Diabetes Connection to Care
Skills:
Hospital Site Explorations
Parameters of Medicine
Independent Study
Spring 2022
Summary
Patients within endocrinology often do not follow up with required medical exams in ophthalmology and other departments. Using insights from not only patients but doctors, nurses, and medical staff to determine several fall out points for patients to be addressed. This included improving the direct communication of referrals, using dead time to convey urgency, and improving the consistency of services offered by floater staff.
And thus we begin...
Hospital Visits
Visiting the facilities that were involved allowed our team to determine not only the general patient experience but observe the full function of the office space. This ranged from computer programs to whiteboard systems when it came to organizing personnel.
Patient Visits
Our team also shadowed several patient visits allowing us to gauge the time and attention paid to each patient at each part of their experience. It also enlightened us to the function of the rooms that they visited and each attribute of the facility the patient would experience.
Staff Interviews
Speaking with the staff both in and out of the hospital also revealed several previously unseen complications. This included the significant use of floater staff that may be unfamiliar with the department and the cycle that patients that struggle to attend their appointments go through.
Key Observations
After Visit Summary
Current referral information gets lost in the noise of the many paged after visit summaries patients are given.
Information Screens
Screens in waiting rooms are present but are underutilized and outdated in the information and interaction they provide.
Floater Protocol
Floaters provide inconsistent care at checkout due to constantly changing departments.
Call Center
There is a call center for the hospital that helps with referrals that is consistently underutilized due to misunderstanding and misinformation about its use.
Solution Series
Due to the constraints faced by this hospital solutions needed to fit within a space that was low cost and easy to adapt with a flexible staff. This lead to a primarily communication based series of solutions aimed both at the patient and staff to alter behavior's that kept the patients from achieving their optimal care.
Eliminating Wait
There are several points in the patient experience where they have to wait for an extended period of time. This occurs not only in the waiting room but in exam rooms where they have "nothing to do but look around". These same exam rooms are stocked with unused iPad screens which we propose could be utilized for not only an educational but interactive experience for patients. This aids in personal motivation as it allows the patient to explore why certain follow up referrals they well get are important.
Additional After
The after visit summary or AVS is something that all patients get but comes in small fonts, dense text, and unclear instructions. Providing an additional page with the AVS allows patients to more clearly understand and follow up on their own care through communicating with them in clear steps to move forward.
QR Code
In addition to the backup sheet the QR code allows patients not only the ability to follow their referral directly but also continue exploring the reasons why they may be getting these referrals on their own time. Lastly it can be used to enable text notifications as a reminder system should the patient have not followed up or need reminders approaching their appointment!
Floaters
Due to the floater system it is common for staff to work in many different departments that are all organized in different ways and update their practices at different times. Introducing a simple check for floaters allows them to quickly acclimate to the endocrinology department and ensure quality care for all patients. It could be attached to whatever type of station they're working including clip boards and lanyards keeping it accessible to any type of work.
Implementation
With the bounds of the hospital an implementation plan was made allowing for solutions that could be immediate to be put in place right away and providing what solutions could build off one another moving forward. This focused on putting out static paper solutions first, creating a QR linked website to link into them second, and then using the media from that moving into the final stages with higher support in text as well.
Moving Forward
A final design proposal was created and presented to our sponsors at the end of the quarter. This included a hand off of all materials involved in the project and an implementation recommendation to pursue should they continue the work ascribed here.