Human Centred Care - Navigating healthcare complexity

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Human centred care leading innovation in health

When the pandemic struck, it revealed opportunities to innovate and improve healthcare systems in different areas of the world. Healthcare was in the spotlight begging for creative solutions.

Remarkably, I have heard several stories where ideations during COVID (where did they have the time or energy) thrived and we are seeing the great innovations come to light. 

My focus is on the innovations and clinical improvements as a result of human centred care and design.

Human-centred design is an approach to problem-solving that puts people first. Their needs, their constraints, their contexts and their perspectives. It focuses on users—not necessarily what designers, researchers, or others think users need.

People-centred care: care that is focused and organised around the health needs and expectations of people and communities rather than on diseases. People-centred care extends the concept of patient-centred care to individuals, families, communities and society.

Whereas patient-centred care is commonly understood as focusing on the individual seeking care — the patient — people-centred care encompasses these clinical encounters and also includes attention to the health of people in their communities and their crucial role in shaping health policy and health services. (Source)

I recently found a podcast with Susanne Le Boutillier chatting with Satyan Chari about bridging gaps in healthcare through human-centred design. He is an Occupational Therapist and currently leads the Clinical Excellence Queensland (CEQ) Bridge Labs program which harnesses the benefits of creative design, systems, and human factors science to improve healthcare.

Present healthcare system challenges are very different from the problems of healthcare in the 1980s. System interactions compel us to create innovative solutions that allow us to look at various healthcare situations through the lens of technical and social complexity.

Satyan understands the value of human resilience while working in complexity. Change happens when people are willing to do the work and employ sustainable solutions.

The neuroscience of conversations

Challenges in healthcare innovation

Common challenges found in healthcare innovation:

  1. Creating and sustaining an Innovative culture:

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Centres struggle to identify and rank problems, ideas or projects that will likely translate to positive health and system outcomes. Across healthcare, two syndromes can be detrimental to project selection: “we’ve done that before” and “not invented here.” Centres lack tested criteria for project selection and may struggle with balancing the need for social impact on the one hand good financial returns on the other. With these scenarios, driving the psychological safety of teams and creating a culture of psychological safety and innovation is critical. Many organisations who are hindered by “old systems” thinking find it easier to establish a separate unit that allows an innovative and collaborative culture to thrive. 

  1. Scoping the innovation process for success and mitigating confirmation bias:

Interdisciplinary design teams are, by nature, optimistic and ambitious – and usually driven by an ambitious need to change the status quo and deliver quality patient care. However, team members can end up taking on responsibilities over and above the call of duty out of a passion for solving a problem. Leadership and teams find it hard to come together to scope and resource projects appropriately as well as put projects on the shelf (or kill them) when needed. This is usually a result of not having a commercialisation focus on innovation and a lack of ability or process to mitigate the confirmation or optimism bias that occurs as a part of their enthusiasm. As a result, team optimism and ambition can be wasted on activities that lack boundaries, focus and accountability.

  1. Managing multi-stakeholder teams of clinicians, designers, engineers, and business managers:

Diverse stakeholders often bring conflicting motivations, perspectives and approaches to collaborative design projects, especially in their prescribed roles. Designers often embrace quantity and speed of idea generation, with quick-and-dirty prototyping; clinicians, cautious, precise, and scientific in their approach to problem solving, can seem rigid and bureaucratic by comparison. Project collaborators often lean more towards near-term or long-term thinking – with near-termers being perceived as quality improvers; long-termers as out-of-touch with reality. Each participant has skills, and perspectives that are valuable to the design, build and efforts in human-centred design and innovation – what is critical is that there is a strong facilitator and project manager to manage multiple stakeholders and keep everyone on track and accountable. 

       4. Navigating pressures to show immediate value

Innovation project sponsors often desire breakthrough, transformative or disruptive innovation but fail to articulate what that means or to support the longer-than-expected timeframes required to show and deliver value. Yet, sponsors often assess proposed concepts for fit and financial return early on. This can result in favoring projects promising a quick ROI over riskier projects offering bigger impact in the long-term.

  1. Establishing appropriate performance metrics and assigning attribution

Innovation is inherently risky which makes bottom-line revenue and time-frame targets challenging to establish. Unrealistic or non-existent financial and non-financial targets and expectations can be demoralising for teams. Sometimes, innovation centers at the front line of human-centered design do not have robust metrics for recognising incremental but critical successes. Issues of attribution can also arise when projects are implemented outside the walls of innovation centers and often take time to come to fruition.

  1. Identifying and supporting pathways to implementation

Outcomes of successful innovation projects, such as a product, service or research finding, often need varying types and degrees of support to transition to the next phase of development. An immediate answer to the question “who implements and how?” is not always evident. Taking a product or innovation from an idea to a product and managing that product through its maturity is often a different skillset that needs to be allocated.

 

Innovation in healthcare

Healthcare organisations with existing innovation centers, and those considering developing them, should consider the following actions to mitigate the challenges mentioned above:

  • Identify a specific purpose that unifies efforts and engage only in activities which forward it.
  • Create forums for project contributors to learn about varying approaches to problem-solving.
  • Develop stakeholder co-creation methods and tools which ensure maximum engagement amidst resource constraints.
  • Enlist project managers and ensure clear roles and responsibilities for all center employees.
  • Set project budgets and scope design projects at the outset to align with funding size and horizons.
  • Establish clear initial operational and performance metrics such as percent of innovation concepts expected to be implemented, number of clinicians and patients involved in co-creation processes, types of IP generated, and stage-gated timelines.
  • Be prepared to revise metrics as the center evolves and celebrate small wins.
  • Share your success and experiences with others so that they can learn from your successes.
 

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