Free Essay. Design Thinking in Chronic Care Models in Nursing: Using Empathy

As with every patient-based project, this designing process shall follow a set of the strategic plan (Blake, 2016). In modern-day planning in patient care environments, innovators and project experts must work closely together to map a clear strategic path based on clear project goals and objectives. While most project development endeavors begin with an expert-determined roadmap illustrating an assumed problem, the design thinking approach takes a more bottom-up approach. The design thinking project proposed in this study will commence in the hypertension and diabetes care department of the health institution. Health experts drawn from the CCM domains will collaborate through workshops to study and innovate for patients that are presently in hypertension and diabetes care.

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In this study, we shall focus on designing a service or system for managing hypertension and diabetes among adults aged between 35 and 65 years old. The series of workshops shall thereby comprise of chronic care nurses, doctors, and experts in human behavior. Collaboration and lateral communication among these healthcare workers will determine the success of the process. They will be equipped with the foundational knowledge of the main design thinking principles and the human behavioral tendencies among patients that the innovation process to address. Above all, nurses will form the central components of the design workshop. At the end of the design project, the healthcare experts and patients shall a unifying care practice that incorporates the value systems of the institution and the clients. This section intends to describe the purpose and key objectives of this study. The author shall, furthermore, include a strategic plan that the project might use in actualizing the initial stages of the project.

Purpose of the Project

The people-centered design has continued to endorse the learning-by-doing practices in the management of chronic illnesses (Porter-Ogrady, 2019). The crucial purpose of this present project is to empathize with clients in the CCM and understand the behavioral components that influence their commitment to diabetes and hypertension management. While solutions have often been proposed for managing these conditions, most of the proposed solutions are often faced by a lack of interest or inconsistent adoption by the clients. To start this design process in the diabetes patients’ population in the selected institution, the experts shall immerse themselves in such a diabetic population and gain personalized non-influenced perspectives of the patients regarding their present care models (Kershaw, 2011).

These empathetically-determined problems from the clients shall thereby be used to propose specific ideas to solve the problems (Johansson-Sköldberg et al., 2013). Continuous and active collaboration and co-leadership by nurses, doctors, and other health practitioners shall characterize the design teams. As such, the other essential purpose of this project is to empower the nurses and various health stakeholders to increase their involvement in the chronic care of diabetic clients. Nurse involvement as co-researchers shall allow them to increase their ownership of the final design product or system.

SMART Objectives

The objectives for the design project shall aim to be Specific, Measurable, Actionable, Realistic, and Time-Based (SMART) (Johansson-Sköldberg et al., 2013). As such, the team shall set original strategic goals that are both realistically defined and are bound by time and scope. At this stage, these proposed project objectives may appear slightly general. In design thinking, the original goals are allowed room for flexibility and change during the process. Some design objectives for the management of diabetes and hypertension between patients and healthcare sector players are described in this section.

Increase the active patient engagement rate in diabetes and hypertension diagnosis and prescription from the present <10% to 40% in one year.

As earlier described in the review of literature for this project, up to 91% of patients are reported to be completely uninvolved in the diagnosis and medication prescription processes of their medical conditions. Authors posit that current diagnoses, testing, and prescription of care practices are highly dominated by expert doctors (National Academies Press, 2011). As such, the patients are often largely unaware of their condition and why they have to follow the treatment regimens the doctors prescribe. From this project, the innovators shall aim to improve doctor-patient active engagement to allow the patients to take full responsibility for their conditions. As such, the author here proposes that by the end of the year-long project, 40% of patients visiting doctors for diabetes screening and prescription should be actively involved in the diagnosis and initial prescription process.

Increase the percentage of nurses that are involved in action research and co-leadership in diabetes and hypertension care units by 10% in two years.

In a 2014 research on nurses´ involvement in research, the American Association of Colleges of Nursing (AACN) noted an increasing trend in research-based nursing programs. The research determined a 3.2% annual rise in nurses registering for doctoral programs (Blake, 2016). Furthermore, Initiative on the Future of Nursing, at the Institute of Medicine, Washington (DC) declared that “Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States” (National Academies Press, 2011). Through design thinking, the project shall intend to increase the nurses´ interest in action-focused research significantly. The study intends to increase the number of nurses enrolled in leadership and research programs to 10% within two years. Involving the nurses actively in safe workshop collaboration platforms shall allow them to develop an active interest in design thinking and innovation. As enthusiastic designers, the nurses shall thereby be interested in improving their leadership abilities through the learning-by-doing workshops.

