Human-Centered Design: Understanding the Problem

This post is part of NACHC’s Innovation Blog Series. This series is hosted monthly by our Center for Community Health Innovation.

Many health center staff likely know quality improvement (QI) tools and processes, such as Plan-Do-Study-Act (PDSA) cycles, asking the 5 whys, root cause analysis, and others. They help streamline and standardize workflows. Through regular monitoring and feedback on process and outcome measures, one can ensure the workflows achieve the intended results.

While there were three wonderful human-centered design themed sessions at NACHC’s Community Health Institute, I attended NACHC’s Center for Community Health Innovation and the Center for Care Innovations roll-up your sleeves design dash workshop. I learned some new approaches that can work both for developing innovative ideas as well as enhancing QI work.

An introduction to a design dash approach

At our tables with small groups of 4 to 5 people, the facilitators walked us through a design dash. The design dash included some interesting tools. The tools aimed to have us listen more closely and shift most of the brainstorming time to understanding the problem. Typically, most of the time is spent on coming up with solutions, but that may misunderstand or misrepresent the end user’s pain point(s).

Staff from Center for Care Innovations with NACHC staff at CHI in August 2022. (From left to right) Chris Conley, Camila Silva, Rigo Garcia, Sofi Bergkvist, Merrill Press, Kathleen Figoni, Nikki Navarrete, Jed Heibel, and Jed Barton.

A key point of human-centered design is to take into consideration the users’ perspectives before jumping into solutions mode. A few tools that can help your health center implement a human-centered approach are listed below:

  • I like, I wish, and I wonder
    • Whenever someone gave an idea, the others in the group provided feedback by finishing each of these phrases.
  • Interviews/Focus Groups
    • Often when presented with a problem, we immediately start looking for solutions. Intentional and active listening to better understand the problem that was most pressing to the user, without our own bias interfering.
  • Immersion
    • While we were not able to apply this method at the workshop due to time constraints, the immersion method is for deep understanding of people’s lives. By “walking a mile in their shoes”, this allows us to have a more in-depth knowledge of what is important to the user instead of focusing on a single portion of their lives. This method allows us to find areas of synergy to create solutions that fit into the users’ lives instead of adding a burden.

Example from the field: Human-centered design and mobile units

A recent NACHC project, completed by the Clinical Affairs team and funded by the CDC, utilized human-centered design methods to engage key stakeholders and patients to redesign a mobile clinic using telehealth for infectious diseases among rural communities.

See the patient journey map below for some of the key themes identified during interviews with staff, county representatives, community partners, and patients. Of note, the assumption that the registration process should be the same on the mobile health unit as in the clinic was shown to be false. By changing the check-in process, fewer patients left after registration and average registration time decreased from 20 minutes to 5 minutes.

Source: Montalvo, Winford, & Hangsleben, [conference presentation], “human-centered design: engaging key stakeholders and patients to redesign a mobile clinic using telehealth for infectious diseases among rural communities.” (August 28, 2022).

Learn how to create your own journey map.

When we bring patients and communities together with care teams to include human-centered design into developing new ideas, whether an innovative solution or QI efforts, even more amazing results are possible. Has your health center utilized a different technique to improve provider and/or user experience? Let us know at innovation@nachc.org for a chance to be featured in our innovation blog series.