palliative care
CANCER JOURNEY
VENTRICULAR ASSIST DEVICE
The goal of this project was to-create the curriculum with CCHMC employees with IDD to increase participation in learning experiences and bolster the growth of an inclusive and high-performing culture.
The team’s research phase consisted of primary and secondary research. The secondary research involved understanding the fundamental context of the issue to inform our interview questions. This mainly consisted of gathering research from articles, and synthesizing main points while looking for where our interviewees would be able to shed light.
Our primary research included 20 interviews: 3 instructors who gave us insight on how to instruct individuals with IDD; 6 Project SEARCH interns who gave us first hand account on how they learn and feedback on prototypes; 5 full time employees with IDD offered us perspective on what the current emergency preparedness curriculum was like; 3 schools; who enlightened the team on what their emergency preparedness curriculum included; and 3 experts including the World Institute on Disability and a neurologist with experience in working with disabled patients and family. Both offered suggestions for implementation and experiences. It was found that many people with disabilities are misunderstood. The bridge of communication disconnects between those with IDD and people in positions of power. This leads to individual needs and accommodations not being met. Implementing a curriculum that accommodates their needs would not only be safer for workers, but would also bring awareness to other institutions in hopes that they make changes in their processes.
Our secondary research consisted of benchmarking emergency preparedness procedures of public and private institutions, and the synthesis of academic articles. This allowed for the team to be more informed about design decisions. There were several takeaways from our secondary research. It was found that many individuals with disabilities experience inconsistent training experiences meaning that they may have one lesson that is accommodated to their needs and another that is made without keeping those with IDD in mind. This is caused by the limited resources made for those with learning disabilities. We learned that through this curriculum, we can encourage adaptability and accessibility allowing for the contents to be understood by all cognitive levels
The deliverables pursued were a workbook, a card game, and emergency presentations all covering active shooter, Stop the Bleed, fire safety, and hospital safety training modules. First, we brainstormed formats of deliverables such as puzzles, board games, conversational prompts, worksheets, etc. We took these formats and placed them on a 2x2 chart. The x-axis determined the level of intervention (how much involvement is required from our team to create the deliverable) and the y-axis determined the level of interaction the audience would have with the deliverable. This 2x2 allows us to see what deliverables are most feasible. We chose the workbook, card game, and presentation because our research informed us that these deliverables would be the most accessible, engaging, and easiest for instructors to change or edit. We excluded options that would require too many resources and/or would not benefit the audience as effectively. This includes ideas such as interactive web modules, puzzles, and boardgames.
After deciding on the format, we began developing the visual identity. We benchmarked any existing design sources that related to our deliverables such as emergency preparedness branding, general branding, color palettes, illustration styles, typefaces, workbooks, and card games. This gives us an understanding of what design styles are currently effective/ineffective for the concept of the deliverables as well as what aligned with ADA compliance and primary and secondary research. We then grouped these findings into visual categories which helped define our design goals. Our design needed to be informative, empowering, accessible, and versatile. These design goals were non-negotiables when developing our concepts. Concept 1 consisted of a human-connected approach relying on a minimalist cartoon style with bright blue accents to aid any call to action. Concept 2 was a fun and friendly direction that utilized an abstract geometric character supplemented with a red and yellow color palette to be more closely associated with emergency signs.
During our stakeholder co-creation session, it was determined that it may be difficult for individuals with IDD to understand what the geometric character is doing in Concept 2. They felt Concept 1’s illustration style would better aid understanding since it closely resembles people. Their suggestions for refinement included: creating more characters to be more gender inclusive; adding another accent color would be beneficial for important information and callouts; and the logo emergency preparedness logo could be misinterpreted. They also informed us that we should include digital PDF formats of the workbooks so that it’s accessible for those with low vision.
After feedback sessions and reviewing Concept 1 with Project SEARCH students, there was no pushback on the logo so we decided not to change it. The style guide, however, was updated according to their remaining feedback and we began developing the design system which consisted of applying this style to the cards, workbook, and class presentations. We were simultaneously developing content for the workbooks and card game referred to the existing CCHMC class presentations and online Stop the Bleed courses as our main source.
