Design Thinking in Mersey Care NHS Foundation Trust

Dr Arun Chidambaram

Steve Bradbury

P4P2

WHAT IS DESIGN THINKING?

Key Phases

The Inspiration Phase:Discovery

Discovery

• End users

• Discussion guide

• Fieldwork

– Interviews

– Observations

– Key documentation

– Analogous inspiration

Discovery

• Interviews with staff• Observed a handover• Analysed data• Lit review• Time spent on the ward• Viewed care plans• Service user stories

Empathy and understanding

8

P4P2 Design

Journey Start Point:

In January 2016 Mersey Care risk identification report identified self-harm as one of our key risk areas. Incidents were on the increase, adding to concerns over a cluster of deaths during 2014-15. A ‘deep dive’ analysis was therefore commissioned.

• 5 ‘hot spot’ wards were identified• High level support was gained• The project structure was established• Literature search was completed• Awareness sessions were delivered• Discovery work was initiated• Feedback sessions were planned

The Inspiration Phase:Synthesis

Synthesis

• What do we mean by synthesis?

– A way of organising and making sense

– Identifying patterns

– Highlighting opportunities for design

• How do we do it?

– Clustering themes

– Point of View (POV) statements

Synthesis Review

• Why?

– Sense-check before investing in design

• When?

– At the end of the synthesis workshop

– As a stand alone exercise*

– At the start of the ideation workshop**

How Might We…?

• Convert your prioritised POVs to HMWs

• Why?– Shifts the emphasis

– from insight to design challenge

– Stimulates creativity

• How?– Focus on needs not solutions

– Opposite condition of POV statement

HMWs

• Too Broad: HMW… design the perfect first aid kit?

• Too Narrow: HMW… create a pocket for the scissors and the adhesive tape?

• Just Right: HMW… help busy parents find the first aid tools they need quickly at home?

Prioritisation of HMWs

• Everyone votes

• Criteria

– Greatest impact

– Feasibility

– Acceptability

The Ideation Phase:Generate

Generating Potential Solutions

• Brainstorm

– As individuals

– As a group

• Cluster similar ideas

• Prioritise

The Ideation Phase:Build

Prototypes

• What is a prototype?

– A way of making ideas more tangible

– Story board; role play; physical model

• Why prototype?

– To learn

The Action Phase:Launch and Refine

Prototypes

• Alpha / Beta prototypes

• Convergence with Model for Improvement

– PDSA cycle / pilot

• Further iteration / refinement

• Full roll out

• Monitor impact

Pilot wards and interventions

Arnold Ward:

Stable and consistent teamsReflective practiceStaff training

Dee Ward:

Structured activityEmotional coping skills groupAlternatives to self-harm

Harrington Ward:

Clear mutual expectationsEmotional coping skills groupAlternatives to self-harm

Poplar Ward:

Safety huddlesStaff training“Know Me”

Monitoring Impact

• Process measures

• Outcome measures

• Balancing measures

0

10

20

30

40

50

60

Ap

r-1

6

May

-16

Jun

-16

Jul-

16

Au

g-1

6

Sep

-16

Oct

-16

No

v-1

6

De

c-1

6

Jan

-17

Feb

-17

Mar

-17

Ap

r-1

7

May

-17

Jun

-17

Jul-

17

Au

g-1

7

Sep

-17

Oct

-17

No

v-1

7

De

c-1

7

Jan

-18

Feb

-18

Mar

-18

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-1

8

Harrington Ward: Self-Harm Incident Frequency

Incidents 2016 Mean

Local Division Self Harm Project

0

10

20

30

40

50

60

70

80

90

100

Self Harm Local Mean Average Upper Natural Process Limit Lower Natural Process Limit

Violence Reduction Project: Impact

30

Violence Reduction Project: Impact

31

Sustainability and spread

• Pilot: 4 wards in 2 divisions

• Phase 2 roll out: 11 wards across 3 divisions