design thinking framework for hea..." refers background in this paper
...capacity for uncovering unforeseen challenges and unintended consequences.(7) In fact, Sterman argues that there are no side effects, simply effects to be learned from(8) and doing so early in a...
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TL;DR: Here it is shown how systems thinking and simulation modeling can help expand the boundaries of the authors' mental models, enhance the ability to generate and learn from evidence, and catalyze effective change in public health and beyond.
Abstract: Policies to promote public health and welfare often fail or worsen the problems they are intended to solve. Evidence-based learning should prevent such policy resistance, but learning in complex systems is often weak and slow. Complexity hinders our ability to discover the delayed and distal impacts of interventions, generating unintended "side effects." Yet learning often fails even when strong evidence is available: common mental models lead to erroneous but self-confirming inferences, allowing harmful beliefs and behaviors to persist and undermining implementation of beneficial policies. Here I show how systems thinking and simulation modeling can help expand the boundaries of our mental models, enhance our ability to generate and learn from evidence, and catalyze effective change in public health and beyond.
782 citations
TL;DR: In this paper, the results of a meta-analytic integration of previous research on productivity loss in brainstorming groups were reported, and the following patterns were observed: Generally, brainstorming gro...
Abstract: This article reports the results of a meta-analytic integration of previous research on productivity loss in brainstorming groups. The following patterns were observed: Generally, brainstorming gro...
776 citations
"A design thinking framework for hea..." refers background in this paper
...Stop brainstorming (sort of): research shows that traditional brainstorming can actually restrict creativity.(10) Instead try more disruptive forms of brainstorming, such as brainswarming which allows for input from a more diverse set of participants and thinking styles....
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