QUT Designers in Healthcare - HEAL 2021 report

Acknowledgements
Acknowledgements 
 
At the outset, we would like to acknowledge the Turrbal and Yugara people,
the traditional owners of the lands where much of this design-led research
was conducted and the report written. We pay respect to their elders
past, present and emerging, and extend that respect to other Australian
Aboriginal and Torres Strait Islander people reading this. 
Thank you to all the consumers who have engaged with us, so honestly and
generously sharing their experiences, hopes and expectations for the future
of healthcare. We would also like to especially acknowledge and thank the
staff of CEQ, and the 7 Hospitals and Health Services across Queensland
Health we have worked with over the past year - we have been fortunate
to work alongside exceedingly smart, creative and committed people who
share a passion to improve healthcare. We also thank and acknowledge
CEQ, for funding and supporting HEAL 2020-2021.
Suggested citation
QUT Design Lab (2021). Healthcare + Design = Innovation. QUT

FOREWORD
FOREWORD___________________________________________
___________________________________________ 1
1
Designers as Agents of Change in Healthcare ....................... 4
Design Dictionary ......................................................... 12
PARTICIPATORY HUMAN CENTRED CO-DESIGN
PARTICIPATORY HUMAN CENTRED CO-DESIGN __________
__________ 18
18
Virtual Outpatient Integration for Chronic Disease - VOICeD ... 2 0
Cancer Wellness ........................................................... 26
Stroke Network ............................................................ 30
DESIGN THINKING
DESIGN THINKING ____________________________________
____________________________________ 34
34
Co-designing a Healing Environment in the PICU .................. 36
The Pain Pressure Cooker: A Rapid One-Hour Co-design Sprint .. 42
PROTOTYPING
PROTOTYPING ________________________________________
________________________________________ 46
46
Protecting our Children: Co-Designing Child Friendly PPE ..... 48
Designing out Diabetic Foot Problems ............................... 52
A Pain Metric in Paediatric Admissions .............................. 56
Interactive CPR Manikin for Community Training ................. 60
DESIGN DOING
DESIGN DOING _______________________________________
_______________________________________ 64
64
Journey to Fun: Playful Wayfinding and Placemaking at QCH ... 66
Improving Cultural Safety in Queensland Hospitals ................ 72
Increasing use of Interpreter Services at Metro South .............. 78
Reducing Urine Sample Contamination in the ED .................. 82
DESIGN VISIONING
DESIGN VISIONING____________________________________
____________________________________ 86
86
Delivering Virtual, Integrated Care in Central Queensland ............ 88
Connecting Rehab Services across West Moreton ....................... 92
Emergency Room Entrances and Exits .................................... 98
CEQ Project Management Framework 2.0 . ............................... 102
THE HEAL DESIGN TEAM
THE HEAL DESIGN TEAM_______________________________ 105
105
FURTHER READING
FURTHER READING ....................................................... 116
116

It gives me great pleasure to write an introduction for the 2021 HEAL
symposium report.
This year’s HEAL Symposium marks a watershed moment for the
story of Design in Healthcare – in Queensland and nationally. Less
than twelve months into the first formal partnership of its kind in
Australia, we now possess of a substantial catalogue of case studies
that demand deeper integration of Design disciplines and expertise
within healthcare. I say Design with a capital ‘D’ to signpost a key
difference between the HEAL model and the more common usage
of the term ‘design’ in healthcare. As an occupational therapist, I
can vouch for the deep humanistic principles that many clinical
colleagues abide by. Yet, there is often a chasm between a ‘co-
design sympathetic mindset’ and actually executing well on these
priorities.  As legendary designer and cognitive psychologist Don
Norman wrote in The Design of Everyday things, “original ideas
are the easy part. Actually producing a successful product is what
is hard.” Whilst healthcare has steadily embraced the philosophy
of co-design and there is growing familiarity with many design-led
approaches - the HEAL model takes us into a far more innovative
space.
First, it recognises and works with the diversity inherent the creative
design professions. Matching clinical improvement projects with
identified specialists from various design disciplines has been
critical to HEAL’s success and has showcased methodologies that
HEAL projects are exemplars
of a far more customised,
problem-specific, expertise-
infused approach to
collaborative design innovation
in healthcare settings.
PAGE 1
PAGE 1

go far beyond the application of generic codesign principles.
HEAL projects are exemplars of a far more customised, problem-
specific, expertise-infused approach to collaborative design
innovation in healthcare settings. This is largely made possible by
the unique nature of the QUT Design Lab and the vast capability
base it is able to draw from. 
Giving clinicians the hands-on experience of applying
design methods at pace has proven transformative for many
improvement practitioners who have chosen to work with us.
Second, HEAL’s approach has been adaptive and agile. While
these can be sometimes nothing more than throwaway buzzwords,
agility and adaptability are part of HEAL’s very DNA. Many
clinician partners have voiced amazement at how quickly proposals
for support were actioned (mere days between submission and
commencement in some cases), and how effortlessly design teams
iterated and extended on initial priorities when the goal posts
shifted.
Third, the HEAL model is ecological. We sought to support
initiatives where design relationships had the best chance of
taking root and a substantial fraction of projects have already
spawned secondary collaborations, drawn leadership to the cause,
and uncovered new sources of funding future work. Our model
has steered away from top-down control and towards empowering
designers and clinical teams to have sufficient freedom to move
and innovate. Letting these teams address problems in context is
creating buy-in and sustainability up front.
Finally, the HEAL model is all about ‘design doing’ – rapid cycles
of prototyping, testing and solution iteration. Giving clinicians
the hands-on experience of applying design methods at pace has
proven transformative for many improvement practitioners who have
chosen to work with us. This report compiles many of these
PAGE 2
PAGE 2

remarkable stories. There are the illuminating narratives of true
innovation – where clinical teams and health services have unlocked
whole new ways of thinking, doing, improving, improvising and
creating when partnered with capable creative professionals. There
is the larger story of discovery - where two communities with
very diverse perspectives have rapidly and repeatedly discovered
synergies and common purpose. Finally, there is also the implicit
story of what successful industry-academic partnership can look like
when organised around translational and impact at the sharp end of
healthcare. 
I commend these stories to you and hope you will discover ideas,
insights and links to weave into your own. We are thankful to have
you along for the journey.
Dr Satyan Chari, PhD
Dr Satyan Chari, PhD
Program Director – CEQ Bridge Labs 
Co-Director – HEAL
Healthcare Improvement Unit
Clinical Excellence Queensland
PAGE 3
PAGE 3

This collaboration between designers and Queensland clinicians
started in 2019, at the QUT Design Lab’s inaugural “Design Week” –
with a theme of “Change by Design”, we worked with Clinical Excel-
lence Queensland Fellows to re-envision and reimagine healthcare
in a design sprint. The outcomes of the event were so inspiring, we
knew that we had to continue the journey.
Healthcare Excellence AcceLerator (HEAL)
Healthcare Excellence AcceLerator (HEAL)
Over 2020-2021, HEAL – a collaboration hub co-led by the QUT
Design Lab and the Healthcare Improvement Unit at Clinical
Excellence Queensland – has acted as a bridge between the QUT
design and innovation community and Queensland Health.
Designers from the QUT Design Lab - with their creative mindsets,
skillsets, and participatory human centered co-design approaches
- have worked in collaboration with clinicians, consumers and
improvement teams across Queensland Health to drive design-led
innovation and accelerate healthcare improvement efforts across the
state. 
HEAL has been a successful experiment, testing a novel idea:
that engaging with and embedding designers into healthcare as
agents of change might help tackle persistent evidence-based
practice gaps, positively disrupt the system, drive innovation, and
trigger transformative change in health services. 
Designers as agents of
Designers as agents of
change in healthcare
change in healthcare
HOW THIS JOURNEY BEGAN
PAGE 4
PAGE 4

HEAL designers and design researchers have collaborated on 20+
projects across 7 Queensland Hospital and Health Services, from Mt
Isa to Cairns, Ipswich, and urban Brisbane. That these partnerships
have triggered deep design-led trans-disciplinary dialogues,
collaborations and innovations during the time of COVID-19 is a
testament to the support of our project partners - the consumers,
clinicians, local communities, policymakers, health system leaders
and managers who are all committed to improving healthcare and
excited about the potential of a design-led approach. We thank all
of our partners for their enthusiastic support and look forward to
continuing and growing our collaborations.
Our human-centred approach to collaboratively
redesigning healthcare is grounded in design thinking,
design doing, and design visioning.
Why Design?
Why Design?
Design - the “transformation of existing conditions into preferred
ones” (Simon, 1996, p. 11) - is a creative, systematic problem-solving
approach that develops better ways for humans to interact with
technology, services, places, and products. A design-led approach is
agile; it embraces uncertainty, complexity, and rapid iteration, thus
offering a unique approach to tackling the ill-defined, complex, and
wicked problems facing healthcare.
While healthcare has been early to recognise the potential of design
methods as a tool for collaboration and innovation, with elements
of design (such as design thinking and experience-based co-
design) increasingly common-place, the integration of professional
designers and design researchers into healthcare – with their unique
processes, mindsets and skillsets of empathizing, ideating, problem-
solving, co-creating, innovating, prototyping, envisioning, visualizing,
and iterating – is rare.
PAGE 5
PAGE 5

As the diverse projects in this report illustrate, designers:
have a mandate to be creative, expanding both the problem
and solution space;
focus on what the future ought to be, rather than what was;
draw people in with empathy, vision, passion and rich,
memorable storytelling;
are natural disruptors, comfortable with uncertainty and
change.
While healthcare has a rich tradition of improvement and
innovation, the reality is that many established tools and thinking
are increasingly ill-suited to addressing pressing complex challenges
- escalating costs, the increasing burden of chronic disease, an
ageing population, systemic inequities in healthcare access and
outcomes for First Nations communities, under-utilisation of
primary care and high levels of system fragmentation. A design-
led approach provides a novel, action-orientated way of facing
complexity while systematically conceiving, developing, and driving
forward new practices for undertaking large-scale transitions – an
approach that compliments implementation science, knowledge
translation frameworks, and consumer-oriented clinical service
innovation models. 
Design Thinking, Doing & Visioning
Design Thinking, Doing & Visioning
As the projects in this report illustrate, HEAL leverages the unique
disciplinary training of designers - in collaborative co-design with
consumers and clinicians - to solve one of the most intractable
problems facing healthcare: knowledge translation, enabling the
application of evidence and theory into local practice. 
PAGE 6
PAGE 6

