Co-designing Murray Street Screening Space
Affiliation
Mount Sinai Hospital
Project Duration
1 month
Role
Project Consultant, Sinai Health's Redevelopment Team
MY ROLE
Interviewer
Facilitator
Visual Designer
User Research
TOOLS
Occupancy Surveys
Patient Journey - Processes Mapping
METHOD
Observation Research
Participatory Design
Co-creation & Co-Design
Project Background
Early-onset of the Pandemic
In the early onset and impetuous spread of Coronavirus, our Canadian hospitals found themselves assembling hospital networks and high-functioning teams to respond to the immediate crisis. Including adapting their facilities to maintain safety for patients, caregivers, and staff.
One of Mount Sinai Hospital’s immediate actions included the implementation of the screening centers at the two main entrances of the hospital on University Avenue and Murray Street. The screening spaces were built outside to set standards of care for the flow of people in the hospital.
Fast-forward to Murray Street Screening Space
In the months of July, the province entered into Stage 3 of pandemic reopening and in conjunction, Mount Sinai has launched a new visitor policy, which will allow for one visitor at the bedside for every patient.
With an increase of influx of patients and visitors that will be entering through the hospital, the leadership wanted to evolve the screening space into a more accommodating space with the flexibility to serve the fluidity of the pandemic and to importantly, enhance the interactions between visitors, staff and Mount Sinai.
Challenge
How might we leverage human-centred design methodologies to develop a deep and shared understanding of the current state of the screening space, so that we can identify opportunities for improvement and to lay out the future development of a new screening environment that fosters positive interactions between visitors, staff and Mount Sinai?
Outcome
Our project team leverage human-centred methods and tools to develop a deeper understanding of the current state in all aspects - in terms of space and service delivery to inform the re-design of the space and service delivery.
Engage Key Stakeholders Early
Our project team understood that the initiatives that we were set to do highly required the input of our stakeholders and screeners to bring it to fruition and its success will be judged by those outside of our jurisdiction. With this, our team set up an onboarding package that shared the practice and promises of human-centred design methodologies. We shared the methods that the team planned on using and the intended outcomes from each method.
Our Process
Co-Creative Workshop
To ensure we understand the current state of the screening space, we conducted a co-creative workshop with a diverse group of stakeholders, including frontline staff, healthcare screeners, internal project management representatives, and the key managerial staff.
Using a tabletop model, we invited the participants to walk us through the end-to-end screening journey in the current space. The participants were encouraged to use the available tools to identify the challenges of the space’s current built environment. During the session, we learned about key physical constraints that both screeners and visitors experience, including accessibility pinch points, poor lighting and loud acoustics.
The screeners also opened up about the screening process. They shared stories of patients and visitors experiencing long lead times to be admitted to the hospital. It became transparent to improve the screening space holistically, it is essential to understand both the current state in both aspects of the physical environment and service delivery, in this case - the screening process.
Participants used photos and stickers to describe their experiences in the screening space
Observational Research
To deepen our understanding from the co-creative session, we conducted observational research at the screening space to observe the visitor and staff behaviours with the physical space and the current service interactions.
Using spatial data surveys, we captured people’s movement in the screening space. We mapped the daily interactions between patients, visitors and healthcare screeners and also their interactions with the physical space. The data captured was time-stamped, which capture the elapsed time for people to get admitted into the hospital.
Through the observations, the physical congestion and pinch points were painfully stark. Patients that required more troubleshooting were redirected to a waiting area, hence creating a congestion. The maps also uncovered the congestion of patients waiting outside of the screening space. As space is confined to its existing conditions, it highlighted a huge opportunity in improvement in the screening process.
To better understand the qualitative information gather, we visualized the patient journeys, which included key elements such as patient’s actions, front- and back- stage actions with time as a primary variable. Visualizing the information helped the team to have a better understanding of the experiences over time, which allowed key stakeholders to vividly identify opportunity areas for optimizing interactions to admit patients in a shorter period of time. Opportunities included simple adjustments - including having the outpatient list organized in alphabetical order to allow healthcare screeners to quickly look for patients’ name.
