User-centred healthcare design: A new model of engagement

Abstract

The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care, South Yorkshire (CLAHRC SY) is one of nine CLAHRCs across England which commenced in October 2008 with funding for five years. The CLAHRCs were introduced in response to recognised gaps in the translation of health research into new products and treatment approaches, and in the implementation of new approaches to clinical practice (Cooksey Report 2006). They are designed to develop mutually beneficial partnerships between higher education institutions and NHS organisations to improve patient outcomes through applied health research and local implementation of the results. The three primary functions of the CLAHRCs are; The conduct of high quality applied health research Implementing findings from research in clinical practice; and Increasing the capacity of NHS organisations to engage with and apply research, including continuing professional development for professionals and managers. The mission is to undertake, over the next five years, high quality, strategic, applied research and related education in order to enable a 'step change' in the way research is delivered and services are designed in South Yorkshire; and to foster knowledge transfer that will improve the quality and effectiveness of health care delivery across South Yorkshire. One of the themes within the SY CLAHRC is User Centred Healthcare Design, the presentations which make up the symposium will provide background to UCHD as a new model of engagement for all stakeholders within healthcare, and describe the first two case studies this innovative, multi disciplinary team, are undertaking. Cooksey, D. 2006 A review of UK health research funding. HMSO, London word count 251 User Centred Healthcare Design Authors: Bowen, S, Participatory design research associate, Art and Design Research Centre, Sheffield Hallam University Cobb, M, Clinical Director of Professional Services, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Dearden, A, Reader in E-Social Action, Communication and Computing research centre, Sheffield Hallam University Wolstenholme, D, Clinical Researcher, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Wright, P, Professor of Human-Centred design, Art and Design Research Centre, Sheffield Hallam University User-Centred Healthcare This presentation will provide the background and theory of User Centred Health Care Design. The classical model of NHS healthcare involves the delivery of specific interventions to combat a patient’s illness. For the increasing numbers of people with long term conditions, delivery of acute care is only a one (possibly small) part of their health care. Day-to-day care and management of people’s health is increasingly about self-care and self-management. People are surrounded by a diverse ecology of products, services, information and other resources that they draw upon to care for their health. User-centred healthcare implies new ways of structuring and providing services that people can interact with to jointly realise their own healthcare. User-Centred Design User-centre Design emphasises users’ perspectives and users’ lived experience. User-centred design engages the people who use, and the people who are affected by, products, services and systems at every stage of development. User-centred design combines the specialist skills of trained designers with the specialist knowledge of people about their own lives, their own capabilities, their challenges, their experience and their desires. User-centred design recognises users and other stakeholders as co-designers. User Centred Healthcare Design UCHD within the CLAHRC is a research project to develop, trial, evaluate and promote user-centred methods for designing user-centred healthcare (Bate and Robert 2007). We are investigating methods where people can participate as co-designers of the systems (social, technological, institutional) that they use to promote their health and wellbeing. We work in collaboration with health researchers, healthcare providers and healthcare users to investigate the impact of user-centred methods in healthcare design, and the issues and challenges faced in adopting such methods. The authors believe that through UCHD we are offering an innovative way to truly engage patients, public (and staff) in their health care and health care systems. Bate, P. and Robert, G. (2007) Bringing user experience to healthcare improvement: the concepts, methods and practices of experience-based design. Radcliffe Publishing, Abingdon, UK. word count 293 Better Outpatients Services for Older People Authors: Bowen, S, Participatory design research associate, Art and Design Research Centre, Sheffield Hallam University Cobb, M, Clinical Director of Professional Services, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Dearden, A, Reader in E-Social Action, Communication and Computing research centre, Sheffield Hallam University Wolstenholme, D, Clinical Researcher, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Wright, P, Professor of Human-Centred design, Art and Design Research Centre, Sheffield Hallam University Everyday over one thousand older people attend and outpatient clinic at the local hospital. Some come for a diagnosis others for treatment, but all will have to navigate and use outpatient areas, facilities and services. Many older people have complex needs that require additional support such as a mobility problem or a cognitive or sensory impairment. When the service fails to meet the particular needs of individual users their independence, dignity and confidence may be compromised or undermined. Consequently older people regard an outpatient visit with apprehension or simply impossible and this may prevent them from receiving the treatment and support they require resulting in a deterioration in their health, wellbeing and independence. Using the UCHD methodology this project worked with older people, carers, staff and other stakeholders and enabled a creative process of learning improvement and innovation using their knowledge and experience, through their 'stories' of outpatients. The framework described in the Experience Based Design toolkit produced by The NHS NHS Institute for innovation and improvement (2008) was used to guide the process, and the UCHD team used the project to reflect on the usefulness of the toolkit. This presentation will outline the creative and facilitated engagement of service users with service providers to develop mutual understanding and to identify process and service improvements. How this led into prioritising specific aspects of the outpatient process, which were developed by smaller co-design groups of patients and staff. We will offer examples of the solutions that were co-designed alongside the process of engaging a diverse group in a complex NHS context. The ebd approach guide and tools 2008, NHS Institute for innovation and improvement, http://www.institute.nhs.uk/ accessed 02 Nov 2009, 22:00 word count 257 Diabetes Case Study Authors: Bowen, S, Participatory design research associate, Art and Design Research Centre, Sheffield Hallam University Cobb, M, Clinical Director of Professional Services, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Dearden, A, Reader in E-Social Action, Communication and Computing research centre, Sheffield Hallam University Wolstenholme, D, Clinical Researcher, Professional Services, Sheffield Teaching Hospital NHS Foundation Trust Wright, P, Professor of Human-Centred design, Art and Design Research Centre, Sheffield Hallam University Recent experience-based co-design projects undertaken by the NHS Institute in collaboration with the Design Council have shown the potential value of a co-design approach to services in the area of chronic illness (The Design Council 2006). The case study will be a close collaboration with the CLAHRC-SY Diabetes theme, who are undertaking both qulaitative and quantitative approaches to looking at the adolescent diabetic population in South Yorkshire. The aim of the case study is firstly to identify the problems of applying an experience-based co-design approach in the context of CLAHRC in South Yorkshire, and secondly to find innovative new service design solutions to the problems associated with the self-management of diabetes in teenagers. This group has been identified as experiencing particular problems in relation to sustained self management of their illness and the project will look at solutions that are personalised to the obstacles experienced by teenagers and to there lifestyles. The project plan is to identify young people with type 1 diabetes who are interested in working with the UCHD team to understand adolescents’ experiences of living with diabetes. To work with these young people to co-design tools (websites, applications, devices etc.) to support their self-management and improve their quality of life. Participating young people would also become ‘co-researchers’ and work with other young people with diabetes, their families and carers, to develop a broader understanding of their experiences, with training and support from the UCHD team. As possible ideas/ themes develop appropriate ‘expert friends’ would be brought in to support the co-designers This presentation will describe the process and progress of this project and the challenges inherent in working towards a new model of health, where the service provision and therefore the research is centred on and co-designed by users. RED REPORT 01: Open Health, 2006, The Design Council. http://www.designcouncil.info/mt/RED/health/REDREPORT01OpenHealth.pdf accessed 02 Nov 2009 22:00 word count 288