NHS x Glasgow School of Art - The cooperation Project
2021
Service Design / User Research / UX & UI
How can the Neurological Rehabilitation Service within NHS Ayrshire & Arran communicate to, engage with and provide for the people who work there and for whom they offer their services in a way that enhances value and purpose for those people?
Before officially starting the first round of project research, we studied and deconstructed the brief of the project in detail from the perspective of project requirements. We believe that only after clarifying the needs, the later research can meet the project requirements as much as possible, increase the purpose of the research and improve the work efficiency of the team.
In order to be able to answer these questions, we started with the research on the organizational structure of the NHS. In order to clarify the working mode and relationship between the NHS and Douglas Grant Rehabilitation Centre, we collected a lot of information on the official websites of NHS and NHS Ayrshire & Arran. Finally we figured out the position of DGRC in the entire organizational structure, the services and scope of services provided by DGRC.
Neurological diseases including Multiple Sclerosis, Parkinson's Disease, Motor Neurone Disease are some of the diseases that the Douglas Grant Rehabilitation Ward focuses on and provides services. So the questions come - What are their characteristics, and what symptoms do patients with these diseases have?
To clarify the characteristics of these diseases and define typical patient portraits, we searched for a lot of information through desk research. According to the general standard for neurological care and support (Healthcare Improvement Scotland, 2019, P.05), neurological diseases can be divided into five types from mild to severe. Among them,'progressive' is the type that we pay attention to - Most of the diseases involved in DGRC belong to this type. they are persistent and will keep getting progressing and of course affect the patient's body function finally.
Before starting the first zoom meeting, we conducted a group brainstorming in advance, and outlined the problem for DGRC in 8 aspects including work flow, working environment, and contact and communication methods. In addition, we also contacted Jenny twice by email, hoping to invite the stakeholder into our early design process, to quickly and accurately grasp the pain points.
After the first engagement session and email contact, we got a lot of useful information and insights about the stakeholder. After coding the transcribed manuscript, we summarized the information in terms of DGRC and patients into four themes, namely, emotion, rehab, communication and technology.
Meanwhile, in terms of the communication tool, DGRC mainly uses email, which leads some patients to think that it is inefficient and uncomfortable.
At this stage, we learned that in DGRC, the engagement level of patients and their families is not enough. Although DGRC has a concept called ‘co-ordinated therapy’, patients and their families are still relatively passive.
We choose to observe patients' posts on various online forums and listen to their stories on methodology of phenomenological research. At the same time, we tried to contact patients who were willing to accept our interview. Finally we found lots of gains and pains of patients in terms of physical and psychological perspective during the rehab process (see the affinity diagram above).
After fully understanding the patient, we began to think about other stakeholders around the patient - under the current system, what channels, institutions and service personnel can patients approach to obtain related services? What kind of people will the patient interact with around during the whole rehab journey? In order to answer these questions and look at patients with neurological diseases from a more systematic perspective, we have drawn this stakeholder map based on the information we collected from previous research. After defining the stakeholder, we found that the people around the patient can be divided into three main categories, starting with the closest degree of contact, which are families, peer patients, friends, rehab organizations, and finally other social support groups.
We have drawn a simple DGRC workflow chart based on the information obtained from the first engagement session. Then we made a DGRC experience map as our engagement tool according to this workflow chart. In this map, we have separately drawn the routes of different stakeholders according to different stages and different scenarios. Then we left some questions that could motivate viewers to think at each stage. When the testers simulately experience the entire map, they can think about some of the problems that they may encounter in this process, and then write their thoughts in the box on the map.
This is the second version of our experience map that we have modified some problems after contacting Jenny -it shows how they exactly work, in which stage different kinds of stakeholders might collaborate with each other and what problems or considerations they may have in different touchpoints. we got a clearer understanding of DGRC's workflow and defined several topics which have many opportunities in the future, like the outcome measurement system that may have a positive impact on expectation management or a better collaborative goal-setting system as well as communication between inpatients and their families.
We also spoke to other relevant stakeholders in the NHS. Throughout the engagement session, we were able to see different perspectives on the issues from different stakeholders and how they were considering some of the issues we had identified in our preliminary research in their current roles, which gave us a broader and systematic view of neurological rehabilitation services. In the process, we discovered more insights.
Before we started thinking about the design output, we mapped out three stakeholders who might be important in our service system based on our preliminary research (empathy map, insights, etc.) We summarised their typical workflows and listed their needs and pain points separately.
By defining the profile of the potential stakeholders, we are able to produce targeted design outputs.
In the group brainstorming session, we settled on a design output format that combined an online digital platform with offline workshops & events. We attempted to design a product-service system that would include patients, MDTs and families to ultimately solve some of the problems encountered by stakeholders during the rehab journey and to enhance their experience of the journey.
After defining the initial design proposal, a rapid prototype was created using pen and paper to initially test the logic and interaction of the solution. Importantly, we tested the solution in real-life scenarios through the method of desktop walkthrough and role play. During the tests, we discovered many details that we had not previously considered, such as how doctors could easily upload the results of patients’ regular examinations to the digital platform, what data had to be presented to patients and doctors accordingly, etc.
As you can see from the comparison above, when using this service, the different stakeholders can be linked more closely by the digital platform. The patient's unmet needs can be met very well.
Users can see their rehabilitation goals and daily training plan in Rehabland. In each goal, they could know the training plan needed to complete the current goal. Through this function, users can clearly track the completion of their goals, so that they can be more motivated to actively participate in the rehab journey, and patients' understanding of the disease could be improved.
It is difficult for some outpatients to get high-quality rehabilitation training guidance at home, so they can complete the rehabilitation training through video guidance in Rehabland.
Every time patients complete the training task, they can answer a simple questionnaire in Rehabland. The small questionnaires consist of questions about emotional change, power change and other symptom change. Rehabland will record and analyze the data and warn the patient when the data is getting worse for more than a week.
In order to have personalized goal setting, home rehab patients can apply for their new rehab goals through the system. The MDT team can see the application and approve the new goals according to patients' health conditions shown by data visualization.
The doctor can check patients’ information and conditions to decide whether the goal can be approved
The communication between patients will greatly affect the patient’s understanding of the condition, thereby affecting their expectations. This is why we designed the ‘Circle’.
Patients can communicate with people who have similar symptoms through offline events.
