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Service Design of Care - OCADU Workshop

Workshop 1 - Inspiring health movements in community networks: Community network innovations
Dr. Rick Botelho, Family physician and U Rochester School of Medicine
Challenge: How can we mobilize people within their local and extended social networks to socialize health learning and experience to improve population health in the community?
Description: We address the problem of community health through the approach known as catalytic innovation, creating lightweight modes of peer learning appropriate for different types of social networks (online, neighborhood, community centres). To overcome the scarcity mindset in healthcare, patients become an integral solution to these complex problems. These peer-driven services complement professional services and build growing networks of peer learning and coaching for health improvement.
The Health Coaching Buddies learning process developed by Dr. Botelho represents such a convenient, inexpensive and accessible peer learning system. These processes aim to improve health behaviors such as self-care of chronic diseases, improving health literacy, reducing social isolation and enhancing personal happiness and social well-being. These innovations can be made widely available, using social media, online programs and mobile phones. They are designed to create meaningful learning experiences that aim to accommodate people’s particular worldviews, needs, preferences and life circumstances, instead of making people fit into a particular program, theory, clinical approach or setting.

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Service Design of Care - OCADU Workshop

  1. 1. Copyright © 2015, Peter Jones Designing Inspiration for Community Health Service Design for Health Movements Peter Jones OCAD University, Toronto Service Design for Health with Dr. Rick Botelho April 21, 2015
  2. 2. Copyright © 2015, Peter Jones Design’s emerging role in complex domains
  3. 3. Copyright © 2015, Peter Jones Where is health located? In the individual? Where they live?
  4. 4. Copyright © 2015, Peter Jones Care occurs in-place, in a community we share with others. Caring requires knowing, trust, patience, humility, honesty, & the primacy of life’s rhythms. “… there must also be developmental change on the other as a result of what I do; I must actually help the other grow.” M Mayerhoff
  5. 5. Copyright © 2015, Peter Jones Design for “new value demand” Less for failure demand • From systems perspective, disease focus is an intervention. • Patient context is temporary • How to motivate prevention, adherence, & continuity?
  6. 6. Copyright © 2015, Peter Jones WHAT IS HEALTH SEEKING ?
  7. 7. Copyright © 2015, Peter Jones All people are health-seekers A health-seeking journey occurs over a lifetime, a continuity that proceeds through youth, adulthood, & older age.
  8. 8. Copyright © 2015, Peter Jones 3 ORDERS OF HEALTH FEEDBACK Dubberly.com & Design for Care
  9. 9. Copyright © 2015, Peter Jones Dubberly.com & Design for Care STAGES OF INTRA-PERSONAL HEALTH SEEKING
  10. 10. Copyright © 2015, Peter Jones Where does Health Live? Dis-eases emerge from so many factors … Can we design for: • Home conditions • Connectedness - Friends & family circles - • Autonomy, mobility & communications • Neighborhood, safety, food supply • = community
  11. 11. Copyright © 2015, Peter Jones
  12. 12. Copyright © 2015, Peter Jones How does identity change when a patient? Are we disempowering self-care?
  13. 13. Copyright © 2015, Peter Jones
  14. 14. Copyright © 2015, Peter Jones Today, services are discrete events
  15. 15. Copyright © 2015, Peter Jones Functional unit of service provision Can connect services across system levels
  16. 16. Copyright © 2015, Peter Jones Functional unit of service Connecting closer to the health-seeker Coordinated services across systems
  17. 17. Copyright © 2015, Peter Jones A Service Design process Human Research Design Research Prototype Testing
  18. 18. Copyright © 2015, Peter Jones Basic service concepts.
  19. 19. Copyright © 2015, Peter Jones A simple service experience map.
  20. 20. Copyright © 2015, Peter Jones Framing Coaching as a Service • Service for “who in a community” • Frames are reflective responses to a desired action. There is always a “prior pattern” • Our “initial appreciation” has huge leverage! • Avoiding jargon & default ways of thinking • What are the affordances in communities? • How do movements (or contagions?) form?
  21. 21. Copyright © 2015, Peter Jones “Frames not only simplify and create alternative views of a problematic situation; they also evoke particular outcome spaces that afford a range of responses.” Paton & Dorst (2011). Briefing and reframing: A situated practice. Design Studies. Language Co-Creation with your stakeholders Releasing fixation from prior frames Considering “users” & their preferred values, taste regimes
  22. 22. Copyright © 2015, Peter Jones Framing exercise. • Develop a framing concept for coaching in your contexts, using handout. • How might coaching / peer exchange take hold in your network or situation? • How would it be understood by others as a value to be co-created? • How would coaching be valued and understood? Individually: Consider & enter responses in form Pairs: Share concepts, identify similar / differing
  23. 23. Copyright © 2015, Peter Jones Debrief • What frames for coaching / movements / did you co- create? • What are the affordances in communities? • How do movements (or contagions?) form? • What’s the analogue today?
  24. 24. Copyright © 2015, Peter Jones Today’s New Design Domains Complexity increases at each .0 Number of stakeholders > Need for collaboration > Multi-tech, multi-design, multi-disciplinary Future healthcare services will require all 4 levels of skill & knowledge. But design skills do not transfer up. Mixed teams always a necessity.
  25. 25. Copyright © 2015, Peter Jones • Integrating clinical & community services • Interventions for social determinants • Community health promotion • Redesigning services for new business models • Design & research for care innovation • Clinical teams communication & coordination • Patient-health experience of service • Redesign EHR / information as workflow • Patient self-service in local clinics • Patient information across care journeys • Innovative & usable wayfinding • Interior space infection control Healthcare design across 4 domains
  26. 26. Copyright © 2015, Peter Jones Demand Side Innovation (Bottom-up) • Human experience – What are real concerns: Student resilience in their first year of university • Mapping out journey of “ups & downs” • Identify key transition points • Top of map - Campus service systems Human-Centred Systems
  27. 27. Copyright © 2015, Peter Jones A Service Design process Human Research Design Research Prototype Testing
  28. 28. Copyright © 2015, Peter Jones Demand Side Innovation (Bottom-up) • Patient side - Human-centred concerns: Mental wellness responsive to students. • People don’t know what services are offered • Fear or stigma associated with therapy • Care complicated by other conditions, life situations • Case study: OCADU Campus Mental Wellness • Research modes: Ethnography, Dialogue, Public workshops • Design methods: Service analysis, Blueprint, Journey, Mapping Human-Centred Service Design
  29. 29. Copyright © 2015, Peter Jones OCADU Health & Wellness Centre – Service Flow Current Service Blueprint
  30. 30. Copyright © 2015, Peter Jones As re-envisioned to enable early student self-care Oikonen, Starkman, Jones, Yip. (2014).
  31. 31. Copyright © 2015, Peter Jones Distributing health care resources among different points of care: • Person-Family • Person-Community • Patient-Patient • Patient-Providers • Providers-Community
  32. 32. Copyright © 2015, Peter Jones Co-creating care in our communities
  33. 33. Copyright © 2015, Peter Jones Extending our communities to larger networks.
  34. 34. Copyright © 2015, Peter Jones