How to think differently
about co-designing solutions
to complex project problems
For hints and tips visit our website at: www.institute.nhs.uk
Step 1:
Step 2:
Local
experience
Similar
situations
The NHS Institute for Innovation and Improvement have been working
with the Derbyshire End of Life project team over the last few months
to look at how ‘thinking differently’ techniques can be applied to a
particular issue in End of Life services.
1:
Local
Experience
The issue is around the need to identify people who do not require
resuscitation more clearly to healthcare professionals so that they do
not receive inappropriate care in an inappropriate setting, particularly
acute hospitals.
Before pursuing the design of a potential solution, it was agreed that
service users/patients would be consulted with to assess their views
on this subject and clarify what would help them to have more control
over their care.
The NHS Institute supported this process by working to create a focus
group of service users, to understand their needs and set up a way
of moving forward to co-design solutions. The initial outcomes were
handed over to the Derbyshire project team who will develop a larger
consultation plan with other patient/service user groups and organisational stakeholders.
A series of questions were developed to help to focus discussions with
different audiences namely, patients, carers and staff. This template
was handed over to the project team for future use in their project.
Working in this way allowed the team to test their ideas before rolling
them out or developing a wider consultation strategy.
For further information please contact:
careoutsidehospital@institute.nhs.uk
2a:
Similar
situations
In looking at the way other international healthcare systems have
addressed this problem, Derbyshire’s project team have considered the
development of an identification system such as a bracelet or necklace.
Comfort care bracelet
In Hawaii, this system, called Comfort Care, is supported by a
legislative framework and provides immediate identification of
a person’s details and needs with regard to their end of life care.
The discussion with the service user group was very fruitful.
What is
the progress
so far?
There was lots of discussion about the positives and negatives of an
ID system such as the one in Hawaii and group members thought
creatively about other potential solutions such as adapting the message
in a bottle system or the medicare necklace used for medicines
management purposes.
The conclusion was that there are a range of ways in which needs can
be identified and maybe it is better that people have a choice about
which option they use rather than being given the one and only
solution. Technology is not the answer as it can fail. It has to be
something tangible that you can carry on your body and the user has to
be in control of it and own it. The user has ultimate control of changing
the identifier, no one else.
Group members felt that an ID system was a positive way of regaining
control which has been lost when you are diagnosed with a terminal
illness.
They also helped the project team by revisiting the fundamental project
problem and suggesting ways forward in which they could proactively
support change. They offered to work directly with the local ambulance
trust and help to market a recently developed out of hours system that
could be a potential focal point of support for people at end of life.
This group had experience of designing an integrated information and
personal records system for people with cancer which they wished to
share.
The design process
You are
invited to...
Thinking differently
creativity
workshop
Questions
developed for
different audiences
Learning
from Hawaii
Working
with cancer
service user
group
(testing and
prototyping)
Three Top Tips
1. Involve service users and potential users of the service as early as
possible in “thinking differently” about project issues.
Their experiences can often lead to creative ideas as well as helpful
reframing of the problem itself.
2. Use focus groups as a way of creating a positive and open
environment for people to express their views and as a safe place
to test ideas with people.
3. Design useful tools to give back to patient/service user groups.
Prototypes