A system for corporate safety team at united airlines to manage fatigue for under the wing ramp workers
How might we reduce E-waste through civic engagement?
The team at ID collaborated with the United airlines safety team to develop a portfolio of solutions to manage fatigue in ramp workers.
CLIENT: United airlines DURATION: 14 WEEKS
This project is still under construction. Until then swipe through the final proposal here
Dealing with Covid-19 taught us that most people are unprepared for unexpected situations like sickness, accidents, and surgeries
CONTEXT
A healthcare power of attorney is a legal document that allows individuals to appoint a specific person they trust as their medical decision-maker in unexpected situations to act on their behalf
.jpg)
It acts as a preventative tool for individuals to ensure their healthcare wishes are reflected in the treatments they receive if individuals are unable to voice them in unexpected
circumstances like surgeries, accidents,
or critical illness.
Despite playing a crucial role in ensuring patient autonomy and delivering relevant care, currently only 6% of patient population has a Healthcare Power of Attorney (HPOA) on file.
CHALLENGE
UCM Health System faces significant challenges in effectively communicating the importance of healthcare power of attorney documents and managing them efficiently.
The existing process at UCM is underdeveloped with limited protocols which reduces patient engagement and delays documents from reflecting in the patient's electronic health records
BARRIER
Communication is limited to 65+ population
The established protocols to introduce the topic are only for end-of-life situations or for elderly patients which are not widely disseminated among the staff.
"I do ask elderly patients about HPOA" - MA
HPOA is not prioritized
Physicians and MAs are tasked with inquiring about the patient’s medical history in a limited amount of time to keep their appointments on schedule. Asking about the HPOA is not prioritized
“I need to take the weight, temperature, pain scale, blood pressure, review patient history... All in 5 minutes to keep the doctor on time.” - MA
Single point dependency
Dependency on a sole individual's knowledge for checking and uploading forms to the patient portal creates a bottleneck, leading to potential delays in the process.
"I'm the only one who knows how to scan the forms" - MA
Unclear and long process
58% didn’t know the process of filing an HPOA and
54% participants that knew about HPOAs,
didn't know where to get one.
"Did not know I needed it" - Survey participant
It is not important
Even amongst those who know about HPOA’s, many (66%) don’t see it as a priority.
'm in my twenties and haven't thought much about end of life care” - Interview participant
Lack of knowledge
40% of our survey sample had never heard of an HPOA, who is eligible for filling one and when is it used.
This is information overload, it is difficult to understand and even when reading it I am still confused.” -Think aloud participant
Research survey with 81 participants revealed
“ I haven't filled one out because I'm still under the delusion that I'm never going to be incapacitated to the point that someone else will need to make health care decisions for me. I still believe that I'm going to be healthy my whole life and then die peacefully in my sleep after my 110th surprise birthday party, which ended at 2am. I'm half-kidding, but yes, it's mostly out of not wanting to believe that "it" (i.e., a horrible disease or terrible accident) is going to happen to me, despite all of the evidence to the contrary that it happens to lots and lots and lots of people..” - participant
USER NEEDS
Individuals find it difficult to establish relevance and urgency of having an HPOA in the pink of health
De-prioritized as its not seen important
Individuals do not act on the information and appoint a medical decision-maker because they do not see the urgency
Deciding a medical decision maker requires vulnerable conversations
They need a guidance support on who should be the agent and to have that conversation
.png)
The ideal patient journey consists of 4 distinct phases
Signing a medical decision-maker is not a one-time decision it’s an ongoing process. Patients require appropriate support throughout the process. We designed an ideal patient journey taking into account the users needs and devised a three pronged approach to establish relevance, enable patients to fill the forms with confidence and make sure the forms are reflected in the EHRs
Monitoring for consistency and effective results
Repeat exposure to normalise having an HPOA for all age groups
Streamlined process with digital and physical touchpoints to boost engagement by minimizing obstacles
A simplified patient-centered process that normalizes having an HPOA for all ages, seamlessly integrating them into patients' medical records for easy tracking
GOALS
We aimed to increase patient awareness regarding the significance of maintaining an HPOA on record. Additionally, our goal was to streamline the process, making it more accessible and routine for completion. Lastly, we sought to facilitate the implementation of these strategies to guarantee the efficacy of the proposed modifications.
We analysed the existing patient journey at UCM via a Mixed methods approach and learnt
METHODS
10+
Reviewed secondary research articles and resources to understand barriers to HPOA completion and best practices in the field.
5
semi structured interviews with patients and non-patients to understand their motivations, needs and experiences with HPOA.
20
think-aloud tests to understand the problems of the HPOA form itself
90+
Responses to digital survey to get an understanding about the perceptions, and knowledge of the general public about HPOA.
2
visits to clinics where we carried out contextual inquiry with doctors and medical assistants (MAs), to understand patient medical staff interaction and in clinic patient journey
60+
think aloud tests and intercepts to test messaging strategies and understand perceptions of HPOA in different age groups.
Undeveloped process and limited protocols in the health system excludes younger population, and introduces delays the process
BARRIERS
PATIENTS
“I need to take the weight, temperature, pain scale, blood pressure, review patient history... All in 5 minutes to keep the doctor on time.” - MA
STAFF
“I need to take the weight, temperature, pain scale, blood pressure, review patient history... All in 5 minutes to keep the doctor on time.” - MA
Single point dependency
Dependency on a sole individual's knowledge for checking and uploading forms to the patient portal creates a bottleneck, leading to potential delays in the process.
HPOA is not prioritized
Physicians and MAs are tasked with inquiring about the patient’s medical history in a limited amount of time to keep their appointments on schedule. Asking about the HPOA is not prioritized
Communication is limited to 65+ population
The established protocols to introduce the topic are only for end-of-life situations or for elderly patients which are not widely disseminated among the staff.
Uncertainty is too abstract to act on it
Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums Lorem ipsums
Lack of knowledge, eligibility and use
44% Lack of process clarity
Unclear and long process
59% Don't know what an HPOA is
DISCOVER: COMMUNICATION STRATEGY
Patients value the conversation about their future health decisions with their decision maker and were motivated to sign an HPOA to be assured of their loved one’s presence
FILL: REDESIGNED FROM FOR BETTER COMPREHESION AND IDENTIFICATION
Patients require specific context to comprehend the significance of HPOA, while medical staff must have swift access to agent details.