How design can make healthcare better

http://www.theguardian.com/society/2015/sep/08/design-big-contribution-improving-healthcare

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At Imperial College NHS trust, where I work as a surgeon treating cancer patients, we have some of the best cancer outcomes in the country. But we also have among the lowest ratings for patient satisfaction. In 2012-13, we were rated the worst trust in the country by patients.

The high number of patients we treat, the high staff turnover (common to London trusts) and the geographically dispersed site combine to leave patients feeling confused about their care and unable to control what is happening to them. We asked a team of designers to examine the patient pathway for breast cancer and see how it could be simplified. When they laid it out, it covered a table measuring two metres by four metres. It is not surprising patients feel confused – we doctors do too.

On the basis of these early prototypes, the prospects look encouraging

Now the team has come up with a greatly simplified explanation of the pathway, presented in a leaflet that sets out what will happen and helps patients to identify their surgeon, their oncologist, their nurse specialist and who to ask when they have a question. An online version of the leaflet is planned, which will allow patients to see when their next appointment is, with whom, and invite them to submit questions in advance, as they think of them, as well as providing a list of questions other patients have asked.

The new leaflet is being trialled in three clinics at Imperial – for breast, bowel and brain cancer patients – and there are plans to introduce it to the prostate cancer clinic at the Royal Marsden hospital. The source of the redesigned cancer leaflet is the Helix (Healthcare Innovation Exchange) Centre, a pop-up design studio in the courtyard of London’s St Mary’s hospital. It is a joint project between the Royal College of Art and the Institute of Global Health Innovation at Imperial College London, which I lead, where designers can work in close contact with clinicians to identify challenges and provide solutions.

With its striking appearance, – overlapping glass panels on a frame of solid oak – the studio looks like a floating Chinese lantern that has been dropped into the precincts of the Victorian hospital, bringing a new perspective to modern problems.

And so it is. In response to the child obesity crisis, for example, the eight-strong design team has come up with a zany card game in which players are challenged to act out instructions – walk like a bear, do frog jumps, play air guitar – as a means of getting them off the sofa. The initial print run of the game, called Zilli, was crowdfunded and will be available to schools and children’s groups soon.

Asthma poses a big challenge for young children because they have difficulty using peak flow meters – a device into which the patient blows to measure lung exhalation rate. The Helix team has designed a whistle and a smartphone app, called Floot, that can measure peak flow from the pitch of the whistle. It is easy as well as fun for young children to use – it makes a noise – and it can record the time and date of attacks, as well as the triggers that caused them. By pressing a red button on the smartphone when an attack occurs the child is prompted to answer questions about where they were and what they were doing. There are plans to trial Floot at the Royal Brompton and St Mary’s hospitals.

A redesigned bowel screening kit is among other projects under way – a response to the poor take up of the national screening test, which is sent to those between the ages of 60 and 74. Bowel Screening Wales have agreed to trial the newly designed kit.

This is the first time designers have worked in such close contact with medical staff. The aim is to find high-impact, low-cost designs that bring frugal innovation to the NHS, improving care and saving costs. On the basis of these early prototypes, the prospects look encouraging.

Design was never mentioned when I was at medical school. Yet it has a huge amount to contribute to improving healthcare.