Project Journal Collaborative NHS

MARIA MARINESCU- DUCA
COLLABORATIVE NHS

CONTENTS
THE TEAM
FRANCESCO
IRINA
MARIA
CAMERON
RUKA
EMILIE
SIAN
BRIEF
FIRST VISIT
IMPRESSIONS
FINAL VISIT
MAPPING DATA
PATIENT SAFETY
DEFINING OPPORTUNITIES
PATIENT JOURNEY
TIME CHART
FINAL PROTOTYPE
STORYBOARD
PRESENTATION
REFLECTION
P2
P3
P6
P8
P10
P16
P20
P22
P26
P28
P32
P34
P35

In collaboration with the NHS we were asked to explore the terrain of Radiography, communicate our understanding
of it as the department stands at the moment and develop new design opportunities and strategies where the
issues raised in our explorations may be addressed.
BRIEF

RADIOLOGY
DEPARTMENT
FIELD RESEARCH, SHADOWING

FIRST VISIT
SNAPSHOTS THROUGH THE WEEK
After developmental workshops and inductions, the he project was initiated with site visits
to the Radiology Department of the Western General Hospital, Edinburgh.
Split into three self-designated teams, we shadowed the medical and administrative
staff, observed and interviewed patients as well as mapped the layout of the Department in
the context of the Hospital.

FIELD SKETCHES DURING INTERVENTIONS
We explored the staff-patient interactions during consultations, delicate moments such as
pre-interventional discussions and were even able to observe the interventions themselves.
The staff-patient bond was one of the strongest points of the process as we observed. The
sentiment of trust and respect was something we proposed to carry into our design
solutions further on.

In-between the hospital visits we
were able to have a team meeting
where we compiled and analysed
the data we acquired.
We singled out the areas we felt it
was important to get more
information on, as well as dividing
tasks in teams in order to avoid
overlap and maximise our time at
Western General.
Through communal input I was able
to compile a questionnaire to use
as a general structure for the
patient interviews.

SCREENGRABS OF THE DIGITAL PROCESS
A particular interest of mine was
understanding the patients journey
with all the digital and analogue
steps that it entails. Both staff and
patients felt very strongly about
this, and in my research, I decided
to prioritise understanding and
mapping out the main structures in
which the patient journey through
radiology occurs.

FINAL VISIT

During the second visit Irina and I spoke primarily with the
administrative staff trying to understand exactly where the
appointment systems friction points are. In our research
we also were exposed to the problem of “floating cases”;
instances where because of lack of information either on
the administrative part or most often, on the convalescent
side, patients lose their medical data, ultimately in
detriment to their health.

MAPPING DATA

RADIOLOGY
In the beginning of the second week we all shared our findings with the group. We explored different
methods of mapping in our quest to display and make sense of the information we had just been given.
RESULTS
GP
RADIOLOGY
DEPARTMENT
TYPICAL SCENARIO
RESULTS
GP
GP
RADIOLOGY
DEPARTMENT
SPECIAL GP RECOMMENDATION
RESULTS
DEPARTMENT
RADIOLOGY
DEPARTMENT
FLOATING
CASE
WHERE IT CAN GO WRONG
GP
RADIOLOGY
DEPARTMENT
!
EMERGENCY CASE

GP
HOME
GP/CLINIC
RESULTS
GP
RADIOLOGY
DEPARTMENT
RADIOLOGY
DEPARTMENT
JOURNEY TO TREATEMENT
RADIOLOGY
1
HOSPITA L
(FRONT DOOR)
GP
1 2
?
RESULTS
RADIOLOGY
DEPARTMENT
2
COMPLEX CASE
HOSPITA L
DEPARTMENT
Subsequently, I would consider our biggest achievement of the week to be systemising the patient
journey into 6 main pathways. We based the pathways off a previous structure of the system Irina and I
created during our second visit, approved by both radiologists and the administrative staff.
HOSPITA L
DEPARTMENT
(OUT PATIENT)
HOSPITA L
DEPARTMENT
(IN PATIENT)
JOURNEY KEY

With the structures in place we further concentrated on rendering the details of the experience, dividing it into
categories:
emotion, environment, administrative factors, time, staff and patients.
Other avenues we approached were patient profiling and hospital mapping, particularly the floors in which radiology is
situated on within its main building.

Through a conjoint structure every
team member profiled the patients they
encountered and if possible, created a
timeline of their day in the institution.

With a floorplan created by Cameron on site we were
able to place these occurrences into context, decisively
outlining the staff members physical journey throughout
interventions, CT & MRI scans and X-rays.
Based on the feedback we received, even at this early
stage, we naturally gravitated towards creating design
opportunities related to wayfinding, weather it be physical
or emotional, through the process.

PATIENT SAFETY, OUR MAIN FOCUS

We narrowed down our research
onto one complex scenario trying
to understand the needs and
feelings of a patient through their
journey. We compiled our
knowledge gained from directly
speaking to patients within
Western General and compiled it
into a complex, detailed journey:
from diagnosis to treatment and
beyond. It proved to be a
successful exercise in channelling
our interest and made us more
aware of the moments when
patients most need support. The
week of limbo (waiting for the
diagnosis), the pre-consultation
phase and orientation through the
institution were the three areas we
decided to design for. The project
evolved with our main group
splitting into three teams, Ruka
and Sian; Irina, Emily and
Francesco; and Cameron and I.
ERIC’S JOURNEY