The workbook and card game was created to follow the formatting of the presentation and the information it included. An implementation plan was included as an bonus deliverable to make sure that the tools provided are used the way it is intended. Personas were also added as a bonus to allow for instructors and any users to understand that the tools can be used for a wide variety of people. The powerpoint was designed to be editable so that institutions can cater the information towards them. A style guide was included in the final handoff to help support those edits.
Our final deliverables were decided based on existing emergency preparedness materials and identified gaps in the education system for Project SEARCH interns. In addition to filling those gaps, we also included suggestions for teaching the curriculum incase there is someone who has less experience instructing those with IDD. This project will be handed over to CCHMC, where their marketing team will take over with branding.
Working with Sickle Treatment & Outcomes Research in the Midwest (STORM), Cincinnati Children’s Hospital and Medical Center (CCHMC), young adults with sickle cell disease, parents and caregivers of individuals with SCD, and community health workers to reveal gaps in educational methods (system) and develop a curated repository of resources (materials) for young adults preparing to make the transition to adult healthcare.
The team’s research phase consisted of primary and secondary research. The secondary research involved understanding the fundamental context of the issue to inform our interview questions. This mainly consisted of gathering research from articles, and synthesizing main points while looking for where our interviewees would be able to shed light.In addition, trend analysis played a crucial role in the project’s research phase.
Trend analysis utilizes current events, academic studies, and articles (manifestations) to discover patterns within our society forecast specific trends, and predict future outcomes. Once these patterns have been brought to light, our manifestations create identities in the form of micro-trends. These microtrends represent a common thread between the manifestations. After observing these patterns and developing micro-trends, an all-encompassing macro-trend is created covering the greater picture developed through the manifestations.
During the ideation phase, we began brainstorming and gathering different opportunity spaces that we could pursue to educate and support members of the sickle cell community with information or resources. We started by listing out these different ideas and then benchmarked educational resources that explain how to present information. Once we began to narrow in on what our resource/tool may look like, we began to benchmark different web portals that effectively show information. We noted what these sites did right, what was less effective, and what we could pull out for our portal. We organized these sticky notes into themes and listed them out so we could include all of the best aspects of these portals. Next, we began to build information architectures of the sites that we thought provided the best structure and information presentation (gottransition, formabridge, and next steps idaho). We did this to observe how we could map out content to be best organized for the users on the portal.
Our team made changes to the homepage, patient page, caregiver page, information architecture, and design style guides. The homepage was simplified by including only the clickable buttons for navigation, basic transition information, and testimonials. We made sure that the buttons provided clear calls to action, allowing users to easily access the patient, caregiver, resources, and FAQ pages. The diagrams on the parent and patient pages were modified to display information clearer. The design was also customized to reflect the interests of each. The information architecture was modified to shift the focus from local to universal usability to ensure the site caters to a broader audience. The team also adopted a cool color palette to create a calming and empowering user experience. The team included geometric designs in the depth background to maintain visual interest without overwhelming the user.
The final deliverables were decided by facilitating discussions with the stakeholders and sponsor team about how and where to organize and present our research and necessary information. From these discussions, we decided to develop our website portal as the main deliverable for this project. Other deliverables developed would be supplementary to the website from research gaps discovered such as the ER/Urgent and travel guides.
The project handoffs include a website mock-up, 9 PDFs, an implementation plan, a style guide, the scd-transition.org URL, and trend research. The URL has been purchased prior and ownership is to be transferred to CCHMC. This project will be handed over to CCHMC, where their marketing team will take over using the provided style guide.
Gene therapy is an innovative therapy for sickle cell disease patients, similar to a bone marrow transplant, where blood is extracted, treated, and reinfused. It's a lengthy, year-long process requiring several procedures and a month's hospitalization. The complexity of the treatment, along with its use of chemotherapy and a high risk of infertility—around 70%—pose challenges in understanding and acceptance. Patients qualifying for this treatment at CCHMC range from 12 to 21 years old and have had sickle cell complications.
In the research phase of the CCHMC Gene Therapy Toolkit project, our team conducted both primary and secondary research to gain a comprehensive understanding of the existing experience for patients with sickle cell disease and their caregivers’ experiences. Primary research included interviews with patients, providers, and families.
