Service Design

Service Design | Memorial Sloan-Kettering

Andy Conrad, Kate Pemberton, Fei Qi, Angela Robertson Fall 2009

This is Sam and Leah. They’ve been dating for 9 months.

Recently, Leah received some surprising news.

She was diagnosed with Leukemia.

What does this mean for a couple?

A traumatic event like cancer can have devastating effects on intimate relationships. The closeness between partners may greatly decrease. Those diagnosed with cancer often feel that the emotional information regarding the disease is lacking.

Trauma decreases desire.There’s a loss of intimate feelings.There’s a lack of emotional information.

Being supportive and feeling valued is important...for both partners

Memorial Sloan-Kettering Cancer Center has the opportunity to provide a new service to help young couples deal with this emotional journey together

Help young couples deal with this emotional journey.

The service is MSKouples.

Living with cancer adds strain to anyrelationship. To increase the likelihood of staying together, new couples need to increase their emotional intelligence by learning how to perceive, understand, andmanage emotions in themselves and others.

Our service builds emotional intelligence by educating the couple on how to handle the different emotions inherent in the cancer journey--from despair to anger, fear to hopefulness.

Emotional intelligence: perceiving, understanding, and managing emotions in yourself and others.

Salovey and Mayer, 1990

Our service prepares couples by providing communication tools, knowledge about relationships and a support network.

Communication tools are learned through discussion and practice with a counselor and other couples.

Relationship knowledge is gained through counseling and interaction with other couples.

In the support network, individuals learn from other’s journeys and experiences. Prepares couples for the cancer journey by providing

communication tools• knowledge about relationships• support network of others in similar situations•

Service benefitscouple feels prepared to make decisions about relationship • partners feel less alone through connection to support network• partner gains understanding of how to provide support•

Meet two couples using MSKouples

In this scenario, Megan and Bill have been dating for seven months. Last week,Megan shared her recent diagnosis.

Scenario 1: Finding support

Megan: “Bill never takes time to read pamphlets. So I thought we’d try a MSK Healthy Cooking Class. It’s a great way to meet other couples who’ve gone through the cancer journey together while learning how to cook healthy meals.”

During the class Megan and Bill talk with Julie and Josh. Julie was diagnosed with breast cancer two years ago. Josh was by her side throughout her journey.

After talking about the Bears game, Josh mentions how he and Julie met with a doctor and a counselor on a regular basis during her treatment. He found this especially helpful as he was able to be supportive and present during Julie’s journey.

Bill: Megan, we should meet with a counselor. Josh told me how helpful it was for him and Julie. I think it would help me better understand what you’re going through and how I can be supportive.

Counselor: “Welcome Megan and Bill. I’m glad you have come in to talk. This is a safe environment, where you can ask questions and discuss concerns about cancer and how it will affect each of you and your relationship.”

Scenario 2: MSK mobile reminders

In this scenario, Brad is a longtime clientof MSK, new boyfriend of Angelina. Angelina wants to be there for Brad but doesn’t know how or when to ask how Bradis doing

Angelina meets with a counselor, expresses her desire to support Brad in whatever ways she can, however, she doesn’t know how.

The counselor tells her about MSK Mobile Tips. This application sends reminders to a mobile phone on days when Brad has treatment, giving personalized recommendations for ways Angelina can help him out.

The next time Brad has chemo, Angelina gets an alert on her phone reminding her that he may be feeling nauseous and low on energy.

Angelina stops at the store on her way home from work to pick up some club soda and rice, foods that are easy on upset stomachs.

MSKouples service components

Discoveryof service

Introductionto service

Education of partners

Maintenance ofrelationship

physical evidence

ads on MSK site, • Google searchespamphlet about • service

coordinator’s office• menu of services• handouts•

cards/pamphlets on • communication tips online communication • information

online info about counseling services/benefits

handouts about issues couples may face

patient actions

incidentally meet MSK meets with coordinator talks with partner (using methods)

couple meets with doctors & counselors

couple or either partner seek support services

partner actions

talks with patient partner engages with MSK

msk onstage

appointment at MSK explanation of • service componentsdiscuss relationship•

counselor may be present calls from nurses/• doctorsin situ invites• mixers•

doctor gives • medical infocounselor gives • emotional info

counseling• partner goes to • treatment

msk backstage

research and compile communication methods, tips

contact other • couplesmail materials, • invitations

support processes

web maintenance• updating calendar• printing • pamphlets

manage schedule web maintenance• print materials•

database of volunteer couples

mobile/email • remindersretreats•

line of interaction

line of visibility

MSKouples blueprintService components in a service blueprint. The four major sections of the blueprint are discovery of the service, introduction to it,education, and maintenance of relationship.

Discoveryof service

Introduction to service

Educationof partners


physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprintWe envision the discovery of service happening through ads on the MSK web site, pamphlets distributed at the treatment center, or a nurse, doctor, or other patient recommending this service.

Discoveryof service




physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprint

,

Introduction to the service is when the client actually meets with a servicecoordinator who explains the servicecomponents and may also provide tipsand techniques for communicating withthe partner. As this is a service for bothmembers of a couple, the client introduces the service to her partner, through pamphlets, the web site, or simply talking it over.

Discoveryof service


Education of partners


physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprintIn the education phase, the couple mayengage with MSK individually or together. They can learn about the emotional ups and downs they may face,as well as engage with other couples who have gone through the same thing.

Discoveryof service



Maintenance of relationship

physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprintMaintenance provides ways in which the client and partner can support eachother. This phase includes mobile or email reminders for the partner as to when chemo or other important eventsare happening.

Discoveryof service




physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprint: Scenario 1 mappingRecalling the first scenario where Meganand Bill go to the Healthy Cooking class, note that is sits on the blueprint primarily in introduction and education.

Our second scenario with Mobile Reminders sits in education and maintenance.

Discoveryof service




physical evidence






patient actions




partner actions


msk onstage





msk backstage



support processes





line of interaction

line of visibility

MSKouples blueprint: Scenario 2 mapping

MSKouples... moving forward

In order to get a service like this startedat MSK, we looked at our assumptionsabout what we are proposing and suggestsome tests to figure out if we are on the right track.

Our first assumption is that the partner has the time to come in. We suggest testing the service at different times and tracking when people are able to come in. From this test, we can learn if the service can be offered at set times, 9-5 Monday-Friday, or be a bit more customized, possibly offering evening or weekend hours.

Another assumption is that cancer is a big hurdle in a relationship. We suggest surveying those in unmarried relationships when diagnosed and counting how many break up due to diagnosis. If there is a high incidence of break-ups, then cancer is indeed a large hurdle.

Third, we assume that all service components are equally valuable. To find out which components should be built on or cut, we can survey or profile our users and find what offerings have the biggest impact.

MSKouples assumption testing

Assumptions that need to be tested

Resources required to test these assumptions

Insights these experiments give to you

partner has time to come in•

cancer is a huge hurdle in • the relationship

all service components are • equally valuable

volunteer couples & staff • with flexible schedules to test service at different times

survey of those who were • in unmarried relationships when they were diagnosed

surveys or profile of users•

track number of people • requesting different times of day

How to measure the results of experiments

count number of people • in early relationships who broke up due to diagnosis

gather feedback to see • which components are making the biggest impacts

discover if service can • be offered at set times vs custom per couple (possible evening appts)

expect that a high • incidence of breakups due to cancer means that cancer is a large hurdle

discover which • components to build and which ones to cut

Documents

Service Design