How do people make decisions in your organization?

If you don’t understand how people make decisions in your organization, you will never be able to influence them.

Erika Hall

Sage advice from Mule Design co-founder Erika Hall. It’s from her article “Research Questions Are Not Interview Questions” and it’s about doing design research well, a skill necessary for success in just about any job.

Another great nugget:

Your research question and how you phrase it determines the success and utility of everything that follows. If you start with a bad question, or the wrong question, you won’t end up with a useful answer. We understand this in daily life, but talking about research in a business context seems to short-circuit common sense. Everyone is too worried about looking smart in front of each other.

Incorporating Design

In a health care world of useless price and cost data (individuals pay little, what’s a charge mean anyway?), comparable quality and outcomes data (see Medicare’s futile attempt at comparison via the Hospital Compare website), similar service offerings (the general hospital is an exercise in commoditization; our system dictates that competing hospitals must offer similar services), and compromised patient satisfaction scores (hospitals game the Press Ganey system by asking for high scores), how does a hospital differentiate itself from competition?

Patient experience.  How does a hospital build patient experiences?  By making design a priority (here’s evidence on why it is important).  Robert Brunner at FastCompany:

The relatively few companies in the world that are really design-driven know the secret: That design is, in fact, everybody’s job. Rather than making design a single step in the process where requirements flow in and ideas flow out, they see design as a constant topic of discussion across all disciplines and steps in the process. It is not a vertical stripe in the horizontal process flow, but a horizontal one that extends from inception through customer service and end of life.

Granted there’s a needed educational component here.  So why not start during the summer reading season (I’m a fan of year-round reading, but if you need the extra momentum brought on by the beach, it’s upon us)?  Here are 30 important design books.  Start with “The Design of Everyday Things,” it will change your perspective.

Applicable design example: hospitals!

Because MRSA and C. diff are increasingly problematic in hospitals (and hospital equipment has been said to be badly designed):

British designers have come together to give the grim and functional hospital ward a much-needed revamp, and in doing so, they have thrown out the clunky old bedside cabinets, the tired mattresses and dubious-looking commodes and replaced them with more futuristic versions.

The makeover has been prompted not by aesthetic shame, but by medical prudence.

Design! The Guardian report continues:

“There are huge issues with superbugs in hospitals, but it’s likely that if we can make the environment easier to clean, we will go a long way to improving the situation. A lot of hospital furniture has nooks and crannies that are repositories for bugs, so the challenge was to design those out,” said David Kester, head of the Design Council.

How the glorious people at the Design Council did it:

Design teams were despatched to hospitals to look over wards and talk to doctors and nurses about how curtains, bedside cabinets, commodes and other ward furniture were used. The Council then called on designers to come up with smooth, cheap and simple alternatives.

Medical Utopia: Designing cities to protect against diseases like swine flu

No doubt that if you have consumed any amount of media in the last 48 hours you are aware of the swine flu.  It is, as well it should be, a growing concern.  And something to think about seriously (the smart people/people who work on things like this for a living have been doing so for a while now re: avian flu).

Snarkmarket points to a thought provoking post at BLDGBLOG that combines a cadre of interests on this blog: medicine/public health/urban planning/design/the future.  Number 10 from This Diseased Utopia: 10 Thoughts on Swine Flu and the City:

In the end, then, what spatial form might a medical utopia take, and how could it be architecturally realized?
In 50 years will you be walking around the edges of the city with your grandkids when one of them asks: Why are these buildings out here, so far away from the rest?

And you’ll say: They’re here because of swine flu: we redesigned the city and our diseases went away.

Patient Experience Rundown

This post at Matter/Anti-Matter sums up nicely the poor patient experience often on display in health care settings:

  • First problem: Lack of efficient communication.
  • Second problem: Lack of personal touch.
  • Third problem: Bad office systems and technology.
  • Fourth problem: No advice.
  • Fifth problem: No prevention.

Here’s what happened:

About four weeks ago, I went for an annual physical and had standard blood work done. I was told to call back in a week, and of course I forgot. Today I had a message that said: “Hello, this is Dr. XX’s office, please call us back at xxx-xxx-xxxx.” That was it–the person didn’t identify herself and also didn’t say what the call was for. When I dialed the number, I was expecting to be told that I owed them money. But actually, the woman on the phone had no idea why she had called me. So I sat on hold, and finally she came back with my blood test results and rattled off a bunch of acronyms and numbers. I’m happy to report the results were good (at least that’s what she said), except my cholesterol was at 201 and it should be less than 200. Then the call ended.

That was it.

Broad generalization here: we’re capable of so much better.

Design, the way of tomorrow

Scott Dadich of Wired on designing under constraint, two important thoughts in reverse order:

The idea of operating within constraints—of making more with less—is especially relevant these days. From Wall Street to Detroit to Washington, the lack of limits has proven to be a false freedom. With all the economic gloom, you might not be blamed for feeling that the boundless American frontier seems a little less expansive. But design teaches us that this is our hour of opportunity.

That’s because designers understand the power of limits. Constraint offers an unparalleled opportunity for growth and innovation.

Think of a young tree, a sapling. With water and sunshine, it can grow tall and strong. But include some careful pruning early in its development—removing low-hanging branches—and the tree will grow taller, stronger, faster. It won’t waste precious resources on growth that doesn’t serve its ultimate purpose. The same principle applies to design. Given fewer resources, you have to make better decisions.

$21,000,000,000 + Health IT – (Human-centered design) = What?

DesignWell takes a human-centered approach in questioning the utility of the $21,000,000,000 outlay for health information technology in the stimulus (err, spending for the more conservative among us) bill:

I assume that most of the stimulus money will go to large technology companies that create complex database systems and algorithms to handle the intensity of data required to make it all work. However, I hope that the stimulus package carves out money to understand how data will actually get into these health records, and more importantly, how people will actually use them.

And comments on the state of personal technology in the health care world:

In all of this we must be cognizant of the real, and very sad, state of technology in most medical settings. Sure we have amazing scanners and procedures that are miracles of science and engineering. But the state of technology that is actually usable by regular, real people (patients, under-educated nurses, and doctors are real people too!) is shoddy at best. As I mentioned, I don’t envision my doctor entering my results into an iPhone app anytime soon.

Last, the missed opportunities for mindful, captivating self-reflection:

In a waiting room, we have a captive audience that is thinking about health issues because they’re about to see a doctor, yet there is nothing to help the patients. There is nothing to help people get ready for a visit to maximize the time with the doctor. There is nothing to help review past records or streamline the process in any way. What an amazing time and place for people to interact with their EHR! But there’s nothing even close to being on the right path for that. Technology is non-existent here, so a massive EHR system would be equally useless.