Our human-centred approach to collaboratively redesigning
healthcare is grounded in design thinking, design doing,
design thinking, design doing, and design
design
visioning
visioning.. In addition to the well-known design thinking
design thinking processes
that underpin Experience-Based Co-Design in healthcare, what
makes our approach distinctive is that we extend that to design
design
doing
doing (co-creating and enacting design-led change initiatives),
and design visioning
design visioning (future-focussed scenario-based speculative
design).
I encourage you to approach reading this report with a flexible,
designer’s mindset - flip back and forward, and start where you need
to! Whether it is codesign methods, a focus on a specific healthcare
challenge or population (from telehealth to cultural safety) or
prototyping, our intent for this report is that it provides insight and
inspiration about experimenting with design-led approaches. We are
always keen to collaborate, so please connect with us - and visit QUT
Design/HEAL for the most up-to-date information on projects.
Professor Evonne Miller
Professor Evonne Miller
Co-Director – HEAL
Director, QUT Design Lab
PAGE 7
PAGE 7

EQUITABLE HEALTHCARE
         INEQUALITY  
COLLABORATION
          BOUNDARIES
CONSUMER EMPOWERMENT  
         ‘SICK-CARE’ SYSTEM
KEEPING PEOPLE HEALTHY  
           CHRONIC DISEASES
INTEGRATED/ VIRTUAL CARE
           LIMITED DIGITAL TRANSFORMATION
VALUE-BASED CARE
COMPLEX SYSTEMS 
CHANGE MINDSET
UNCERTAINTY / PATTERNS / CLUES
A FUTURE-READY SYSTEM
CHANGE FATIGUE
THE FUTURE IS NOW

Whole system change is not
linear or simple.
There are no quick fixes.
But a design-led approach to
supporting locally-led initiatives
facilitates innovative responses
to the wicked problems in
healthcare, & creates a critical
mass of change agents.
PAGE 9
PAGE 9

IMAGE DESCRIPTION:
Where it all began, QUT Design
Week 2019.
DESIGN
WEEK
2019
PAGE 11
PAGE 11

Design Mindset
Design Mindset
A mindset is a way of being and thinking. Design
mindsets are action-orientated, solution-focused,
positive and imaginative – focused on creating a
desired, improved future.
Design Thinking
Design Thinking
A creative, human centered structured approach
to complex problems, defined by five iterative
steps: Empathize – Define – Ideate – Prototype –
Test.
Design Doing
Design Doing
As Don Norman preaches “we need more design
doing” – design thinking is not magic and does
not free us from actual design doing: creating
and implementing change in collaborative
partnerships.
Design Visioning
Design Visioning
By nature, designers are futurists: we create
ideas that do not yet exist. We use that ability to
shape our collective imagination and to inspire
optimistic future-focused dialogue about “what
might be”.
DESIGN
PAGE 12
PAGE 12

DICTIONARY
Participatory Human-Centered Co-Design
Participatory Human-Centered Co-Design
Designing with, not for, people means
participatory engagements, sharing power,
prioritising relationships, and building capability
– and such participatory partnerships often lead
to breakthrough innovations.
Design Prototyping
Design Prototyping
A prototype is the tangible representation of
an actual idea. Design prototypes vary in their
degrees of fidelity – the level of detail and
functionality. Low-fidelity prototypes may be
made from paper and cardboard, while high-
fidelity prototypes are closer to the final version.
PAGE 13
PAGE 13

11 MONTHS
7 QLD HOSPITALS &
HEALTH SERVICES
250+ CLINICIANS,
CONSUMERS &
LEADERSHIP TEAMS
20+ PROJECTS
30 DESIGN
RESEARCHERS
PAGE 14
PAGE 14

DESIGN
DESIGN
STARTS WITH
STARTS WITH
CHANGE
CHANGE
PAGE 15
PAGE 15

THINKING
PROTOTYPING
DOING
VISIONING
PARTICIPATORY

PARTICIPATORY
HUMAN
CENTRED
CO-DESIGN

Designing with, not for, people recognizes that health
service users - consumers and staff - are experts of their
own lived experience, and this expertise, knowledge and
ideas is critical to innovation. 
Engagement and participation, and related concepts of co-
production, co-creation, co-design and co-innovation is the “new
Zeitgeist – the spirit of our times in quality improvement” (Palmer et
al., 2019, p. 247), for as Don Berwick (2003) wisely suggested nearly
two decades ago, healthcare “workers and leaders can often best find
the gaps that matter by listening very carefully to the people they
serve: patients and families”.  
Participatory human-centered co-design methods emphasize first-
hand investigation, understanding who you are designing for
- and designing in partnership with them - alongside an iterative,
experimental approach of collecting data, making discoveries, and
organizing ideas. Critically, the process emphasizes discovering
the right problem to solve, by investing in both problem-finding
and problem-solving to understand - at a human and systems-level
- where and how we might have the most leverage. 
All HEAL projects are guided by a user-centered approach, with the
following projects demonstrating participatory human-centered co-
design in practice. 
UNDERSTAND CREATE
PAGE 19
PAGE 19

Virtual Outpatient Integration for Chronic
Disease (VOICeD)
QUT HEAL TEAM: Evonne Miller, Jessica Cheers
PARTNERS: Statewide Diabetes Clinical Network – Gaurav Puri,
Brent Knack

Hours spent in waiting rooms, long commutes to the
hospital, conflicting medical advice, indecipherable
medical “gobbledygook”, no parking, covered windows
and sterile white coats – these are just some of the
things that can make the face-to-face healthcare system
less than desirable. Fortunately, emerging digital health
services can promise more efficient, accessible care,
but may also spark feelings of distrust and isolation, or
create barriers for those with low digital literacy.
When Dr Gaurav Puri, Chair of the Statewide Diabetes Clinical
Network, asked Mike from Thursday Island why he couldn’t attend
his diabetes appointments, Mike replied that he simply didn’t have
the time to come to them all. For those managing chronic disease
and multiple co-morbidities, regular appointments with multiple
practitioners can become an incredible burden on their quality of
life.
Realising that this was a problem faced by many Queenslanders,
Dr Puri envisaged what would soon become VOICeD – Virtual
Outpatient Integration for Chronic Disease. The telehealth
service was designed to meet the needs of people with diabetes,
by allowing them to see multiple healthcare practitioners in one
virtual appointment. This would help ease the burden of the current
medical model, with some patients travelling for hours to attend
each appointment, and bring consistent, accessible care to patients
anywhere.
The team wanted to foreground the patient experience, streamlining
and humanising the transition to the digital platform as well as
recognising the diverse needs of people with diabetes and their
practitioners.
PAGE 21
PAGE 21

Through a series of experience-design sessions, a participatory
design workshop, and user testing, the HEAL team aimed to:
1. Understand the healthcare experience of people with
diabetes using traditional face-to-face services
2. Explore their relationship with telehealth / digital health
technologies, particularly how this has been impacted by
COVID-19
3. Understand the needs, barriers, and current points of
tension for patients and clinicians prior to introducing a new
design solution
4. Collectively imagine the future of healthcare, ensuring that
VOICeD embodied their vision for the future.
The participatory co-design process in action
The participatory co-design process in action
This collaboration involved six design phases: mapping, visualising,
mapping, visualising,
collaboratively designing, implementing, user testing, and continued
collaboratively designing, implementing, user testing, and continued
improvement.
improvement.
1 MAPPING
2 VISUALISINGw
3 COLLABORATIVELY DESIGNING
4 IMPLEMENTING
5 USER TESTING
6 CONTINUED IMPROVEMENT
PAGE 22
PAGE 22

The team began with a number of intensive journey mapping
sessions, followed by a simple wordmark that could work within
the visual constraints of the government context and a series of
illustrations to bring the personas to life. A slogan was created to
capture the intention of the service, plain and simple: Bringing you
care, anywhere.
Once the entire service was mapped from a practitioner perspective
and visuals had been created to communicate the initial concept to
stakeholders and potential patients, the team conducted a three-hour
Participatory Design session with five people who had experienced
chronic disease – potential future VOICeD users. They used a well-
known Participatory Design method called a Future Workshop to
envision possible and imaginary futures, critique present practice,
and imagine potential utopian and dystopian visions of healthcare.
The resulting outcomes
The resulting outcomes
Implementation focussed particularly on functional aesthetics –
combining the human factors with the visual design to produce a
version of the service that was user tested by the participants from
the first workshop, closing the loop on their input by enabling them
VOICeD Participatory Design Session
PAGE 23
PAGE 23

to evaluate the developed product. Participants were given the
same experience as a patient of the service, receiving instructional
documents by email in advance, attending their appointment and
transferring between practitioners. Following their “appointment”,
each participant then spoke to the HEAL team individually over the
phone to gauge their response to the process, following the typical
feedback questionnaire that new patients would receive, while
also allowing for more open-ended discussion. Participants had a
few issues to improve the experience of using the service, largely
reiterating changes the VOICeD team intended to implement long-
term.
From the outset, the VOICeD team had committed to continue to
improve, test and evaluate the service long-term, and are continuing
to implement recommendations from the HEAL collaboration. They
are also collecting qualitative data from patients on an ongoing basis
to better understand the patient experience.
The VOICeD launch was successful, and patients continue to
respond positively to the service – 100% of users surveyed would
recommend the service, and 83% described it as a “very good
experience”. In addition, patient’s time in clinics has been reduced
by 350% over a 12 month period, while maintaining patient
satisfaction with the service they are receiving. Three times less
routine appointments are now needed, and three new VOICeD
services are currently being developed after the initial launch of
Diabetes Renal Cardiac – Maternity, Diabetes Transition, and Child
Development are all underway.
PAGE 24
PAGE 24

Mapping the Stroke Network
PAGE 25
PAGE 25

Cancer Wellness
QUT HEAL TEAM: Evonne Miller, Jessica Cheers
PARTNERS: Princess Alexandra Hospital Cancer Wellness Initiative
team – Jodie Nixon, Elizabeth Pinkham, Emma McKinnell