Examples of Spatial Data Mapping Results
Observational Research: Beyond Sinai Health's Walls
Our team valued the benefits of cross-pollinating ideas from other screening teams from our peer hospitals to generate a new knowledge base for future implementation/our upcoming co-design sessions.. With this in mind, we reached out to peer hospitals, including North York General Hospital and Toronto General Hospital, who graciously invited us for half-day guided tour to walk through their screening spaces and learn how their screening team make decisions.
The guided tours provided rich insights into the physical details of their built environment and the screening process. We asked questions including who uses the space, where are things kept and why are things organized the way that they area, and what were their lessons learned.
North York General Hospital's Visitor Screening Space Set up
Co-Designing the Future Murray Street Screening Area
With a better understanding of current service interactions and space challenges, we facilitated a co-design with front-line staff, hospital multidisciplinary team members, and other key stakeholders representing different roles and senioritis to envision the future state of the screening area. For this specific project, the manager of the screening area shared the same vision with our team on the importance of including front-line staff to contribute to concrete outcomes and gain ownership of the solution.
Before we started to envision the future state, we dedicated time to revisit and deliver the patient insight journey maps as a collective to get previous and new participants familiarized with the findings from the initial co-creation and observations research. These journey maps and other supporting visuals were glued on the bristol boards that were placed in the room that allowed the participants to refer to it during the future ideation with the tabletop model.
Co-Design On-boarding with Participants
The participants were then invited to create a future screening space with a scaled tabletop model with the provided pieces. The participants were encouraged to express their internal thoughts out loud for other participants to promote cross-pollinating ideas with others. As participants completed an iteration, our team asked participants to test out and provide direct feedback on the concepts, effectively amplifying their voices and elevating their feedback.
Left: Participant Prototyping on Scaled Tabletop Model
Right: Co-design was Live-Streamed with Healthcare Screeners that allowed them to Provide Feedback Live
In two iteration rounds, we prototype a new layout of the screening area that addresses the critical space issues and a new service model that allow screeners to attend to both patient and staff entering into the hospital, in an effort to reduce waiting time for the patrons and troubleshooting time for the screeners
"The co-design really helped us to visualize the environment and it was great having an idea of what was actually going to be feasible given resources that were available."
Healthcare Screener
Project Outputs
Strategies
We developed a final set of design recommendations and concepts bucket by constructability and services to improve the physical environment of the screening area holistically. The recommendations were presented to Executive members for consideration and approval for implementation and construction.
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Left: Final Results of Co-Design
Right: Architect's Schematic Drawings for Implementation
Tools
Prototyping with a scaled tabletop model was an effective tool that helped us ideate together. The three-dimension tool allowed people without a design/construction background to understand and break down complex information and allowed participants to communicate their ideas tangibly.
Throughout the process, we introduced and used an online whiteboard platform called Miro, as a form of communication tool to maintain constant communications with the Multidisciplinary teams and key stakeholders. Miro was continued to be used by our project team to review design drawings (schematic to design development) with our core Multidisciplinary teams online, which made approvals more efficient.
Mount Sinai's MDT team Provided Feedback and Approvals using Miro
Project Outcomes
Mindsets
This project brought to light the importance of engaging frontline staff in developing new experiences and space. With aligned intent, key Departmental staff and our project team involved front-line staff on an ongoing basis to get closer to their experience that informed not only the insights, opportunities but to ensure solutions are co-created. For many front-line and other departmental staff, they felt empowered by the design process and felt heard as they were able to authentically speak to peers and even leadership about their experiences. The experiences they shared helped guide the design and ultimately, the implementation of the screening area.
Culture
Our project team was initially tasked with a narrowly-defined scope of work, which was to redesign the physical component of the screening space. As more time was spent observing the space, it became clear that attention needed to be paid to core service offerings and the service delivery of the screening space. The occupancy surveys were momentum visualizations that articulate these insights to the key managerial stakeholders and it enabled us to act in concert to redesign the screening area holistically.