Study Objective: To determine the value of utilizing high-fidelity emergency department simulation as a tool in the human-centered design process as part of a design thinking course on improving patient experience. Methods: In design thinking methodology, empathy research is recognized as a critical component of generating high-fidelity insights into the problem of inquiry. In health care, empathy would ideally be achieved by a combination of interviews and by "walking in your patients' shoes." However, due to hospital policies, direct observation and patient interaction by a group of students within the emergency department is not feasible. A 400-square-foot room in our simulation center was partitioned to reflect a generic emergency department with one trauma bay, one medical resuscitation bay, and ten patient care areas. The simulation participants included two emergency physicians, three nurses, an ED technician, and two scribes. Clinical scenarios were developed by the course instructors and portrayed by the graduate and undergraduate students taking the course. The simulation lasted forty minutes. In contrast to traditional medical simulation, medical management of the clinical scenarios was not emphasized. Instead, we recreated the realistic emergency department experience to allow the student participants to empathize many of the emotions, stresses, and sensations experienced by patients and family members in a real emergency department. This included doctor-patient interactions, noise levels, critically ill patients nearby, difficult discussions with providers, and waiting to be seen or updated about time-sensitive medical and psychiatric complaints. Results: The design thinking process is traditionally composed of five sequential phases: empathize, define the problem, generate ideas, prototype, test and evaluate the solutions. This department-level scenario provided immersion in the patient experience and formed the foundation of the first two phases. Course participants noted a high sense of empathy achieved through the simulation. The insights generated in this phase were subsequently utilized to accelerate progress through the subsequent stages of the design thinking process. Furthermore, nine of eleven respondents noted that the simulation was one of the most memorable components of the design thinking course. Conclusion: Design thinking can benefit from utilizing simulation, particularly in the emergency department or other care settings where direct observation is challenging. Department-level simulation represents an innovative approach to modeling, understanding, and optimizing the patient experience. It may also hold promise for investigating other operational issues such as patient throughput or the introduction of new health technologies.
Leroux, E., Wagner, E., Boughan, M., & Wagner, A. (2016). 292 Exploring the Role of Simulation in Design Thinking: Redesigning the Emergency Medicine Patient Experience Through a Simulated 12-Bed Treatment Area. Annals of Emergency Medicine, 68(4), S114. https://doi.org/10.1016/j.annemergmed.2016.08.307