The conversation around wellness as a crucial
compliment to medical cancer treatment is ever-
growing. Yet, in Queensland there is currently no public
cancer centre specifically designed to holistically treat
all aspects of the self –mind, body and spirit.
The Cancer Wellness Initiative (CWI) was established by Princess
Alexandra Hospital’s (PAH) Cancer Services and funded by the
PA Research Foundation to “advocate and innovate towards the
provision of integrated, streamlined wellness support to all cancer
patients receiving care at the Princess Alexandra Hospital” (Cancer
Wellness Initiative, 2020). Initially, the vision was to establish a
physical centre where wellness programs and support could be
delivered. However, when the sudden and unexpected wide-spread
shift towards online modalities occurred in 2020, the team needed
to reimagine the service delivery model to meet the wellness needs
of people with cancer at the PAH without the ability to provide in-
person care.
Given the over-abundance of cancer information online, conflicting
advice and potential to lead people down online rabbit holes, the
team wanted to create an authoritative, evidence-based, virtual home
for PA patients seeking wellness information, programs and services.
Multiple workshops were run by the Cancer Wellness Initiative prior
to the engagement with HEAL, which had begun to scaffold ideas
for the initial service design, ensuring a truly collaborative design
process throughout.
The collaboration between HEAL and the CWI involved four phases:
Mapping, Visualising, Co-designing and Evaluating. First, the team
imagined their outcomes and mapped out the future of the service.
It was immediately clear that the team needed to re-connect with
end-users – people with cancer and patients at the PAH – to better
understand how their current and emerging needs could be met with
an online offering.
PAGE 27
PAGE 27

Creating a new brand
Creating a new brand
Prior to engaging end-users in a co-design workshop, the HEAL
team felt that creating a cohesive brand identity would help to
cement the aspirations of the project – a visual that could help
delineate the CWI as a unique service while celebrating its ties to
the PA Research Foundation and hospital, derived from the shapes
contained within the PA Research Foundation logo to reflect their
support, using the flower motif to allude to themes of wellness.
This branding was used in the participatory co-design workshop
with five people who were at various stages of their cancer
treatment and recovery. A key lesson from this collaboration was the
importance of engaging with end-users throughout the entire design
process, especially when the initial goals change or new limitations
are imposed throughout the life of the project. Six key themes were
identified from the workshop:
1.
1. Cancer wellness information should be digestible
Cancer wellness information should be digestible -
- We’re
given so much information at once that it gets overwhelming
2. Cancer wellness information should be consistent and
2. Cancer wellness information should be consistent and
reliable -
reliable - I didn’t know until one of the other patients told me
about...
3. Cancer wellness should be presented in a way that is
3. Cancer wellness should be presented in a way that is
normalising
normalising - I need reassurance that what I’m experiencing
is normal
4. Cancer wellness should be site-specific
4. Cancer wellness should be site-specific -I want to know
what’s happening at the PAH
5. The platform should support the shift in mindset, from
5. The platform should support the shift in mindset, from
cancer treatment to wellness
cancer treatment to wellness - In the beginning it was
all about the cancer, then my mindset shifted
6. The platform should support supporters of people with
6. The platform should support supporters of people with
cancer
cancer- Half of the battle was communicating all of this
information to “the committee” –my partner, family,
and friends
PAGE 28
PAGE 28

Delivering nuanced information
Delivering nuanced information
After this initial work with HEAL, Jess was brought on by the
CWI team to design and develop the new online platform based
on workshop recommendations, implementing feedback and
conducting user testing to iteratively improve the website. The
ongoing collaboration between HEAL designers and CWI had a
profoundly positive impact on the direction of the project.
The project was founded on the notion that patients at the PAH
were craving a unified source for reliable and supportive wellness
information. However, given the overwhelm experienced by many
people with cancer, it was crucial that the nuanced delivery of this
information was carefully considered. By engaging with people with
cancer directly and clearly documenting the knowledge translation
process into actionable outcomes, the HEAL team were able to
support the CWI in re-imagining the future of the initiative.
Participatory co-design workshop
PAGE 29
PAGE 29

Stroke Network
QUT HEAL TEAM: Jessica Cheers
PARTNERS: Statewide Stroke Clinical Network (SSCN) – Catherine
Jacques

Stroke care in Queensland is complicated by the
heterogeneity of the condition, the limited time available
for a positive intervention, and the state’s geography.
The goal of the Queensland Statewide Stroke Clinician’s
Network (SSCN) is to improve equitable access to stroke
care, regardless of geographic location.
Decision-makers within Queensland Health and Hospital Health
Services often did not have a full understanding of the variation
that currently exists in access to and delivery of care, including
how each element of the patient journey impacts on the next. This
participatory design project visually illustrated the complexity of
the system – this was designed to assist with communication and
advocacy at all levels of the Department of Health, as well as in
clinical environments, where it could be used to help clinicians
identify local opportunities for improvement.
Mapping complexities and variations
Mapping complexities and variations
Following four human-centred co-design workshops involving
clinicians from across the state (both virtually and in-person), the
visual designer created communication tools highlighting the
complexity of the system, and identifying areas where variation
exists broadly across Queensland Health in the provision of stroke
care.
The SSCN Steering Committee provided feedback, as did
the broader SSCN network at a Clinical Forum. These were
opportunities to explore three different infographics that were
designed, using the persona of Jenny, who had suffered an ischaemic
stroke and required an endovascular clot retrieval. Seven patient
journey maps were developed, showing the difference in care and
the timeline of delivery depending upon where our persona - Jenny -
had her stroke and which hospital she was transferred to. Across the
state, more than a seven-hour difference in initial treatment time
PAGE 31
PAGE 31

for the endovascular clot
removal was described
in the patient journey
maps, depending upon the
referring and receiving
sites for treatment.
The final infographics
will be freely available
from the SSCN intranet
page to all clinicians
across Queensland, to
use in their local settings
to support and enhance
understanding of the
variation in existing
systems of care for stroke
patients, and to assist them
in identifying local areas
for improvement.
PAGE 32
PAGE 32

Patient Journey Map for the Stroke Network
PAGE 33
PAGE 33

Design is “learning by doing”, with the hands-on user-
Design is “learning by doing”, with the hands-on user-
centered design-thinking framework is a problem-solving
centered design-thinking framework is a problem-solving
tool designed to spark innovation. Best conceptualized
tool designed to spark innovation. Best conceptualized
as three processes - 1) understand, 2) explore, and 3)
as three processes - 1) understand, 2) explore, and 3)
materialize, the popular Hasso-Plattner Institute of
materialize, the popular Hasso-Plattner Institute of
Design at Stanford (d.school) model of design thinking
Design at Stanford (d.school) model of design thinking
breaks the process down into six iterative stages: 
breaks the process down into six iterative stages: 
1 EMPATHISE
use empathy to understand; 
use empathy to understand; 
2
DEFINE
bring clarity and focus to the design process, crafting
bring clarity and focus to the design process, crafting
a meaningful and actionable problem statement; 
a meaningful and actionable problem statement; 
3 IDEATE
collective minds brainstorm multiple
collective minds brainstorm multiple
creative ideas;
creative ideas;
4 PROTOTYPE
create low-fidelity (quick, easy, low-cost) prototypes
create low-fidelity (quick, easy, low-cost) prototypes
to elicit feedback from users and colleagues; 
to elicit feedback from users and colleagues; 
5 TEST
share and test your prototype with users; what works
share and test your prototype with users; what works
and what doesn’t?; 
and what doesn’t?; 
6 IMPLEMENT
implement the vision. 
implement the vision. 
PAGE 35
PAGE 35

Co-designing a Healing Environment
in the PICU
QUT HEAL TEAM: Natalie Wright, Anastasia Tyurina, Judy Matthews,
Evonne Miller, Leighann Ness Wilson, Sarah Johnstone, Guy Lobwein.
Partners: Queensland Children’s Hospital PICU – Jane Harnischfeger,
Debbie Long, Alexandra Ferguson, Jane Tilbury, Steven Wood, Leith
Lilley, Michaela Waal, Christian Stocker.

While advancements in health care provided in Pae-
diatric Intensive Care Units (PICUs) have led to fewer
deaths, these improvements are unfortunately coun-
tered by the emergence of side effects of critical illness,
known as post PICU- syndrome (pPICs), which occur
because children are often over-sedated and experience
long periods of immobilisation in hospital.
From PICU Liberation to Partnership
From PICU Liberation to Partnership
When the HEAL team was invited to work with the PICU at
Queensland Children’s Hospital (QCH) in Brisbane, Australia in
2020-2021, the ‘PICU Liberation’ Team were already incorporating
an innovative rehabilitation bundle of eight complementary steps to
reduce sedation, allow children to awaken and breathe comfortably,
encourage early mobilisation, and engage families in their child’s
care. However, despite their efforts to ‘liberate’ children from critical
illness and improve their recovery and functioning after discharge,
there was concern that the quality of their family-centred care (FCC)
was being influenced by the constraints of the hospital systems, com-
munication tools and physical environment.
Driven by the three core principles of FCC (partnership, participa-
tion and protection) and utilising design-led methodologies, the
PICU Partnership Project aimed to enable the creation of a more
therapeutic (comfortable, effective, meaningful and supportive) phys-
ical, social and digital environment for parents and families, meeting
basic human needs in time of crisis, and providing a positive psy-
chological long-term impact on families, their children, and the staff
caring for them.
The site: the QCH PICU
The site: the QCH PICU
In the QCH PICU, parents enter the ward through a secure entrance
on Level 4 of the hospital and must have pre-arranged access with
administration staff or a social worker, as the current reception desk
which straddles both sides of this entrance is largely unmanned
PAGE 37
PAGE 37

HEAL HDR Intern with a PICU family
and unwelcoming. From this central corridor they visit their child in
either a Riverside or Hillside room. Parents can freely access a large
shared (with staff) balcony providing fresh air at the end of the main
corridor, which is also used for end-of-life ceremonies; a small family
room including a kitchenette with seating and a dining table in a
remote corner of the Riverside rooms; and a tiny enclosed expressing
room for nursing mothers. The only room in the ward with a parents’
toilet, shower, and laundry was inaccessible and being used for
storage.
PAGE 38
PAGE 38

