Designing realistic medicine

@RODNEYMOUNTAIN @MIKEPRESS @OPENCHANGEUK
DESIGNING
REALISTIC MEDICINE
ROD MOUNTAIN MIKE PRESS

A SURGEON
AND A DESIGNER
WALK INTO A BAR….

HEALTHCARE
SERVICE DESIGN
WHAT IS REALISTIC MEDICINE?
HOW CAN SERVICE DESIGN ADVANCE IT?
WHAT HAVE WE DONE SO FAR?
WHAT CAN WE DO NEXT?

@openchangeuk www.openchange.co.uk@RODNEYMOUNTAIN @MIKEPRESS @OPENCHANGEUK
HEALTHCARE
SERVICE DESIGN

THE SCOTTISH APPROACH
TO SERVICE DESIGN

Scottish Approach to Service Design: Principles
Using our public services should be as
simple and straight forward as it can be.
As Simple As They Can Be
Users should be in the room when design
decisions that affect them are made.
Users In the Team
All of Scotland’s people should be able to
participate in the design of our public services.
No One Left Behind
Learn, understand, envision,
make, test and deliver together
Always Connect
User Not Organisation Needs
Ensure services are delivered in the best way
possible to solve user’s problems and meet
user’s needs. Users should not need to
understand how the public sector works.
Collaborate, Share, Reuse
Work with other organisations to make the
user’s journey coherent and minimise
duplication, and to improve the efficiency of
design.
Inclusive and Accessible
Our tools and methods must be accessible and
inclusive – anyone who wants to should be able
to participate in any public service design
activity.
With, Not Just For
Public services are how governments deliver
their policies – designing with and not just for
enables both policy and implementation to
continuously improve.

WHAT IS
REALISTIC MEDICINE?

SUBJECTIVE
HUMAN EXPERIENCE 
= 
OBJECTIVE
BEAN COUNTING

GLOBAL HEALTHCARE  
CHANGES
1
2
3
4
5

VALUE
DIGITAL
WELLNESS
SUSTAINABLE
COMMUNITY BASED

VALUE
DIGITAL
WELLNESS
SUSTAINABLE
COMMUNITY BASED
STEPHEN HAWKING Illustration: Ellie Foreman-Peck

HOW CAN
SERVICE DESIGN ADVANCE
REALISTIC MEDICINE?

+
WHY COMBINE QUALITY
IMPROVEMENT & SERVICE DESIGN?Chief Medical Ofﬁcer’s Annual Report 2014-15
REALISTIC MEDICINE
REALISTIC MEDICINECAN WE:
CHANGEOURSTYLETO
SHARED DECISION-MAKING?
BUILDAPERSONALISED
APPROACH TO CARE?
REDUCE HARM
AND WASTE?
REDUCE UNNECESSARY
VARIATION IN PRACTICE
AND OUTCOMES?
MANAGE RISK BETTER?
BECOME IMPROVERS
AND INNOVATORS?
SCOTTISH APPROACH TO SERVICE DESIGN

WHAT’S THE DIFFERENCE?
IMPROVEMENT
DESIGN
BASED ON SYSTEM ANALYSIS
SETTING STANDARDS
QUANTATIVE
LEFT BRAIN
SERVICE
DESIGN
BASED ON USER EXPERIENCE
CREATING EXPERIENCES
QUALITATIVE
RIGHT BRAIN

AIMS
QI AIMS
SERVICE EFFICIENCIES
INCREMENTAL CHANGE
PROBLEM SOLVING
FACT FINDING
SD AIMS
USER EXPERIENCES
RADICAL CHANGE
PROBLEM FINDING
INTUITION

PROCESS
QUANTITATIVE
PROCESS
RISK AVERSE
MORE HIERACHICAL
MEASURABLE
LESS EMOTIONAL
QUALITATIVE
PROCESS
RISK TAKING
LESS HIERACHICAL
OBSERVATIONAL
MORE EMOTIONAL

METHODS
QI METHODS
FEEDBACK
SURVEYS
OPINIONS
MEETINGS
TEST OF CHANGE
SD METHODS
USER ENGAGEMENT
CREATIVE THINKING
EMPATHY MAPPING
JOURNEYS /
TOUCHPOINTS
PROTOTYPING

OUTCOMES
QI OUTCOMES
WRITTEN STANDARDS
PROTOCOLS/GUIDELINES
LESS RADICAL PROPOSALS
MEDIUM TERM SOLUTIONS
SD OUTCOMES
VISUAL NARRATIVE
INFOGRAPHICS/MEDIA
MORE RADICAL PROPOSALS
LONGTERM SOLUTIONS

Now is the time to link left brain with right and
create an enlightened alliance of
Quality Improvement and Service Design in Scotland
QI & SD ALLIANCE

Learn from each other
vocabulary, tools, conﬁdence
Work with each other
subtle, cultural, value, trust
Train and Teach together
Adapt tools and techniques
WHY PARTNER QI and SD mindsets?

WHAT HAVE
WE DONE SO FAR?

WHAT HAVE
WE DONE SO FAR?
1. COMMUNITY
2. CAPACITY
3. LEADERSHIP

CONDITIONS FOR DESIGN
TO ACHIEVE IMPACT
IN PUBLIC AND THIRD
SECTOR PROJECTS
Condition 1: Community Building
Build and Maintain Trust

TO ACHIEVE IMPACT
IN PUBLIC AND THIRD
SECTOR PROJECTS
Condition 2: Capacity
Build Capacity and Skills

TO ACHIEVE IMPACT
IN PUBLIC AND THIRD
SECTOR PROJECTS
Condition 3: Leadership
Align Change with
Organisational Values

WHAT HAVE
WE DONE SO FAR?
COMMUNITY BUILDING

WHAT HAVE
WE DONE SO FAR?
CAPACITY

NINEWELLS HOSPITAL
5,000 STAFF SERVING POPULATION OF 500,000
25 MILES OF CORRIDORS
2ND LARGEST HOSPITAL IN SCOTLAND
PIONEERED KEYHOLE SURGERY
UK’S ONLY FRANK GEHRY BUILDING

NINEWELLS SAFARI

SERVICE DESIGN FOR GPs

DASMAN KUWAIT

WHAT HAVE
WE DONE SO FAR?
LEADERSHIP

WHAT CAN
WE DO NEXT?

HOW DO WE DO IT?
Link our organisations
Scale, embed and spread
Joint training and activity
Establish, build relationships
Create the future we want
A Society philosophy
Cathedral thinking / V&A effect

IT’S NOT ROCKET SCIENCE
DESIGNING
REALISTIC MEDICINE

THREE
LOCAL LEVEL PRIORITIES
1. SPACES TO INNOVATE & CO-CREATE
2. INSTITUTIONAL PERMISSION TO
COLLABORATE
3. BUILD DESIGN CAPACITY
4. FUNDING

THE SCOTTISH APPROACH
TO SERVICE DESIGN
IS ABOUT GIVING POWER TO PEOPLE

Designing realistic medicine

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