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Faces of CMHA: “Baseball cards and white coats – how innovation and design thinking can shape health care”

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Get to know Alison DeMuy, Director, Strategy and Innovation at CMHA Waterloo Wellington. Follow the ‘Faces of CMHA’ series for a glimpse into the lives of the people who spend each day working to make a difference at the Canadian Mental Health Association:

In a previous life as an innovation consultant, I worked with a team at an Ontario hospital who had recently disallowed physicians from wearing white lab coats.

The “white coat policy” was an attempt to equalize the hospital staff so everyone wore scrubs – from the cleaning staff to the physicians. That way, all staff were considered visually on the same playing field, and no one treated the physicians with any extra privilege.

The result was disastrous.

Patients and their family did not like the fact that they didn’t understand who was who, and they felt uncomfortable knowing who they could ask about medications and who they could ask about lunch tray clearing. It was a noble idea to equalize staff, but one that was implemented without truly understanding the needs of staff, patients, and families.

This is an example of how we often identify a problem, go right to a solution, implement it widely, and then are faced with undoing it because we didn’t truly understand the problem in the first place. What was thought to be an innovative idea really wasn’t, because it wasn’t rooted in a true understanding of need.

Innovation is defined as “something new or different,” but I don’t think something is innovative just because it’s new – the same way I don’t think something is innovative just because it uses technology. My definition is this: Innovation is meeting an unmet need in a new way. That doesn’t always mean the creation of an app, and it doesn’t mean it’s innovative just because it’s new – it is only innovative if the solution is truly rooted in a meaningful understanding of the unmet need.

Innovation is defined as “something new or different”, but I don’t think something is innovative just because it’s new – the same way I don’t think something is innovative just because it uses technology. My definition is this: Innovation is meeting an unmet need in a new way.

I’m a big fan of a methodology called Design Thinking.

Design Thinking (also known as “experience-based design” or “human-centered design”) is an approach that has been used by designers for decades, whereby they use tools to understand the end-user – to truly experience a product or service from their vantage point: how they interact, feel, think, see, do.

Only once using this “empathy based” research does the designer come up with ideas for a solution. But before the idea is widely implemented, it is rapid prototyped, tested, changed, and then tested again. Only once the idea reaches a point of success or maturity is it widely implemented — and even then, it is constantly tested, altered, and measured for continuous improvement. With Design Thinking, “failure” is seen as a learning opportunity, and constant change and improvement is the norm.

I think it would be very interesting to use design thinking more in how we operate.

Before we implement a solution widely, let’s spend some time up front to truly understand the unmet need or the problem we are trying to solve. Let’s use our observational skills, research, and engagement strategies to help us understand the opportunities for innovation – this could be our clients, their families, and our own staff and internal processes. Don’t be afraid to prototype and test an idea – try it out, learn from mistakes, and then change the idea and start again.

Working this way would be our first step to building a “culture of innovation,” where we are not only allowed to try new ways to improve, but we are encouraged and enabled to do so.

Before we implement a solution widely, let’s spend some time up front to truly understand the unmet need or the problem we are trying to solve.

We used this approach a few years ago at CMHA when looking at our adult intensive services.

Brooke Young led a project called Designing Better. Instead of trying to understand lots of folks a little, the project did deep dives into the lives of a few clients to truly understand their daily experience, what they needed, and how our services might adapt to meet those needs.

The outcome of this was a service standard called “Dignity by Default,” which became a foundation to the work being done to reshape our adult intensive services into FACT (Flexible Assertive Community Treatment) or team-based care teams. This is one of many examples of how empathy-based understanding produces better results.

So how did we solve the “white coat” problem at the hospital?

The staff continued to only wear scrubs – they didn’t want go back to the days when physicians were the only ones to wear white coats. This was important, as the staff really wanted to create a team-like approach to care.

For the patients who still needed to understand who did what, we prototyped and tested an idea that was co-designed with staff and patients. The idea came to a nurse one day when she was watching one of her pediatric patients play with baseball cards.

The young patient was shuffling his baseball cards to create his perfect baseball team – he had a catcher, a pitcher, a few outfielders, and his top infield players. The nurse brought an idea, along with the young patient, to our innovation workshop where we prototyped the idea of creating personalized baseball cards for each staff person.

Nurses, physicians, and cleaning staff all created baseballs cards with their photos, stats (i.e. the role they played at the hospital, such as physician, nurse, etc.), favourite movie quote, and other fun personal info. When they entered a patient’s room, they presented the patient with their baseball card.

It was a great way for the staff to greet the patient, but more importantly, the patient then had a fun, creative way to know who was on their “team.” We prototyped, tested, and changed the idea until we ultimately knew it was a success.

Because the idea was rooted in meaningful observation and understanding of need, this low-tech idea is a simple example of design thinking innovation.

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