The role of spatial design and visual communication in enhancing
The role of spatial design and visual communication in enhancing
care
care
Initial guided observation around the QCH PICU combined with
existing data collected from past parents and staff suggested the
following issues – focussed on the spatial environment and visual
communication - could improve the delivery of family-centred care:
Entry to PICU required remodeling to improve the ‘hello’ and
‘goodbye’ experience and signal a culture of support.
The spatial layout, visuals and wayfinding did not support
easy navigation for parents to rooms, nor any understanding about
the spaces available for parents to use for self-care.
A central space, which houses easily accessible parental self-
care facilities (such as kitchens, bathrooms and laundry facilities),
is required, along with more options for both private and public
meeting and rest spaces for families to grieve or seek support from
other families.
The location and lack of storage (leading to clutter) in rooms
and corridors makes it more difficult for parents to find anything,
including each other. There is a need for storage solutions for
parents’ personal belongings and to better locate equipment and
supplies in corridors and rooms.
The visual communication for the PICU is inconsistent
and unclear, and could better assist with (1) navigation of the
environment; (2); post-discharge information; and (3) the building of
a support community for parents.
PAGE 39
PAGE 39

Design-led engagement and storytelling strategies
Design-led engagement and storytelling strategies
The team instigated four engagement and storytelling strategies to
encourage the participation of parents and staff and gain different
types of data providing insight into how the design of the space
supports (or not) social and emotional needs.
- Interactive Static Displays
- Interactive Static Displays used to engage both visitors and
staff in sharing analogue thoughts and ideas about particular
current spaces in ‘real space’ (as opposed to ‘real time’)
- Parent Pack
- Parent Pack using a self-documentation method where users
observe, reflect, and document their everyday lives and
experiences.
- PICU Marketplace
- PICU Marketplace a series of four drop-in activities, hosted
in the PICU main corridor adjacent the balcony over two days.
- Focus Groups and Interviews
- Focus Groups and Interviews
Using this data, the HEAL design team is developing
recommendations for priorities to formulate design briefs for
potential future work on Interior Design, Wayfinding and Signage
Design, and Visual Communication Collateral, some of which will
be developed by QUT Work Integrated Learning students (see next
page).
Interactive Static Displays
PAGE 40
PAGE 40

During 2021 Semester 1, seven students in the Bachelor of
Design (Visual Communication) and Bachelor of Creative
Industries majoring in Interactive and Visual Design, were
invited to join the PICU Partnership Project team and elected
to undertake a work integrated learning (WIL) unit project
to assist with the development of visual communication
and interactive design collateral to support the co-design
of a more healing environment for PICU families and staff.
This specifically related to parent/staff engagement and
storytelling activities to inform an Interior Design and
Wayfinding Concept Proposal to activate and re-imagine key
areas of shared spaces, as well as concepts for more long-
term strategies for communication to parents and families
in PICU and post-discharge, for example materials, posters,
flyers, data visualisations and infographics.
Bringing the University to the Hospital
PAGE 41
PAGE 41

The Pain Pressure Cooker: A Rapid One-
Hour Co-design Sprint
QUT HEAL TEAM: Evonne Miller, Marianella Chamorro-Koc
PARTNERS: Queensland Children’s Hospital - Caroline Macaulay

Design “sprints” are normally 3-5 days in length,
enabling a deep dive, with creative and strategic
thinking about issues, priorities and responses.
Time constraints sometimes call for shorter activities, which can
also provide valuable insights. Here, as part of the Queensland’s
Children’s Hospital 2020 Ideas Festival, we ran a rapid one-hour co-
design sprint to help clinical stakeholders understand, brainstorm,
and design better ways to achieve optimal procedural care, reducing
pain for children and youth. Procedural pain is short-lived acute pain
associated with medical investigations and treatments (e.g., blood
tests, immunisations, IVs/Port access, dressing removals/changes,
nasogastric tube insertions), with this workshop focussed on how we
might “design out procedural pain”.
The design thinking process - in one hour 
The design thinking process - in one hour 
Participants were introduced to the six-step design thinking process:
Empathy – Define – Ideate – Prototype – Test – Implement focused
on how to create a pain-free journey for two personas: 5 year old
Annabelle (in hospital for a MRI with cannulation) and 16 year old
Tiffany (who has a chronic heart condition). 
Step 1: Empathy:
Step 1: Empathy:
Picking one persona, teams created empathy maps - bringing Tiffany
or Annabelle’s attitudes, behaviours and experience to the front of
mind as they noted down what each says, thinks, does and feels,
as well as “pains and gains”.  Empathy, as nursing scholar Theresa
Wiseman (1996) explains has four key attributes: to see the world
as others see it; to be non-judgemental; to understand another’s
feelings; and to communicate that understanding. 
Step 2 & 3: Define and Ideate:
Step 2 & 3: Define and Ideate:
The problem statement was defined as “how might we create a more
comfortable, calm experience?”, with groups then challenged to
generate a minimum of 10 ideas in 20 minutes. Each group
PAGE 43
PAGE 43

considered key touchpoints in the patient’s journey map (before,
during and after the procedure), with each person instructed
to advocate and think from a specific perspective: the patient,
the family, the staff, the space, and technology. The rapid pace
and purposeful perspective taking was designed to encourage
innovative, out-of-the box thinking. After the groups had ideated
and brainstormed, they pinned their solutions on around the room
and voted for their favourite – dotmocracy (dot-voting) in action!
This process generated much discussion and extended ideas, as
participants engaged with diverse ideas generated by other groups. 
Step 4: Prototyping:
Step 4: Prototyping:
Having been inspired by the ideas of others, teams were now tasked
with generating one preferred solution - their prototype. They
had 10 minutes to decide on and prototype one solution to pitch to
the room. Prototypes, Brown (2020) reminds us, “should command
only as much time, effort, and investment as are needed to generate
useful feedback and evolve an idea” (p. 19). Groups voted in the
winner, who received a handmade paper hat proclaiming them the
“Design Visionary”.
While time constraints meant we were unable to complete steps
5 and 6 of the Design Thinking process (Test and Implement),
our condensed one hour design-thinking sprint achieved its aim:
it brought together a diverse range of stakeholders from across
the hospital to discuss different approaches to managing pain,
generated much energy and enthusiasm for developing, testing and
implementing some of the ideas generated - from distraction games/
techniques during procedures (virtual reality, mindfulness, playing
with equipment prior), to redesigning the car park so the journey is
Dotmocracy: this quick and simple method of dot
voting is a fun way to visually capture the mood,
views, and priorities of people in the room.
PAGE 44
PAGE 44

calm from the car to the clinical spaces (murals, apps, VR) or tasking
a staff member to prepare proactively and thoughtfully for the child’s
arrival (favourite music playing or screen showing a topic they love,
eg cricket), as well as extending The Comfort Promise. 
A critique of design thinking is that it simply takes too long: our
approach shows the value of a condensed version (albeit in the
first instance with clinicians and NGO service providers). This is
just the start of creating a more comfortable and calm experience,
and we must continue to innovate and think differently about pain,
for as Eccleston et al. (2020) note: “how much of what we do (or
fail to do) now for children in pain will come to be seen as unwise,
unacceptable, or unethical in another 40 years?”
The ‘Design Visionary’ Hat in action
PAGE 45
PAGE 45

Prototyping is making a preliminary model of something,
from which other forms or products are developed. It
is a representation of a design idea, used to generate
learnings for the final development or build.
Prototyping is action oriented, with the intention of
creating a tangible product. It moves people beyond
talking into active creating and design doing. Typically,
prototypes are built in iterative processes, where the
lessons learned from one iteration informs the build of
the next version. The design question for prototyping is
always: what can be learned from this model?
Prototypes are usually cheap (with a minimal investment
of money or resources), quick (with a minimal
investment of time), and generative (so that there is
plenty of learning).
PAGE 47
PAGE 47

Protecting our Children: Co-Designing Child
Friendly PPE
QUT HEAL TEAM: Marianella Chamorro-Koc, Rafael Gomez,
Isabel Byram, Erina Wannenburg
PARTNERS: Queensland Children’s Hospital – Julia Clark,
Kerri-Lyn Webb, Heidi Atkins. Sunshine Coast University Hospital – Clare
Thomas, Lauren Kearney.

The COVID-19 global pandemic made the term Personal
Protective Equipment (PPE) ubiquitous. However, amid
supply shortages, access issues and debates regarding
the efficacy of PPE in a healthcare context, the voice of
one group has remained largely silent – children.    
PPE can be scary, unfriendly, and confronting for children, which, in
turn, can have a significant impact on the ability of HCPs to build
rapport and a safe, trusting relationship with children and their
families. Thus, in this project, the HEAL team have been working
with the Sunshine Coast University Hospital and Queensland
Children’s Hospital to develop less frightening PPE for HCPs to
wear.
Co-discovering childrens’ and clinicians’ experiences with PPE
Co-discovering childrens’ and clinicians’ experiences with PPE
The team focussed on uncovering and understanding the experience
of children of various ages, their families, and clinicians, of the
therapeutic process when PPE is worn. Quantitative surveys asked
children, young people and their families about their perceptions
of PPEs and their emotional response to them, with clinicians also
surveyed about the positive and challenging aspects of wearing
PPE while interacting with children. Virtual qualitative field
observations were conducted at each participating hospital, to
understand the interactions between clinicians, children and their
carers while using PPE, and clinicians with their team members,
tools, and environment.
Virtual qualitative field observations of PPE child-clinician
Virtual qualitative field observations of PPE child-clinician
interactions
interactions
Due to clinical protocols, the field observations had to be conducted
remotely - smart video tripods collected data via video. One
device captured the child’s gestures and emotional response
to the clinician during consultations, while the other captured
the clinicians’ movements and interactions with others and with the
environment.  These field observations were analysed using
PAGE 49
PAGE 49

Observer (a specialised software for qualitative analysis in behaviour
research) which facilitated the coding of each moment in the
interactions. Findings from the survey and field observation analysis
informed and generated new opportunities for PPE design, with
a design sprint – by the design team – resulted in two early PPE
designs: Sunny and Buddy.
Sunny: Pilot Solution
PAGE 50
PAGE 50

Phase 3:
Phase 3: Implementation
Implementation will focus on product development,
including technical specification documentation, prototyping
and testing, with a consideration of manufacturing requirements
and testing the prototype against required standards.
Buddy: Pilot Solution
Phase 2: Co-design
Phase 2: Co-design
Implementation are in
progress. Phase 2 will
consist of co-design
workshops and focus
groups with paediatricians,
nurses, children, and their
carers to develop new PPE
design ideas and design
priorities – adopting a
hands-on approach where
designers and participants
can work together in
creating new designs.
PAGE 51
PAGE 51

