HCD provides a framework for more deeply connecting diverse stakeholders in collaborations that generate creative interdisciplinary solutions. It can also help participants see multiple stakeholders as customers whose needs can be met and lead to design solutions that meet a broad range of those needs. For example, a Kaiser Permanente Northwest team is working on supporting family caregivers of patients with dementia. Patients and caregivers are often unclear about what follows an initial diagnosis by a primary care provider, and PCPs often feel inadequately equipped with resources to address next steps.
PI can rigorously dissect systems and processes to identify root causes of defects and breakdowns; HCD focuses on human needs and helps identify which parts of a process matter most to people and how the process fits into their lives.”
A group that included family caregivers, PCPs, memory clinic specialists, social workers, and an Alzheimer’s Association representative created a prototype of a pre-configured electronic health record feature to trigger appropriate referrals that PCPs could use to initiate a smooth and timely care path. PCPs who didn’t participate in the CoDesign session tested the prototype, reporting that their confidence about providing appropriate support and resources for caregivers increased more than threefold, from 1.8 to 6.2 on a 10-point scale. The feature met the needs of caregivers, PCPs, and social workers and is currently poised for spread throughout Kaiser Permanente Northwest.
Deeply understanding customer needs also helps improve patient experiences outside care delivery. A Consumer Financial Service Experience team at Kaiser Permanente worked to increase billing transparency for cost-sharing patients receiving imaging services. Using interviewing for empathy, contextual customer observations, and partnering with patients, the team learned about the personal nature of cost communications preferences and how and when patients wanted to be alerted to cost changes and connected to a financial expert. During prototype testing of a new approach for communicating imaging costs, patients said their likelihood to recommend to others the way KP communicates about imaging costs based on their preference increased more than fourfold (from an average score of 1.67 to 7.47 on a scale of 0–10).
What HCD Helps Kaiser Permanente Learn
PI can rigorously dissect systems and processes to identify root causes of defects and breakdowns; HCD focuses on human needs and helps identify which parts of a process matter most to people and how the process fits into their lives.
PI and HCD fit together naturally, following a similar process of assessing/understanding, identifying ways to improve and innovate, and testing and implementing solutions. During the assessment stage of uncovering opportunities, HCD techniques like interviewing for empathy, observations/shadowing, and journey and empathy mapping can provide a deeper perspective on the needs of patients, family members, and staff and a framework for organizing their experiences.
HCD can help bridge the gap from developing a new idea to broad use by ensuring that implementation is more people-centered and positions new solutions in a way that speaks to staff and patients.”
While developing solutions, HCD offers creative brainstorming techniques to explore a range of possibilities, methods for gaining inspiration from other industries addressing similar needs, and setting the stage for interdisciplinary collaboration. HCD approaches to rapid iterative testing can enhance learning from early Plan-Do-Study-Act cycles, increasing the team’s comfort with rough prototypes and exploring a range of solutions before settling on one. HCD can help bridge the gap from developing a new idea to broad use by ensuring that implementation is more people-centered and positions new solutions in a way that speaks to staff and patients.
Methods may vary, but most health care organizations practice some type of PI to which HCD can be joined. While Kaiser Permanente continues to spread this integration of PI and HCD throughout the organization, experience to date suggests beginning with three steps:
· Invest in building HCD capability across organizational functional areas with a focus on applying methods in service of better outcomes and a stronger organizational culture. Create a core group of HCD experts to coach and mentor others. Develop a common language — a shared organizational vocabulary everyone uses to talk about HCD — and create content and curriculum materials that reinforce both language and practices. Incorporate HCD into experiential training at deepening levels of competency.
o Budget time upfront for staff to learn and practice HCD in their roles. On an ongoing basis, allocate the time needed to identify and engage with customers, conduct interviews and shadowing, and bring stakeholders into interdisciplinary collaboration. This investment can help avoid long-term pitfalls. In the recent survey of HCD training graduates at Kaiser Permanente who worked on improving care and services, while only 23% felt that their work would go faster with HCD, 65% felt that it would reduce rework and 73% reported that applying HCD helped them avoid working on the wrong problem.
· Create a discipline of leveraging PI and HCD processes and methods throughout projects to help understand opportunities, create and test solutions that deliver even stronger outcomes, and spread solutions more easily.
· Select a mix of initial projects that align with top organizational priorities to illuminate the value of applying PI and HCD together and share the case studies to educate and inspire. Leverage leadership support to select priorities and identify appropriate outcomes.
Acknowledgments: We gratefully acknowledge the expertise at integrating HCD and PI and at program assessment of Alice Ducey, Jennifer Cunha, Nicole Tuite, Elaine Carty, Andrew Black, Deborah Jones, Jennifer Burciaga and Jeff Hall and the contribution of many, especially Ben Grossman-Kahn, Sami Packard, Jennifer Cunha, and Melissa Chevalier in shaping the HCD@KP compass. Lisa Schilling and Dennis Deas provided critical input, and Jennifer Green and Jane Roessner provided editing support.