Secondary research involved benchmarking existing materials for gene therapy and attending a speaker speaker session to learn about other treatments for sickle cell disease. This helped us identify gaps in knowledge and misconceptions about gene therapy as a treatment.Each treatment for sickle cell disease has its own complexities and key factors that can affect the patients decision. Because of this, we created a journey map detailing the different options to treat sickle cell disease. From that, we were able to identify key factors why someone would choose gene therapy and what the most important information is for patients and their families to know before committing to this journey.
For the co-creation phase, our team came up with a variety of potential solutions with varying levels of interaction and intervention. We explored both digital and physical options, from developing a website, to creating a physical experience for patients and their families to learn about gene therapy as a treatment. We also created an empathy map in order to document the patient experience, as well as a stakeholder map to identify everyone involved in the process of gene therapy. From the maps created, we developed a content matrix to establish what information is needed for teenagers and adults who are considering gene therapy, as well as information needed for caregivers to best support and aid the patient in the process. With the help of providers, we were able to collect content about psychosocial care, risk management, and fertility preservation.From the maps we created, we identified that the most important pillars of knowledge throughout gene therapy are comprehension, preparedness, and support. This informed our decision to make a suite of materials that introduced gene therapy in an approachable way, and support patients and their families as they continued treatment.
In the refinement phase, the team focused on developing a cohesive style guide for the toolkit, as well as populating the overviews and guidebooks with content most applicable for each demographic previously mentioned. The content that we wrote was validated by both providers and patients to ensure that the language used was appropriate to the demographic, while being comprehensible by all. The aim of the style guide was to create a sense of trustworthiness, as to not overwhelm.Final deliverables included five pieces of material including: overviews for teenagers, adults, and caregivers, as well as guidebooks for teenagers and adults. An implementation plan was also created in order for CCHMC to produce and share these materials with those considering gene therapy as an option in their sickle cell journey.Feedback during the final report of the semester focused on review of the content and the visual look and feel of the materials. The creation of this toolkit highlighted the need for accessible and understandable materials for patients to understand and consider innovations in the medical field.
The goal of this project was to create solutions to educate, prepare, and empower patients with sickle cell disease undergoing gene therapy. As part of the implementation plan, these materials are going to be tested by CCHMC in focus groups with patients to ensure their comprehensiveness. Furthermore, CCHMC will be looking into copywriting the materials in order to distribute them to other locations.
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The team synthesized six interviews from a relevant project with primary care providers, nurses, and nurse practitioners on the topic of sickle cell trait (SCT) in their offices. To complement the primary research, the team conducted secondary research on office management, reading labs, primary care provider (PCP) approaches, hemoglobin electrophoresis, and understanding electronic health records (EHR). After understanding the problem and comparing systems nationwide, the team created a journey map and a stakeholder map. These maps demonstrated the full referral system for families with a newborn diagnosed with SCT. They also identified all stakeholders involved.
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During the ideation phase, the team identified three opportunity areas for our deliverables: physical tools, digital tools, and systems. We then collaboratedwith the CCHMC sponsor team to place our created archetypes into the category where they could be most effective. The team benchmarked five specific itemsthat could be particularly helpful: a reference sheet, an infographic, educational materials, a website, and an animatic. Additionally, we conducted a SWOT analysisfor each potential deliverable and held a working session to gather feedback and insights from the sponsors to guide the creation process.
During the refinement stage, the team began and polished our five deliverables, effectively delegating tasks among developing the idea of a point person, website concepts, infographic path, reference sheet information, and animatic creation.
Download Refinement PresentationThe SCT Team will begin thinking about how to disperse these materials to effectively put them in place.
The CCHMC learning lab will use systems engineering methodology to envision, develop, prototype and test augmented Clinical Decision Support (CDS) approaches to increase their appropriateness and acceptance of CDS tools and improve diagnostic excellence. This will be accomplished through the collaborative efforts of the CCHMC PICU Innovation Accelerator and the Live Well Collaborative for problem analysis and design and with involvement . The team collaborated to design visual representations of the PICU workflow that are both comprehensive for experienced staff and user-friendly for newcomers. They conducted interviews and observations to create a shared understanding among staff and to pinpoint areas for improvement. By identifying both facilitators and barriers in the workflow, they aim to develop Clinical Decision Support (CDS) tools that enhance efficiency without disrupting current processes.
