EMERGENCY ROOM SERVICE DESIGN

The ER innovation team during one of the project meeting.

“ How might we improve ER staff working experience and create an internal team of practitioners capable of continually adapting  solutions and responding creatively to the context changes? ”

Employer: Università di Modena e Reggio Emilia               Client: S. Orsola Hospital, Bologna                                      September 2017 - december 2018

The Team:                                                                                 Matteo Vignoli - Academic responsible                                Ottaviano La Cenere- Project manager & Senior business process engineer                                                                            Clio Dosi- Senior business process engineer                                   Silvia Marchini - User researcher and design thinking coach 

Goal of the project: 

Improve the ER staff working condition, which tends to be exposed to dramatic stress and workload level. Train the healthcare professionals to adopt a new approach to copy with a continuously evolving context characterized by scarce resources, equipment and staff, and an increasing in-flow of patients.

The output:

The final output consisted of four solutions; two were process changes, immediately adopted to optimize the communication among healthcare professionals from different units. The other solutions required infrastructural changes in the hospital building, and were both approved, financed, and implemented. (One of them is the ER waiting room redesign) We also modified the IT system to improve the process tracking and spot the bottlenecks.                        

The ER waitng room after we have redesigned it.

The process:   

In public healthcare organizations, most of the time, innovations are mainly transferred from literature to the field. Still, this approach can work only if the healthcare staff develops the awareness to implement the new procedures adapting it to their context's peculiarity. Therefore the project was divided into the following phases:

Creation of an ER innovation team: physicians, nurses, and aid nurses were gathered for the first time around the same table to collaborate and develop solutions to improve their working conditions. The Emergency Room is an extremely fragile environment. Therefore, healthcare professionals were the only ones capable of intervening. My role was to empower them through a methodological approach to frame, prioritize ER problems and generate appropriate solutions. 
Context research: I spent about 1 month observing the healthcare professionals working on their environment, interviewing them, and researching the emergency room and healthcare field. The final goal was to understand the ER process and the ER staff's needs.

*Prototypes embedded in the user's daily activity and conducted in the setting of ongoing clinical work and patient care.

Problem framing: during the research and the interviews, many significant problems emerged, however, due to the complexity of the emergency room environment, it has been challenging to identify the main problem to focus on. Furthermore, most of the problems mentioned during the interviews were mainly perception-based and needed to be validated.
We identified, together with the healthcare staff, the main assumptions and tested them in several ways: data collection, computational scenarios, experiments and live prototypes.*
I worked in close contact with the healthcare staff to run these tests, furthermore I cooperated with the business engineers of my team to analyze the ER processes and collect data.

Ideation and definition: The healthcare staff's involvement in the ideation phase was necessary to design a solution adapted to each category's needs and accepted by the majority of the hospital personnel.
The definition of the solution required to me the switch from having a role of designer enabler, to my intervention as a full service designer.

The ER innovation team during one of the project meeting.