Conference Agenda

Many approaches to innovation are active in the health sector, the majority derived from the world of quality improvement. While these methods are potent and can yield significant results, when used in healthcare they frequently concentrate on individual patient pathways or specific components of a healthcare system - yet many of the challenges in healthcare are associated with patient and staff experiences and the poor interfaces between different parts of a service.

In the conventional quality improvement (QI) toolbox there are relatively few methods that support exploration of these more holistic challenges. Design and systems thinking, however, have much to offer. Design thinking has methods and frameworks that put the user at the centre, encourage divergent and convergent thinking, promote early prototyping & iteration and support collaboration through visualisation. Systems thinking helps map the complex connections and relationships between different actors and elements within a system, it explores flows & feedback loops and encourages looking at the system in its entirety from the perspectives of events, trends, connections and mindsets.

To translate design and systems thinking into action, healthcare professionals need design and systems methods that are framed around their very particular challenges, are described in the vocabulary of health and complement existing paradigms of quality improvement.

This paper describes how a Patient Ecosystem Mapping methodology has been developed that enables a healthcare team to build a ‘London Underground’ style map of the patient pathways within which they work and then use this to reflect on potential improvements. The principles of the mapping process are described.

Examples of how the Patient Ecosystem Mapping methodology has been used on various projects and Scotland and Northern Ireland are described. The maps have acted as Boundary Objects, breaking down silos and empowering teams to take ownership of their areas of healthcare. The way different frameworks from systems thinking, such as the iceberg model, have been used to help review the maps is also described.

The work is a case study in how design and systems thinking principles can be integrated into a working method with real world value. The work is also a case study in how non-design professionals (from healthcare) can be upskilled in design approaches.

Regardless of age, location, or condition, access to healthcare remains a fundamental need for all individuals. However, significant gaps persist in delivering equitable and empathetic care despite advancements. Before the 2021 COVID-19 pandemic, the World Health Organization stated that more than half of the global population was not fully covered by essential health services. The U.S. Department of Health and Human Services, via a 2018 Census Report, declared that about 1 in 10 people in the United States were without health insurance. The absence of insurance often correlates with limited access to primary care providers and essential services, underlining the urgency for change.

As leaders, designers, and educators, we frequently think about how we might make our world a better place. Assuming accessible healthcare coverage, a door opens to contemplate equitable possibilities, with empathy emerging as a central theme. Empathy from healthcare providers towards patients and vice versa holds the potential to revolutionize healthcare. The aim is to cultivate and sustain fundamental aspects of productive human interactions between patients, healthcare providers, and support staff. Building trust and understanding between these stakeholders is essential to making informed decisions that produce improved outcomes. However, achieving this work requires innovative approaches that transcend traditional paradigms.

This paper explores reflexivity and situatedness in engaging students and professionals with local community members as co-designers and mentors in educational experiential projects. The epistemological, theoretical frameworks and dialectic character that emerge from institutional spaces working in community projects tend to offer broad and yet exclusionary conceptualizations of participation. They are inclined to refer to conceptual constructions through the discourse of professionals and technocrats comprising various codifications and objectified representations used and (re)produced by these agents. These conceptualizations contrast with the representational action directly experienced and perceived through the complex system of symbols, rules, and codifications of individuals regarding their community. Guided by critical social thought highlighting the politics of knowledge (co)production, this paper unpacks the promises, complexities, and challenges of a responsible innovation approach in offering avenues for inclusive participation. We use a semester class based on a long-term community engagement project as a case study to document how students and technocrats informed their praxis, recognized and addressed the apparent unforeseen consequences, made explicit the normative within the technical, coalesced plural views, and supported collective learning.