Developing a General Decision Tool for Future Cancer Care: Getting Feedback from Users in Busy Hospital Environments

Background and Aims: During the last decade more and more design researchers and practitioners have been collaborating with clinicians, patients and relatives in order to improve healthcare systems. Shared decision making has thereby been one field, attracting increased attention. Hospitals pose a specific challenge for involving all stakeholders in the design development process and therefore require the development of methods that work in busy healthcare environments. Based on this perspective, the abstract presents an ongoing research collaboration (started in 2014) between The Patients Cancer Hospital in Vejle and Design School Kolding in Denmark with the main objective of creating a general decision aid for future cancer care. The aims of the collaborative design development are twofold: to enhance clarity and understanding of the decision aid via communication design and to decrease barriers for successful implementation via extensive involvement of patients, relatives and clinicians in the design process. The present abstract puts forward a participatory method of getting feedback from different stakeholder groups on the illustration design of the decision aid.

Methods: The decision aid was presented on a poster to get feedback on the visual design of the illustrations. Three different visual versions of illustrations have been tested with patients, relatives and clinicians. Stakeholders were asked to vote for the most professional, clear, trustworthy and friendly version of the tool. The voting was facilitated by a sticker dot beyond the version most appreciated. Additionally, voters were asked to explain their choice verbally on the backside of a comment card. 16 posters have been mounted in staff rooms, waiting rooms as well as hospital hallways for a period of 24 days. Clinical staff has received information on the voting experiment and introduced the project to patients and relatives. One designer circulated from poster to poster, giving additional information and collecting stakeholders’ immediate feedback. A second poster voting round (building on learnings from the first one) is currently undertaken, final results will be available by the end of March 2017.

Results: In the course of the first poster voting round, 200 clinicians, patients and relatives took part in the poster experiment, 33 cards with comments were handed in and 40 informal interviews were conducted. Clinicians and patients choose the same design proposals - 90% went for the identical design suggestion, commenting on it as being friendly, easy to understand and positive. In one oncology department’s staff room an alternative proposal received the majority of votes.

Conclusions: Human-centered design in healthcare requires methods adapted to its demanding and occupied environments. Methods based on a strong visual impact and a simple voting system attract widespread attention of all stakeholders, while keeping time requirements to a minimum. According to contemporary research, successful implementation of SDM remains a key challenge. Methods that support story telling of SDM, as well as extensive stakeholder involvement are thus put forward as a valuable tool for design and implementation.