MAPPING OUT STAFF AND PATIENT EMOTIONS

Consent form
Information
leaflet
CT Solution
Phones GP
Face to face
dialogue with
GP
Appointment
letter
Coloured
signs, arrows
Dialogue with hospital staff
Verbal
instructions
Phone call
(who and when?)
Face to face
dialogue with GP
Information
leaflet
Appointment
letter
Open minded
Reassured
Open minded
Inquisitive
Reassured
Hopeful
Accepting
Comfortable
Hopeful
Accepting Relieved Reassured Reassured
Hopeful
Relieved
Safe
Loved
Reassured
Hopeful
Safe
Trusting
Recieves
At home Feels ill Gets worse Goes to GP
Suspected to Makes
appointment
have cancer appointment
letter
Week of
limbo
Travels to
hospital
Locates
radiology
Speaks to
reception
Waiting room
time
Called for CT
scan
Scan briefing
CT Sc a n
Leaves
hospital
Week of
limbo
Goes back to
GP
Diagnosed
with cancer
Given
information
Goes home
Discusses
with family
Recieves
appointment
letter
Goes to
hospital
department
Investigation Sets up plan
Treatment
starts
Irritated Nervous Shocked
Impatient
Overwhelmed
Sad
Nervous
Nervous
Sc ared
Uncomforta -
ble
Embarassed
Confused
Lonely
Em pty
Sad
Nervous
Agitated
Overwhelmed
Lost
Guilty
Anxious
Lost
Overwhelmed
Nervous
Degraded
Anxious
Sc ared
Stres s ed
Shocked
Lonely
Anxious
Agitated
Lonely
Sc ared
Nervous
Agitated
Tired
Lonely
Anxious
Lost
Confused
Confused
Confused
Confused
Anxious
Nervous
Nervous
Agitated
Sc ared
Agitated
Anxious
Powerless
Agitated
Sc ared
Confused
Dazed
Lonely
Powerless
Anxious
Lost
Overwhelmed
Uncomforta -
ble
Lost
Angry
Insecure
Nervous
Confused
Confused
Em pty
Degraded
Actions
Angry
Impatient
Powerless
Emotions
Impatient
Overwhelmed
New rituals
Exposed patients
Touchpoints
Appointments
Orientation
Building relationships
Emotional gaps
EMOTIONAL PATHWAY

DEFINING OPPORTUNITIES

Within our team Cameron and I focused on the institution’s direct
communication with patients, either analogue through letters or digital via
a website. We felt it was necessary to create a visual representation of the
patient journey that is accessible and easy to communicate. Synthesizing
the steps we have been researching we came up with the map.

GP
RADIOLOGY
DEPARTMENT
GP
X - RAY PATIENT JOURNEY

One of the most utilized
modes of communication we
found was the X-ray
appointment letter:
X-ray appointments do not
permit a specific timeslot, it
is rather a period of 30 days
where the patient can drop in
to get their scan done.
Through complaints from
both the staff and patients we
concluded it was important to
develop a tool that can aid
this process. We explored the
possibility of making
appointments for this service
but realised that it would be
better suited to work with the
system as is.
Thus, we created a time chart
that can be part of the
appointment letter, as less as
included in the institution’s
website, detailing the busy
hospital times.

100
50
50
25
Mon Tue Wed Thu Fri
08:00 10:00 12:00 14:00 16:00 18:00
Mon Tue Wed Thu Fri
Mon Tue Wed Thu Fri
Mon Tue Wed Thu Fri
INCIPIENT ITERATIONS

Monday
Tuesday
Wednesday
Thursday
Friday
08:00 09:00 10:00 12:00 13:00 14:00 16:00 17:00 18:00
08:00 09:00 10:00 12:00 13:00 14:00 16:00 17:00 18:00
Monday
Tuesday
Wednesday
Thursday
Friday
08:00 09:00 10:00 12:00 13:00 14:00 16:00 17:00 18:00

Live time updates
Home
Appointment Times
When’s the best time to come
for your appointment? - spacing 6, Frutiger
busy periods vary week to week, this map is only an estimation.
(CHART IN CONTEXT)
busy periods vary week to week, this map is only an estimation.
CHOSEN TIME CHART

Visually we wanted to keep it cohesive with the NHS
graphical guidelines, following their font and colour
scheme.
However, it was important that it was not presented
as a set of data, we wanted to simplify it whilst
keeping the content intact- preserve the data, but
lessen the complexity of charts and numbers,
alleviating the anxiety.

FINAL PROTOTYPE

CURRENT APPOINTMENT LETTER
OUR DESIGN

TEXT CHANGES

One of our main priorities as a group was to clarify the communication with the hospital. To us, this
included the transportation to the radiology department.
Cameron set up a mock-up of the website where we were able to clearly represent what we felt orientation
towards the department needed. The website would be able to show ways by means of transport, physical
difficulties and would cater to impairments that visitors may have, both online and offline.

THE STORYBOARD

Preparing for the final presentation was an integral part of the NHS collaborative project.
Good timing and keeping a good pace in the presentation was crucial. We carefully
selected our vocabulary trying to avoid design jargons as well as making sure there
weren’t any incorrectly used medical terms. As all the subgroups collaborated actively
throughout the project, compiling all our design propositions did not prove to be
difficult; they were already indispensable to one another.

REFLECTION

The presentation was well received, with the newly designed X-ray letter
being ultimately considered for integration into the Western General
mailing system. Collaborative NHS was an extremely fulfilling project. The
most important part I felt was analysing the impressive amount of data we
were all able to capture. Seeing the process through various perspectives
afforded me and our team with unique, intuitive design concepts.
Link to blog: https://westerngeneralradiography.wordpress.com