Designing out Diabetic Foot Problems
QUT HEAL TEAM: Marianella Chamorro-Koc, Isabel Byram
PARTNERS: Mount Isa Hospital – Sarah Bohan. Gidgee Healing

This research, currently in the preliminary stage, is
investigatingthepossibilitiestoimprovepodiatryservices,
particularly for diabetic foot disease (DFD), in regional
Australia. Rates of diabetes are expected to double in
Queensland, and it is the fastest-growing chronic health
disease in our rural, regional and Indigenous areas.
Diabetic foot disease in Mt Isa - and the potential of digital,
Diabetic foot disease in Mt Isa - and the potential of digital,
customised podiatric shoes
customised podiatric shoes
In Mt Isa, almost a quarter of the population identify as Aboriginal
and/or Torres Strait Islander, and many have foot issues, where the
focus is on the management of high-risk feet. DFD is often managed
through specialised footwear prescribed by a podiatrist or surgeon.
However, none of the podiatry care options in Mt Isa (Mt Isa Base
Hospital, Gidgee Healing, and Advance Foot Clinic) have the
capacity for in-house manufacturing, leading to either referral and
travel for patients who need custom solutions, or resourceful ‘make-
do-and-mend’ solutions, which are not always ideal. These challenges
can mean that compliance with prescribed footwear in DFD tends
to be poor, due to long wait times to receive the footwear, or the
footwear being impractical to use in everyday activities.
The project team are investigating ways to improve podiatry services
for DFD in regional Australia by working with Mt Isa Base Hospital
and Gidgee Healing to provide better service for clients in the Mt
Isa area - focussing on increasing the use of digital technology, by
auditing the existing supply chain and exploring the potential of
digital, customised podiatric shoes in regional locations. Adopting
a transformative service design approach to develop an enhanced
supply chain across regional hospitals, industry, specialists and
patients in the footwear design, HEAL research intern Isabel Byram
spent two days in Mt Isa on an exploratory visit, where she shadowed
staff and spoke with patients about their experiences.
PAGE 53
PAGE 53

The project identified that current options for podiatric footwear
tend to be closed-in shoes, which are not appropriate, either
culturally or functionally, for the climate in Mt Isa, which averages
above 30-degrees Celsius. Finally, Gidgee Healing have noted that
shirts from the Deadly Choices healthcare campaign and NAIDOC
are extremely popular and prized within the local Indigenous
community. Therefore, there may be opportunities to develop
podiatric footwear that similarly reflects Indigenous heritage, and
that will make the custom footwear more valuable to the wearer, and
thus increase the likelihood that they will keep and use it.
Patient receiving treatment
PAGE 54
PAGE 54

Moving forward, using design-led methods and strategies, our
aim is to advance orthotic design options, creating a service
design pathway for work with regional Australia, which will also
contribute to Australia’s digital transformation through advanced
manufacturing in healthcare. We intend to partner with the local
Indigenous community, the Kalkadoon people, on culturally
appropriate and desirable designs, and enhance the supply chain
to (i) reduce waiting times to receive prescribed footwear and (ii)
support the production of footwear that are designed with regional
DFD patients’ needs and preferences in mind.
Current podiatric
footwear available for
patients
PAGE 55
PAGE 55

Designing with Technology for Empathy in Healthcare: A
Pain Metric in Paediatric Admissions
QUT HEAL TEAM: Marianella Chamorro-Koc, Rafael Gomez,
Erina Wannenburg, James Dwyer
PARTNERS: Sunshine Coast University Hospital – Scott Schoffeld

Your child is being admitted to hospital after falling off
a swing. They keep telling you they’re fine, but you’re
sure they’re in agony and just putting on a brave front.
Wouldn’t it be great to have a machine that could tell
the clinicians exactly how much it hurt?
This project is positioned in the context of Admissions to the
Emergency room, in that initial stage or touchpoint when the nurse
asks a child about how much pain they have. People experience and
express pain differently, and in the context of an admission to the
Emergency Room, children might not respond to the protocol of
questions accurately. Unlike adults (who can verbally express how
they experience pain), young children who are pre-verbal can only
express their feelings of pain and anxiety through crying, and older
children who are in pain or feeling unwell often revert to pre-verbal
communication as well. This project seeks to enhance the decision-
making of the nurse in that moment, both (1) with a more accurate
and effective way understand how much pain the child is feeling, and
(2) by transforming that moment into a more positive experience for
the child.
Assessing pain in paediatric admissions
Assessing pain in paediatric admissions
In hospitals admissions, tiredness, business, and the heightened
emotions of a child in pain might influence the nurse and clinician’s
accurate assessment of that child’s pain. Assessing pain in paediatric
environment is a core task that is currently conducted using a 1
to 10 scale or, for younger children, a scale of happy to sad faces.
We wondered whether emotional and/or technological design
can improve the clinician’s empathetic assessment of pain.  The
exploration is positioned in the context of that initial stage when
pain is assessed (e.g. triage, at the start or during consultation
or procedure). 
PAGE 57
PAGE 57

Our strategy is to use a human-centred design approach to
understand the complexity of such scenarios and interactions with
children experiencing pain. We began with an initial exploration of
the paediatric pain assessment process through remote interviews
and expert walkthroughs. Following that, we have developed an
initial prototype to use as a research tool for assessing the pain level
of a hand/forearm injury. The device features: (i) a pain metric, (ii) an
anxiety metric, and (iii) an emotional engagement strategy. Pain is
measured through sensors that capture data about skin inflammation
and temperature, change of colour and size of the hand/forearm.
The anxiety metric is measured through sensors capturing heart
rate data. The emotional engagement strategy is a feature that
aims to engage non-verbal as well as older children in a therapeutic
relationship with the clinician. Our next steps are to test the initial
prototype through a co-discovery with healthcare professionals, to
inform the development of a final prototype.
Pain metric initial prototype
PAGE 58
PAGE 58

FUTURES
         WICKED PROBLEMS 
LEARNING SPACE
          SOLUTION SPACE
PARTNERSHIPS  
         MOMENTUM
SEEING DIFFERENTLY  
           UNDERSTANDING
TRANSFORMATION
           COMPLEX SYSTEMS
CREATE THE
MOMENT

Interactive CPR Manikin for Community Training
QUT HEAL TEAM: Marianella Chamorro-Koc, James Dwyer
PARTNERS: Royal Brisbane and Women’s Hospital Clinical Skills
Development Service – Luke Wainwright

In 2016, a 13-year old boy saved his baseball coach, who
had suffered a heart attack, by administering cardio-
pulmonary resuscitation (CPR). In 2019, a teenager
saved her father’s life by giving him CPR, which she
had learned as a child. There are countless examples
demonstrating that children can save lives by performing
CPR, and studies around the world support the
importance and appropriateness of providing children
with CPR education and training.
CPR saves lives; however, there are several impediments to
undertaking CPR training. First, when it comes to teaching children,
CPR manikins used in training are often adult size, making it
difficult for children to use correctly. Second, simulators and/or
clinical manikins used to teach CPR techniques are expensive, as is
community access to CPR training. Working with the Royal Brisbane
and Women’s Hospital, this project aims to equip future generations
and the broader community with CPR skills through developing
engaging interactive devices that expedite learning and are
accessible from a cost-effective and local manufacturing perspective.
Designing child-sized affordable CPR manikins
Designing child-sized affordable CPR manikins
The project initially began by considering the viability of local
manufacturing of CPR manikins, to lower costs and thus make them
widely available to the community for CPR training. In doing so,
the project started with an exploration of the design of a child-size
interactive manikin to teach children the technique.
This exploration was done within an Industrial Design unit at QUT,
where 55 Industrial Design students were presented with a design
challenge. The design challenge required students to apply their
design process, manufacturing knowledge, and skills to design a
child-size manikin for children to learn CPR. Students were advised
that the manikin should be designed to: (i) accommodate an insert
PAGE 61
PAGE 61

containing the electronics that support the haptic feedback
(interaction) to facilitate the children’s learning, and (ii) demonstrate
a local manufacturing and sustainability approach. The manikin
design needed to include two main components: (a) the child-size
manikin, and (b) an insert with the interactive electronics.
Designing people-focussed solutions
Designing people-focussed solutions
The HEAL team also worked with the Clinical Skills Development
Services (CSDS) team at the Royal Brisbane and Women’s Hospital
to understand what CPR manikins are and what functional
requirements they present. The HEAL team followed a product
investigation structure and conducted user research studies with
schoolteachers, children and parents. Using a Human-Centred
Design approach, the team developed 11 different interactive
manikin solutions to teach children how to give CPR to another
child. With the use of interactive technology, and underpinned
by embodied interaction concepts, the child-size manikins
demonstrated and guided a child on how to apply compressions, at
the right pace, and at the right depth. The manikin designs exhibit
LED lights to indicate facial change of colour, or blood circulation.
Manikins were designed considering
cost-effective local manufacturing and
ease of use in different scenarios (e.g.,
by teachers at schools, on the beach by
lifesavers, etc). Based on the successful
child-size interactive CPR manikin
prototypes, we selected one prototype
solution design and further developed
the interactive concept, adding in
one more challenge - the addition of
breasts. the right pace, and at the right
depth. The manikin designs exhibit
LED lights to indicate facial change of
colour, or blood circulation.
Manikin prototyping
PAGE 62
PAGE 62

In CPR training and real-life application, breasts present two
different types of obstacles for the common citizen: (i) they
discourage people from touching them to apply CPR technique, and
(ii) they present a physical obstacle in applying chest compression
at the right depth and pace. To address this, the team used a
research-through-design approach alongside iterative prototyping.
The team scaled up the chosen solution and investigated the best
possible ways to simulate breasts, in such a way that training with
the prototype would help the community to familiarise themselves
with the feel of the breasts, and the depth they need to target for a
successful CPR chest compression. This manikin is currently in the
design phase.
Manikin prototyping with breasts
PAGE 63
PAGE 63

As Don Norman preaches “we need more design doing”
– participatory design workshops and design thinking is
not magic and does not free us from actual design doing
– creating and implementing change, in collaborative
partnerships. In our focus on design doing, we are
inspired by the four “D’s” of the Double Diamond design
process, popularized by the UK Design Council:

DISCOVER: opening up and questioning; 
DEFINE: agree on most important issues to tackle;

DEVELOP: test responses, prototypes, & ideas;
DELIVER: produce & implement practical, solutions. 
Of course, the trajectory of change in the complex often bureaucratic
context of healthcare is not easy or straightforward.  The often slow
and uneven progress from ideas to implementation can challenge
morale, momentum and confidence. Protocols, processes, competing
priorities, and hierarchical, risk-adverse organizational cultures can
make the practicalities of simply ‘doing things’ and ‘getting things
done’ difficult (Bowen et al., 2013). However, our design-led approach
has focussed on the delivery of tangible outcomes over the past year
- as we see in the following projects. 
PAGE 65
PAGE 65

Journey to Fun: Playful Wayfinding and
Placemaking at QCH 
QUT HEAL TEAM: Jen Seevinck, Evonne Miller, Kirsten Baade Gillian Ridsdale
PARTNERS: Queensland Children’s Hospital – Lynne Seear, Matthew Douglas,
Belinda Taylor, Helen-Louise Usher. Entertainment Precinct partners: Starlight
Children’s Foundation (Starlight Express Room), Children’s Hospital Foundation
(Kidzone), and Radio Lollipop.