The Live Well Team validated the process and workflow maps from the previous semester with the PICU team. After, we created patient personas and journey maps that represent different patient types within the unit. We then went to PICU to onboard new members on the team allowing them to shadow rounds. We started an FMEA (Failure Mode Effects Analysis) report highlighting different failure modes within the various events in PICU which included the pain point, who it affected, and possible opportunity areas.
In the ideation phase, the Live Well team observed nine VR simulations in the PICU to study where each role gathers data to inform their decision making and the overall diagnosis. We journey mapped the locations and tools currently used (vital sign monitor, EPIC, verbal communication, hand-off) and overlaid them to uncover what a typical diagnostic process looks like for each role. From there, we used those journey maps and the FMEA to hypothesize digital CDS tool requirements as well as opportunity areas within the larger PICU ecosystem.
During the refinement phase, the team validated the FMEA events and the CDS requirements for a new digital tool that we previously defined. To help understand the context of a future CDS tool, we created 3D drawings of PICU units and huddle room to visualize where a new tool would exist. We also synthesized the main challenges and opportunity areas that exist throughout PICU and CCHMC to the main points.
The summer term wrapped up the first part of the Discover PICU where it will be turned over for PICU to use the hypotheses and insights we generated to create new VR simulations to test. Then, in one-two years from now, Live Well will rejoin the PICU team for next steps.
For Phase 1 of the research, our team conducted three observations and thirteen in-person interviews across six disciplines (MD Attending, MD Fellow, APN, PCF, RN, and RN) within the PICU. The purpose of these interviews was to enhance our understanding of the PICU unit and the roles and responsibilities of each discipline. Additionally, the LiveWell team had the opportunity to conduct three in-person observation sessions in the PICU—two in the morning and one at night. The goal of these observations was to gain firsthand insight into the PICU workflow and the collaboration between teams.
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During the ideation phase, the Live Well team analyzed information gathered from our observations and interviews in the research phase. We worked as a team to ideate how to best organize this information visually, in a way that was thorough and accurate for current and knowledgeable PICU staff members, as well as straightforward and easy to understand for those who are being educated about how the PICU works.
The team created a “mother map”, which covered the day to day tasks of each PICU team member, as well as scheduled events on the PICU floor. This included Hand-off, Rounds, Summary, and Huddle. It also highlights the different communication methods and “sources of truth” that each team member relies on when going about their routine.Next, we worked on mapping out the unscheduled events that happen on the PICU floor, including different types of admissions, as well as emergency code events for deteriorating patients. These were visualized based on our observations of these events during our time on the PICU floor. We also witnessed an eCPR code blue simulation, which proved very helpful for accurately representing the process and communication flows of that stressful, fast-paced event.
During the refinement phase, the team restructured some of our maps and visualizations and continued to expand on the insights we gathered from our feedback sessions in the Ideation phase. We also went back to the PICU and gained personal feedback from team members in each position. Additionally, we held a validation workshop after a huddle session where we received more feedback from other positions we hadn’t talked to at length before. This was also helpful because they were able to look at our maps and make suggestions that could immediately be implemented and confirmed right there. The team also worked on scripting and finalizing the animation videos for the final report-out.
Download Refinement PresentationAfter our final report out, we handed off the project to the PICU team to be implemented internally.
Most individuals with sickle cell disease and sickle cell trait are diagnosed at birth with universal newborn screening (NBS). However, there is considerable variability in how families receive this information from state departments of health follow-up programs, primary care providers, and even community-based organizations. There is often a gap in knowledge and self-confidence in sharing information, as there are no certifications or evidence-based best practices for NBS coordinators. There are also cultural and social determinants of health factors that should be considered when providing this information to families and should be integrated into NBS training.
The Cincinnati Comprehensive Sickle Cell Center has hosted a Hemoglobinopathy Counselor Training Course for over 20 years, and it is one of the only programs in the country. There are several gaps in knowledge and comfort levels among NBS coordinators that have identified a clear need for an interactive training platform and companion materials to educate families.
