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A Healthier Tomorrow
Experience Based Design (ebd)
1
South West LHIN Health Links Learning Collaborative
Cohort 1
Presented by The Partnering for Quality Program
September 29, 2015
“The ebd approach is about sharing and understanding the experiences
of patients, carers and staff together to design
better services.”
© NHS Institute for Innovation and Improvement 2010. All rights reserved.
Doing “to” patients Doing “for” patients Doing “with” patients
Barbara Balik, Common Fire, Meeting of the Minds June 2011, The Change Foundation
To For With
Provider makes rules
and controls all
schedules
Patient/family have
some input
Patient/family as
source of control
Information not shared
with patients
Some transparency,
public data
Shared knowledge
and decision making
“I talk-you listen” “We help you” “We walk together”
Compliance focus Improvement focus Co-design focus
Unilateral Benevolent Partnership
Evolution of Patient Experience in Healthcare
The ebd approach provided an early evidence base and practical guidance.
© NHS Institute for Innovation and Improvement 2009
Practical Guidance Evaluation of the pilot
Peer reviewed
paper
A book
written by
the researchers
Core principles of the ebd approach
• A partnership between patients staff and carers
• An emphasis on experience/emotion rather than attitude or opinion
• Narrative and storytelling approach to identify ‘triggers’ and ‘touch points’
• An emphasis on the co-design of services
• Systematic evaluation of improvements and benefits
© NHS Institute for Innovation and Improvement 2009
Satisfaction versus Experience
© NHS Institute for Innovation and Improvement 2009
3 Ways to do service improvement
1. Don’t listen very much to our users and we do the designing
2. Listen to our users then go off and do the designing
3. Listen to our users and then go off with them to do the designing
(Professor Paul Bate 2007)
© NHS Institute for Innovation and Improvement 2009
© NHS Institute for Innovation and Improvement 2009
Experience Based Design is about designing better experiences…
© NHS Institute for Innovation and Improvement 2009
Methods for Capturing
De
pth
Interviews Shadowing
Filming Observation
Breadth
Emotion questionnaire Focus groups Observation
Understand the Experience
There are three key techniques in this section – they are closely linked and one leads naturally on to the other: 1) Identifying emotions 2) Determining the touchpoints 3) Mapping the emotions
© NHS Institute for Innovation and Improvement 2009
Emotional mapping
Designing a better Experience
• What’s different?
CO-DESIGN
Patients are equal partners at the table in the design and implementation of the solution(s)
Planning an experience event
© NHS Institute for Innovation and Improvement 2010. All rights reserved.
working in partnerships with patients can create some apprehension, but it has the potential to transform health
services
• Engage with all participants equally to plan the date(s) and location(s) of event(s)
• Avoid acronyms or medical terminology (i.e. simple English) • Remember that staff are often as nervous as
patients/family members • Staff may try to lead, external facilitation is important • Remember to track who is doing what by when
Measure the Improvement
Aim
Change
Measure
Improvement Cycle
The Improvement Guide: A practical approach to enhancing organizational performance (2nd Edition 2009)
Gerard J. Langley, Kevin M. Nolan, Thomas W. Nolan, Clifford L. Norman, Lloyd P. Provost
Use Quantitative and Qualitative reporting together
FROM TO
Registration:
frustrated, nervous
Registration:
calm, understanding
Measure improvement: the qualitative perspective
• Collect stories
• Observe
• Use mapping techniques
• Before and after – from and to
Pre- ebd Workshop
Post – ebd workshop
A Healthier Tomorrow
Client Care Conference – emotional mapping
Pre Conference Planning
Conference Follow Up Key
Touch Points
Emotions
Satisfied
Appreciative
Confused
Afraid
Excited/Anxious
Leery
Pleased
Satisfied
Informed
Glad
Comfortable
Detached
Overwhelmed
Satisfied
Pleased
Informed/Supported
Overwhelmed
Triggers
Provided suggestions to
help stay at home
Told me things I needed
Dr. was there
Did not ask patient
Seeing all the
professionals
Discontinued Patient
Reporting
Know who to call
instead of going to
hospital
Can’t remember all the
information
Being invited Unclear purpose A lot of people
coming into my home
Not sure why
invited
Health Links: Patients feeling respected
Health Links: Patients reporting confidence in achieving goals
Health Links: Patients feeling supported
A Healthier Tomorrow
Learning Opportunities offered by the PFQ Program
• Quality Improvement 101 (Oct 20th)– Owen Sound Best Western
• Process Mapping
• Problem Solving & Root Cause Analysis
• Patients First: Involving Patients in Their Care (Nov 5th) – Ivey Spencer
Leadership Centre
• Health Literacy
• Brief Action Planning
• Experience Based Design
• Experience vs. Satisfaction; what capture tools to use when
• Quality Improvement 101 (Nov 24th)– London/Elgin (Stoneridge Best
Western)
• Process Mapping
• Problem Solving & Root Cause Analysis