On Level 6 of the Queensland Children’s Hospital
you’ll find the Entertainment Precinct – home to three
separate non-clinical spaces focused on providing
children, young people and their families with joyful
places for distraction. Kidzone, Radio Lollipop and the
Starlight Express Room are independently operated by
partner charities with purpose-built facilities for patients
and their families to engage, play, learn and relax.
The entrance and arrival space at Level 6 did not reflect this
atmosphere of play, and these joyful places were difficult to locate.
Hospitals are large, complex spaces, which both first-time and repeat
visitors often finding confusing and difficult to navigate at a time
of physical and emotional stress. The Entertainment Precinct was
no exception: our brief was to create a strong visual identity for the
entertainment precinct, that more clearly signalled and signposted
the paths to Kidzone, Radio Lollipop, and the Starlight Express
Room. Our design needed to direct and to distract - and any solution
also needed to (1) compliment the hospital’s existing architectural
and artistic scheme; (2) meet health and safety requirements, being
non-invasive, non-touch, and able to support deep cleaning; and (3)
provide appropriate graphic representation for the precinct partners.
Wayfinding in Hospitals
Wayfinding in Hospitals
Wayfinding is the strategy people use to navigate or orient
themselves within a physical environment - and hospitals across the
globe are increasingly developing innovative approaches to guide
and support visitors so that they can easily discover the way on their
own (instead of struggling or having to ask for help). 
Contemporary approaches to enhance the hospital wayfinding
experience include integrating wayfinding visuals on all surfaces,
including the floors and roofs; playful wayfinding; integrating
PAGE 67
PAGE 67

narrative and memorable landmarks at key navigational decision
points; creating journeys that are easily describable in one simple
sentence, using basic English (e.g., “I will meet you at the waterfall
lift”); and acknowledging diversity, culture and inclusion, as well as
using digital technology. 
While specific approaches vary according to the user group, local
culture, customs, and setting, research constantly shows that
connections to, views of, and the colours of nature are calming
and healing. Children, across all stages of cognitive development,
consistently prefer art with nature – something that resonated with
the hospital design and informed our own approach.
Current entrance and arrival space at QCH
The Design Process
The Design Process
The HEAL design team visited the site multiple times, did a deep
dive into published research and international design exemplars
(e.g., Nationwide Children’s Hospital in Ohio; Evelina Hospital in
London; Great Ormond Street Hospital for Children), and ran two
design workshops with QCH stakeholders (including the precinct
partners, who surveyed their users about their interactions with the
space) to provide feedback on our design concepts. The design
PAGE 68
PAGE 68

ideation process iterated through sketching and photo mock-ups,
created in a human-centred design process. 
Our initial concept centered on play, art, and the endangered animals
of Queensland, with a deep discussion about the value of a broader
nature theme (birds, insects and other Queensland animals), as
well as responding to the hospital’s unique design: the multi-award-
winning building is one of Australia’s largest paediatric hospitals,
with the 12 levels intentionally designed to ‘not to feel like a hospital’,
with multiple public and private gardens. QCH features a ‘living tree’
design, with a network of trunks and branches that assist wayfinding,
alongside a central interior atrium space with different coloured
floors. The atrium features large sculptures of Eclectus Parrots,
which are visible from Level 6. During the design workshops, the
concept of parrots (and the adventures they can get up to!) became
our central narrative character in shaping a unified theme for this
hospital floor.
Feedback from the first workshop was that our parrot needed to
complement existing designs, reflect distinct partner identities and
the child’s voice, while valuing play, puzzles, stories, nature, the local
site and a creative journey. In the next iteration, artist Kirsten Baade
created some early parrot designs for feedback, including using
different coloured feathers from each parrot to use for wayfinding
and mark the journey to fun at each precinct partner’s location. She
was embedded with the hospital’s design team for several days,
working with the Digital Engagement Manager Matthew Douglas as
the designs developed.
In addition, the QUT design team engaged deeply with the
wayfinding design problem for the walls, floors, and lift areas. Level 6
of the Queensland Children’s Hospital has two main points of access
– two lifts – and these became a focus for design consideration, as
they would be significant for conveying the atmosphere of play as
well as to support memorable wayfinding – “I came in at the forest
lift”, or “Go past the waterfall lift”. This design approach makes
PAGE 69
PAGE 69

these places easily describable as journeys – consistent with the best
practice we found in our review of contemporary wayfinding design.
The wayfinding solution – playful parrots
The wayfinding solution – playful parrots
The second design workshop explicitly tested these ideas, with QCH
stakeholders generating activities or stories that the parrots might
engage with to drive the design of the final murals for the walls and
lifts. There was much excitement about how this concept will enliven
the area, enhancing wayfinding but also potentially providing
different ways to connect with the parrot theme. These ideas
included competitions for children to name the parrots; associated
colouring in activities and drawings shown on screens; extending
the theme with VR/AR and large fixed items, such as tree and nature
themed internal seating areas. 
PAGE 70
PAGE 70

The final wayfinding and mural designs are in the last stages of
approval at QCH, to be printed and installed on the 6th floor in
coming months. In this design solution coloured feather decals
populate the floor, while similarly coloured parrots on the walls lead
children, their families, clinicians and visitors to the lively precinct
areas of fun: the red parrots and feathers to Radio Lollipop, green to
Kidzone and purple to the Starlight Express room.
Nature scenes and parrots engaged in various activities – singing,
reading, flying, listening to music, cuddling chicks – are located
along the corridor walls and columns, distracting the patients and
families from their troubles.
The wayfinding solution - playful parrots
PAGE 71
PAGE 71

Improving Cultural Safety in Queensland
Improving Cultural Safety in Queensland
Hospitals
Hospitals
QUT HEAL TEAM: Manuela Taboada, Sean Maher, Susan Carson,
Thalia Bruner, Evonne Miller
PARTNERS: Aboriginal and Torres Strait Islander Leadership Team –
Kirsty Leo and Jacinta Thompson

The anxiety of being unwell, the uncertainty about
what will happen and what the processes are, coupled
with being separated from loved ones and surrounded
by strangers can make hospitals uncomfortable
places to be.
In Australia, First Nations (FN) patients, as well as patients from
other culturally diverse backgrounds, experience heightened levels
of discomfort, as they often feel culturally unsafe when interacting
with the healthcare system. The National Scheme’s Aboriginal and
Torres Strait Islander Health and Cultural Safety Strategy 2020-2025
explains that culturally safe practice is
“…the ongoing critical reflection of clinicians and systems
knowledge, skills, attitudes, practicing behaviors and power
differentials in delivering safe, accessible and
responsive healthcare free of racism.”
Pathways to overcome barriers
Pathways to overcome barriers
This project sought to demonstrate and raise awareness of the
importance of cultural safety in healthcare settings through creating
short, animated videos aimed at clinicians. The videos demonstrate
the cultural barriers and anxieties from the clinician’s and patient’s
perspectives, provide clear definitions, and suggest a pathway to
overcoming these barriers through building cultural awareness,
cultural sensitivity and understanding cultural safety. It is envisaged
that a set of activities and materials will accompany the videos, to
support clinicians in improving their cultural awareness and cultural
sensitivity, and thus be able to provide a culturally safe treatment
environment.
PAGE 73
PAGE 73

After a detailed briefing on cultural safety in hospital settings from
First Nations people, the project team created three storyboards
and draft animations to capture the existing knowledge, vision and
ideas regarding visual representation, animation effects and camera
movements, which could be played independently or together:
Concept 1:
Concept 1: focused on cultural awareness from the perspective of
the clinician, showing the barriers that exist between them and FN
patients. Barriers were presented as words in a bias curtain between
the clinician and the patient.
Concept 2:
Concept 2: focused on cultural sensitivity, still from the perspective
of the clinician, but from a reflective point of view, where the
clinician reviews their thoughts and biases about caring for FN
patients.
Concept 3:
Concept 3: focused on cultural safety, this time from the perspective
of the patient, showing the anxieties and feelings of being unsafe in
the hospital environment and what cultural safety means.
Video 1: Storyboard on cultural awareness
PAGE 74
PAGE 74

Video 2: Storyboard on cultural sensitiveness
Video 3: Storyboard on cultural safety
PAGE 75
PAGE 75

Involving clinicians through co-design
Involving clinicians through co-design
These ideas were tested at a co-design workshop with a reference
group of Queensland Health clinicians, who were invited to provide
feedback on the storyline and visuals. It was important to involve
clinicians early in the development and creation of the videos, to
ensure that the voices and perceptions of the intended audience
are taken into consideration, and to challenge the designers’ and
creators’ own biases and assumptions. Learnings were:
1. The importance of contextualising key arguments.
2. The words on the “bias curtain” and the way it is presented
might feel like ‘finger pointing’, causing anxiety.
3. The need for visual accuracy and up-to-datedness about
what the treatment room, clinicians and equipment look like.
Time is critical
Time is critical
The workshop revealed that the co-design process itself needs to be
culturally sensitive, embracing uncertainty, multiple perspectives,
and expectations – and that such profound transformational
processes need more time to be delivered and digested.
The three short animated videos are currently under development.
From an aesthetic perspective, emphasis is being placed on the
typographic treatment of words and thoughts in the videos to create
familiarity. The videos make use of hospital ambient sounds - such
as machine beeps and pulses and the background rush of carts, beds
and people. These hospital sounds will be taken over and silenced by
biometric sounds from the human body - heartbeat, breathing and
blood pumping sounds - to depict the anxiety that may occur when
building cultural awareness, cultural sensitivity and understanding
cultural safety.
PAGE 76
PAGE 76