Create a patient-focused system that will increase Patients´ sensitivity and long-term commitment to chronic care programs.

By understanding the interests and motivation of the employees, the design team shall create a process or system that is sensitive to their needs and dynamic behavior. As already stated in this study, the design team shall carefully empathize with the patients. From such deep empathy, the collaborative team shall determine a people-centered diabetes management system that is proactively sensitive to patient context and individual interests. Rapid prototyping of the proposed solution shall allow the team to evaluate the project before the final launch and thoroughly review probable systemic flaws in the proposed system (Johansson-Sköldberg et al., 2013).

Increase the number of nurses and patients that are proactively engaged in collaborative environments in the care model by 15% and 40%, respectively, within two years.

By following the design thinking principles, the design team shall be actively involved in problem definition, description, and solution. To ensure such problem-based systems function seamlessly, designers must be continuously engaged in multi-disciplinary collaborative environments. As such, design workshops shall allow all the participants to be change-oriented and focused on heightened lateral communication. Within the first two years of the design workshops, 15% more of the nurses and 40% more of the patients should express their willingness to participate in the design workshops actively (Kershaw, 2011). Proactive engagement as a construct shall be measured through a perception study on the patients´ commitment to continue in the CCM.

Project Strategy

In this design journey, the strategic plan shall entail the progression of the five main stages of the design thinking process. As such, the design team shall go through the phases of designing according to the human-centered design principles. This section briefly describes the stages of the designing journey for diabetic and hypertension patients.

The first phase, as already stated variously in this project description, involves empathizing with the patients (Johansson-Sköldberg et al., 2013). In this empathy phase, the design team shall plan meetings with the patients in friendly and comfortable environments. Such meetings will be used to gather the inspirations, fears, strengths, weaknesses, motivations, and cultural proclivities of the patients concerning their diabetic care routines. The patients shall be allowed to highlight every issue they have regarding their care journey. To gain such deep emotions and personal problems of the patients, the team shall use a combination of focus groups, observations, interviews, and complete immersion methodologies. In such settings, the patients will feel free to disclose their problems and strengths while living with diabetes and hypertension (Kershaw, 2011).

From the empathy phase, the design team shall converge in the first workshop to define and ideate for the problem (Johansson-Sköldberg et al., 2013). In problem definition, the project team shall identify a workable project question that shall serve as the focal point in ideation. The question in the problem and solution definition phase shall follow the “How might we….” format based on the problems identified. The question shall be structured in a way that guides the project team to respond to the problem through probable solutions. An example of a problem statement might be “How might we provide an engaging environment and follow-up care practices for hypertension and diabetic patients to foster client self-care and learning process about their chronic conditions.” Most importantly, this question must only be developed after the empathy phase is completed.

After the problem is defined and ideated around, the team shall converge on one potential idea or a combination of ideas for the next phase. The next phase in the design thinking journey involves the prototyping of the idea. The ideation phase shall involve a series of brainstorming workshop sessions until the members arrive at the idea they feel is the best compromise based on the feasibility, acceptability, and suitability trilogy. This final idea (or combination of ideas) is then taken to the prototyping phase. In this last phase, the idea is tested against the dynamics of the institution to determine any bottlenecks that may hinder the final launch. Any revisions to the prototype of the system or service are then effected before the final implementation (Johansson-Sköldberg et al., 2013).

Conclusion

This section briefly discussed the objectives and strategic planning of the design thinking workshops and processes. In the analysis, the author proposes a general-purpose and objectives of the project. In this study, the project purpose only acts as a framework for beginning the process for innovation for diabetes and hypertension wings of the institution. According to the design thinking principles, the fundamental idea (or combination of ideas) in the design thinking journey must only be developed after a conversation with the clients. We thereby the general (yet SMART) objectives above as the focal points of the designing journey.