THE DESIGN JOURNEY AND PROCESS
TEACHES PEOPLE TO BECOME
COMFORTABLE WITH UNCERTAINTY -
A CRITICAL 21st CENTURY SKILL
BECAUSE:
EVERYTHING HAS CHANGED,
IS CHANGING AND
WILL CONTINUE TO CHANGE
“the illiterate of the 21st century will not be
those who cannot read or write,
but those who cannot learn, unlearn and relearn”
Alvin Toffler
PAGE 77
PAGE 77

Increasing use of Interpreter Services at
Metro South
QUT HEAL TEAM: Janice Rieger, Sarah Johnstone, Thalia Bruner
PARTNERS: Metro South Addictions and Mental Health Team -
Karen Beaver, Ruby Chari

Recent clinical incident analysis and data reviews have
highlighted an underutilisation of interpreter service for
those consumers who have been flagged as “interpreter
required”. This creates significant inequality for CALD
(culturally and linguistically diverse) patients and others
who require ‘just access’ to healthcare.
As it currently stands, Interpreter Services are made available to all
Queensland Health hospitals and health centres 24 hours a day, at
no charge to the patient. All Queensland Government agencies are
required to provide and pay for qualified interpreting services for
customers who are hearing impaired or have difficulties communi-
cating in English. However, preliminary identification of the barriers
to using interpreter services has highlighted that some staff believe
interpreter services are unable to be utilised due to the associated
costs and budgetary constraints.
Enhancing access and use of interpreters
Enhancing access and use of interpreters
This project focused on (1) uncovering ideas for enhancing access
and use of interpreters and (2) co-designing an education tool
to increase the use of interpreter services (focussing in the first
instance on multicultural mental health clients and their clinicians).
The overall aim of this clinician-led project was to increase access
and use of the existing service from the clinician’s perspective
(clinician-led) by identifying pain points and barriers for service
uptake and co-designing solutions which addressed these barriers.
Assessing the challenges – a survey and online workshop
Assessing the challenges – a survey and online workshop
The first step in this project was to engage with administrative staff
and clinicians from across the Metro South Health region through
a short survey which provided insight into their use of interpreter
services. The survey results indicated a need for greater clarity
around the cost of service (i.e., mythbusting), along with roles
and responsibilities for requesting and assessing the need for an
interpreter, and fostering a culture of inclusion amongst clinicians.
PAGE 79
PAGE 79

Issues included:
- The booking process (for those who use it) is quick and
effective, but is is unclear who is responsible for bookings

- Experiences with interpreters are generally positive,
with some concerns about confidentiality

- There is inconsistency in the availability of interpreters

- There is a belief using the service costs the department

- There is a lack of clarity around what should happen if an
interpreter does not arrive for a patient’s booking.
A selection of survey respondents then participated in a 90-minute
online workshop which used interactive quizzes – focused on
‘Mythbusting and Truth-Sharing’ – to clarify some of the findings
from the survey, and conversations surrounding possible ideas for
‘Tools & Resources’ and ‘Training & Support’.
The HEAL team co-developed a storyboard for an educational
animation, the basis of which emerged from a story shared by a
clinician in the survey. The last phase of the workshop provided
participants with an opportunity to share their feedback on the
storyboard - possibly be the first of a suite of new training videos
directed at increasing uptake of the interpreter service.
The value of interpreters - developing a short animation
The value of interpreters - developing a short animation
The clinician’s story, and the resulting animation, calls attention
to the positive impact that interpreters can have on the client’s
experience and level of understanding, and portrays the value of
having an inclusive mindset towards creating ‘Just’ healthcare.
The animation also provides further education around who needs
interpreters, by highlighting that even if a patient may not ‘look
CALD’ or can speak some English, does not mean that they could not
benefit from having an interpreter present.
PAGE 80
PAGE 80

Appointment storyboard
Post - appointment storyboard
PAGE 81
PAGE 81

Reducing Urine Sample Contamination
in the ED
QUT HEAL TEAM: Evonne Miller, Lisa Scharoun, Zoe Ryan
PARTNERS: Queensland’s Healthcare Improvement Unit  PROV-
ED Project (Promoting Value-Based Care in Emergency
Departments) coordinators Tanya Milburn and Sarah Ashover.

Have you ever had to provide a urine sample for the
doctor? Recent research in a Brisbane Emergency
Department found that nearly half – 41.5% of all mid-
stream urine samples – collected from women were
contaminated. While contamination rates vary by site,
institution, collection, storage and transport, poor
patient technique – due to inadequate instructions – is
a key reason for contamination.
Eley and colleagues (2016) developed and tested a graphical
illustration to simply explain the process to patients, with this
intervention reducing contamination rates from 40% to 25%. But,
when the Clinical Excellence Queensland led PROV-ED Project
(Promoting Value-Based Care in Emergency Departments) started
to explore rolling these posters out to other emergency departments
– as the Reducing Urine Contamination in Emergency (RedUCE)
initiative – initial feedback from staff and consumers was that the
original design was overly graphic, especially for use with children
and in different cultural contexts. 
The team explored several options to improve the experience
of urine collection   – from an infographic, to disrupting the
process and designing a different container for urine collection, to
developing animations that turned urine collection into a game for
children. In the end, we settled on redesigning and simplifying the
poster, using a gestural drawing approach (a loose form of sketching
that expresses movement by capturing basic form). 
PAGE 83
PAGE 83

We combined what had been separate posters for men and women
into the one poster, and reduced the number of steps, to further
simplify the process. We are still tweaking the final design, which
has gone through multiple rounds of iterative design sessions about
the images, the number of steps, and the narration – but the images
opposite show the original design and the current beta version.
Existing emergency
department graphics
PAGE 84
PAGE 84

Currrent beta version
PAGE 85
PAGE 85

By nature, designers are futurists: we create ideas
that do not yet exist. In design visioning, we use that
ability to shape our collective imagination and to inspire
optimistic future-focussed dialogue and storytelling
about “what might be”.   
Design visioning activities provides teams with the time
and space to have focussed, reflective, and meaningful
discussions around the future - to see new possibilities
and think bigger about the impact of changing
technologies, processes, and cultures, and gain clarity
about the innovation you are striving towards and why.
As the following projects show, engaging in design
visioning is a critical way to engage, gain clarity about
preferred options, and sustain momentum.
PAGE 87
PAGE 87

Delivering Virtual, Integrated Care
in Central Queensland 
QUT HEAL TEAM: Evonne Miller, Shari Read, Lisa Scharoun,
Sarah Johnstone
PARTNERS: Central Queensland HHS – Kerri-Anne Frakes,
Eric Miller, Kelsie West. Clinical Excellence Queensland – Anna
Wesselman

Like many hospitals and health services across the
globe, Central Queensland (CQ) is turning to virtual,
integrated and connected care to enhance the
healthcare experience for their geographically and
socially diverse community.
While the COVID-19 pandemic has accelerated the widespread
adoption of collaboration and communication technologies, virtual
care remains a different model of care for both consumers and
clinicians - and changing healthcare systems and practices is no easy
task. 
Co-designing the future of care 
Co-designing the future of care 
The HEAL team worked with CQ to explore the opportunities,
learnings, barriers, and best paths forward - alongside multiple
online strategic planning sessions, we travelled to Rockhampton
for three days in April 2021 to engage with key local stakeholders
– clinicians, GPs, allied health, QAS, consumers and strategic
leadership teams. 
Over a four hour in person and virtual co-design solution exploration
workshop, over 50 local stakeholders explored the viability,
appeal, barriers, opportunities and best paths forward for potential
technology enabled solutions for three specific personas: Anne, who
has COPD, her GP Carl, and her specialist, Shona.
We started with our vision for the future - asking: what does care
look like in 2030, and how could it be improved for these 3 key
stakeholders?Participants very clearly saw future healthcare as
virtual, connected, and provided in consumers’ homes: patients
would be active partners in their healthcare, driving health decisions
by drawing on bio-medial data they collected. As a sector, the hope
was healthcare would be less risk-adverse and more collaborative -
PAGE 89
PAGE 89

The focus then turned to the challenges (the myths, fears, hopes and
taboos) of achieving this vision, before exploring what “excited and
disappointed” about three specific proposed solutions:
1. virtual care
1. virtual care through remote patient monitoring (drawing
on knowledge from a current trial with Phillips, focusing on
chronic conditions);
2. how to better connect GPs
2. how to better connect GPs in primary care with specialists;
3.
3. how to reduce the pressure on emergency departments,
reduce the pressure on emergency departments,
perhaps via an ambulatory emergency care model.
Teams then identified - at very practical macro, messo and micro
levels - what governments, hospitals, clinicians, and consumers
needed to “stop, start and continue doing” to deliver virtual care.
Innovation in the Face of Complexity 
Innovation in the Face of Complexity 
To close, teams pitched their own technology-enabled care vision,
focusing on priority actions over the next 12 months. Each group
allocated 1.85 Million dollars - in play money - to invest in the
winning ideas, which centered on expanding HITH (Hospital in
the Home) and  clinicians’ scope of practice. With stakeholders
enthused over a shared vision of virtual care, the ongoing challenge
is developing strategies, tools, and systems that make this transition
as seamless as possible. Driving change and a truly integrated care
service - across quality of care, process, technology, governance,
diverse personalities, local contextual challenges and priorities -
is no easy task, but CQ is committed to leveraging technological
innovations to improve healthcare. 
PAGE 90
PAGE 90

Personas are fictional characters designed to help us better consider,
imagine, and step into the shoes of another- to have empathy and use
that empathetic imagination to guide our actions. Personas assist with
strategizing and communicating, serving as archetypes. The first step
in the design process is Empathize, which be done through creating 
personas and/or the completion of empathy maps.
Ideally, personas are research-based - created from workshops,
interviews, observations, quantitative and qualitative data, or in the
medical context, drawing on actual cases to trigger deep reflection and
discussion, helping ensure any initiatives resonate. 
In the CQ project, the persona of Anne so resonated with one consumer
in the workshop that Geoff he shared his wife’s Peta-Anne’s journey of
COPD with the group - she actually died in the car outside a regional
hospital, was brought back to life, and then spent the next year in and
out of hospital, before receiving a lung transplant. Geoff shared his
hope that contemporary technologies might have enabled him and his
wife to stay at home, rather than have COPD disrupt their lives quite as
much. Whether it is through personas, empathy maps or the powerful
narratives of real-life consumers, good design - and good healthcare -
always starts with listening and deep empathy. 
Personas and Empathy Mapping 
PAGE 91
PAGE 91

Connecting Rehab Services across
West Moreton
QUT HEAL TEAM: Evonne Miller, Abbe Winter, Sarah Johnstone,
Sam Regi
PARTNERS: West Moreton – Sarah Sorensen and Therese Hayes

How do you provide connected, seamless, high-value
care across multiple dispersed sites? That’s the
challenge facing West Moreton, which manages 5
Hospitals and several health services across nearly 10,
000 kilometres. West Moreton is also Queensland’s
fastest growing HHS, with the population projected to
almost double by 2036, from 312,000 to 587,600.
Planning for such rapid growth in a regional and rural area means
West Moreton must radically re-design service delivery - and they
worked with HEAL on their first initiative: activating the 22-bed
Boonah hospital as a step-down site for rehab, with a focus on
creating seamless care transitions with the 392 bed Ipswich Hospital
- 50 kilometres away.
An Appreciative Inquiry Approach to Service Transformation
An Appreciative Inquiry Approach to Service Transformation
We started with a workshop: over 50 clinicians and consumers
collaborated in a Co-Designing Service Transformation workshop
to envision what seamless care transitions between Ipswich and
Boonah might look like. The workshop was grounded in a positive
psychology-inspired appreciative inquiry (AI) approach, first
developed by Cooperrider et al. (2008). AI is a strength-based
model that encourages change agents to look at people, systems
and their organisation with “appreciative eyes”: instead of the
traditional deficit-based model of focusing on “what’s wrong, what’s
the problem”, AI shifts the lens to focus on strengths, achievements
and opportunities – purposely engaging in a positive, strengths-
based dialogue about the future.
Sketching and sharing exceptional moments in healthcare
Sketching and sharing exceptional moments in healthcare
Participants were asked to draw and share a moment of “exceptional
practice” – when they were engaged, excited, and proud of their work.
Clinicians sketched memories of when a patient spoke for the first
time in 6 weeks (saying “I love you, Mum”); of taking a patient – after
PAGE 93
PAGE 93

14 months of in-patient treatment – to visit their rural property for a
picnic; the ward Xmas Party (bringing staff and patients together to
celebrate); or when staff collaborated to bring a much beloved and
missed dog into the hospital to visit its owner. Images were pinned
to the wall, gallery style, triggering a collective discussion about
“what a great rehab experience looks like at WM”.
Empathy Mapping through Storyboarding – Don, Ruby, & Clara
Empathy Mapping through Storyboarding – Don, Ruby, & Clara
The workshop continued with an empathy mapping task.
Participants were given two personas – 82 year old Don (carer for
his 78 year old wife, Ruby, who has Diabetes and had a stroke a week
ago) and 59-year-old Clara, whose complex medical history and
multiple comorbidities included kidney disease, early stage chronic
obstructive pulmonary disease (COPD) and frequent falls. A fall
from her mobility scooter led to an infected gash, sepsis and a stay in
ICU, triggering a referral to Rehab.
Outdoor space at Ipswich Hospital Rehab
PAGE 94
PAGE 94

After selecting one of these personas (or creating their own), the
groups created a storyboard of transitioning between facilities
through the medium of a comic - best case and worst-case scenarios,
along with what patients, their families, and staff “think, feel and do”
as they engage with the rehab system. These were pinned to the wall
for discussion, with participants using “callout cards” to add scenes
or comments to other groups’ scenarios.
System Analysis: ‘Fears, Hopes, Myths, Legends’ Matrix
System Analysis: ‘Fears, Hopes, Myths, Legends’ Matrix
This next activity unpacked deeply held feelings about the proposed
changes, with participants individually listing their ‘Fears, Hopes,
Myths, Legends’ – from the perspective of both staff and patients.
Hopes, for example, centered on: being able to improve client
centered care and outcomes, to have no wait-list for rehab, to expand
the service, provide an organized multi-disciplinary approach,
develop a mobile rehab team, and use virtual care to positively
improve patient care. 
Ideation – idea-storming from six different perspectives
Ideation – idea-storming from six different perspectives
The last hour of the workshop centred on ideation where, with
open and creative mindsets developed from the previous activities,
participants engaged in a creative brainstorming process – to
explore what could be done to create a “positive seamless Rehab
journey for Don, Ruby or Clara”, with each person in the group
challenged to speak from a different perspective (e.g., the patient, the
carer/family, the staff, the space, technology, and communication).
Prototype – Designing Change
Prototype – Designing Change
In the final activity, participants picked one idea to develop and
pitch to the room - these centered on ways clinicians could ensure
the planned changes supported their shared values of providing
a quality, effective and consumer-centered rehab care experience.
Groups proposed system-level solutions, such as The Boonah Bus
and developing a home-like rehab centre (where multi-disciplinary
PAGE 95
PAGE 95

teams work in collaboration in a less clinical, more home-like
environment), options which are currently being considered for
further development.
Arts-based methods and design storytelling
Arts-based methods and design storytelling
The second part of the project used arts-based methods and
design storytelling - a digital story and a photovoice exhibition -
to trigger a public dialogue about the experience of rehab at WM.
Photovoice (the joining of photography with voice) is a visual
research methodology which uses photography to document,
reflect on, and promote critical dialogue on important issues.  Here,
we asked clinicians, consumers, and their families to photograph
their experience of rehab - from the mundane to the momentous.
Participants shared in photographs (with accompanying narratives)
and cook again, to
achievements and
dreams for the future
of rehab, with these
narratives also captured
in a short video.
The video and images
formed part of a public
on-site exhibition at
Ipswich Hospital – which
provided a tiny peak into
the hidden world of rehab,
the committed clinicians
and the stories of locals
learning to walk, eat and
speak again.
Carer Persona Sheet
PAGE 96
PAGE 96

PROBLEM
         DIAGNOSIS
DEEP REFLECTION
          ANALYSIS
PROVICATION  
         IMAGINATION
EXPERIMENTATION
         ACTION
OPPORTUNITY
         TRANSFORMATION
CHANGE THE RULES OF THE GAME, TO
TURN PROBLEMS INTO OPPORTUNITIES
DESIGNERS

Emergency Room Entrances and Exits
QUT HEAL TEAM: Lindy Burton, Jane Carthey, Evonne Miller,
Sandra Astill,
PARTNERS: Scott Schofield - Sunshine Coast University Hospital.
Melanie Forbes - Bond University

Emergency Departments are highly dynamic, stressful
environments for both clinicians and consumers, who
wait for treatment, often feeling frustrated about un-
certain ED processes and procedures. While numerous
systems have been implemented to reduce crowding,
shorten patient wait times, improve flow, operation and
patient outcomes, less research has focussed explicitly
on the physical design of the ED.
Critically, the COVID-19 pandemic has further focussed attention
on the role and design of the ED – spaces which are the first
to recognize and respond to public health outbreaks – and the
importance of flexible and adaptive space designs in healthcare. 
What works (and what doesn’t) in ED design
What works (and what doesn’t) in ED design
The project team interviewed eight medical, nursing and allied
health staff to better understand how they experience their hospital
spaces, including any spatial facilitators and barriers to the delivery
of positive healthcare in the ED – including entry, admission,
triage, waiting and discharge areas, including the staff work areas
associated with these spaces. Participants were located in a number
of hospitals throughout Queensland, providing an insight into the
differences in the workspaces and patients of urban, regional and
remote hospital settings.
We asked staff to critically reflect on  “what works and what doesn’t”
in terms of their work environments’ physical designs. Participants
drew on their past experiences of working in other locations,
comparing it to their current workplace, the functionality of the
workspaces during challenging times, and the diversity of patients
coming through their areas, with a focus on vulnerable users,
Recognizing that the COVID19 global pandemic (and new protocols
of social distancing, clear screens, assigned routes, and increased
hand washing) would have an ongoing influence on ED design, we
PAGE 99
PAGE 99

also asked how their spaces have changed as a result of the
pandemic. Finally, we asked them to suggest how designers could
improve the hospital workplace and their ideal hospital work
environment. 
Conceptually, our research was guided by a desire to create
healthcare environments and EDs that are salutogenic (ie., actively
promoting health wellbeing for patients and staff), and we were also
informed by an awareness and appreciation of biophlic design - that
integrating nature and views of nature into the built form enhances
wellbeing.
Redesigning the ED - where to start? 
Redesigning the ED - where to start? 
Spatial design decisions were influential. Clinicians described how
the design and layout of the waiting room impacted the patient
experience - a well-placed triage desk, a children’s play area, screen
for ‘health propaganda’, a taxi phone, a phone charger and multiple
port adaptors and the addition of a waiting room nurse to improve
communication with the waiting public were all initiatives seen
to enhance the ED experience.  Wayfinding was often a challenge,
however: “currently it is like a maze.  We need to have coloured lines
on the floor or walls for people to follow” and “we would like to put
these colour coded lines on the ground where we can say to family
‘Follow the light blue line and you’ll find the coffee machine at the
end of it ‘or ‘follow the green line and you’ll find the exit’. We can’t do
that in this hospital, so it is difficult to direct family and patients …
they all have to be individually escorted inside if they’ve never been
here before”. 
Staff also appreciated consistency in relation to design and
equipment set-up as important in the ED setting - “knowing where
the buttons are, and not having to really think and look where you
are means you can be on autopilot… it makes your job easier to have
these uniform sort of panels”. Recalling past workplaces, “the hub
and spoke design” was seen an efficient use of space because of the
visibility it provides, as well as the time saving in locating patients,
PAGE 100
PAGE 100

QUT Designers in Healthcare - HEAL 2021 report

QUT Designers in Healthcare - HEAL 2021 report

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (16)

Similaire à QUT Designers in Healthcare - HEAL 2021 report

Similaire à QUT Designers in Healthcare - HEAL 2021 report (20)

Plus de QUT

Plus de QUT (20)

Dernier

Dernier (20)

QUT Designers in Healthcare - HEAL 2021 report