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The team conducted 10 interviews with partners, Newborn Screening Coordinators, and parents to understand the current landscape of sickle cell trait (SCT)education. To complement the primary research, the team benchmarked current sites, videos, websites, handouts, and physical kits that explain SCT. In addition, after gaining functional literacy the team began visualizing maps to help partners and LWC staff gain a contextual understanding of sickle cell trait education.
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From the research, the team synthesized educational content necessary for NBSCs and families. NBSCs will require a guidebook, standard operating procedures, and a counseling presentation for families. Meanwhile, families need a one-pager and video animations that highlight key information about sickle cell trait. To achieve this, the team brainstormed ideas for font, color, and character style that could be uniformly applied across the educational materials. Throughout the process, the LWC team collaborated with the partner team on educational content, storyboard order, and the selection of the appropriate style to proceed with.
During the refinement phase, the team organized 8 validation sessions involving NBSCs, families, and LWC team members. Participants were prompted to highlight their main takeaways from the slideshow, confirming the team’s success in conveying key messages about sickle cell trait: clarifying that it is not sickle cell disease, it is inherited, and cannot transform into the disease. Additionally, the team consulted with CCHMC hemoglobinopathy trainers to validate the content for the NBSC SOP and guidebook.
After the final report-out, all materials made by the LWC team were finalized and shared with the CCHMC team to use.
Phase 1: Live Well’s multidisciplinary team conducted a comprehensive analysis of the CEC by reviewing their internal SWOT analysis, research papers, articles, and website reviews. Moreover, the team engaged in interviews with both internal and external stakeholders that aim to gain deeper understanding into the CEC landscape. This helped the team identify pain points and uncover opportunities for improvement within the system. Based on the gathered information, the team designed an organizational schematic and a user journey map, while also defining the three CEC specializations.
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Phase 2:In Phase 2 of the project, the CEC tasked the Live Well team to focus on developing two specific tools. The first tool would enable researchers to report community engagement levels in each research phase. The second tool would focus on a dissemination platform for the CEC including a presentation and quick start guide. During the ideation phase the team designed multiple iterations of mission statements, service journey maps, marketing tools, as well as service diagrams, receiving feedback between each iteration.
Final Deliverables: The Live Well Team presented a process diagram that incorporated Live Well’s process and the community involvement scale from the CEC. The team received feedback from different CEC members regarding the diagram and continued to refine. REACH: Report of Engagement in Community Research, is a tool to gauge how involved community members are in each step of the research process. The team also created a “Quick Start Guide” (QSG) for the CEC to use as an education and marketing tool. The team put together a list of key topics to include and co-created with the members of the CEC. The team conducted a couple co-creation sessions to make sure they were including the right information in the QSG, and a presentation to explain the CEC for both academic and community partners.
Download Refinement PresentationAfter our final report out, we handed off the project to the CEC team to be implemented internally.
The Live Well Collaborative (LWC) partnered with Cincinnati Children’s Hospital and Medical Center (CCHMC) to find design solutions to respond to the ongoing nursing and respiratory therapist shortage. Through our process, it is important for the Live Well team to understand the generational influences as well as the global, career, and institutional challenges faced by nurses and respiratory therapists. This problem spans local, national, and international scopes.
Our research phase began with interviews onsite at CCHMC. The team completed 59 interviews in three weeks and synthesized the data gathered in collaborative Miro boards. Information was sorted by generation (Gen Z, Millennial, Gen Y); by specialty; by pain points; and by years of experience. These findings informed focal points of secondary research categories of values, mental and physical health, education, and social aspects.
After analyzing these categories and diving deeper into secondary research, we identified macro and micro trends to highlight critical shifts in healthcare and in modern society. These trends include Passion Pool, Empathy Evolution, and Tech Takeover. From our secondary research, we concluded that the nursing and respiratory therapy shortage is an international problem, so the scope of the project has been altered. We have reframed our goal to finding a design solution to respond to the shortage within Cincinnati Children’s Hospital and Medical Center (CCHMC).
During the refinement phase, the team involved nurses and respiratory therapists in the co-creation process to gather their ideas & solutions. To achieve this, the team conducted two structured activities. For the first, we invited 8 nurses & 1 RT to the Live Well space in three groups. The team collected, analyzed, and categorized the ideas into buckets before refining the activities for a second round of co-creation. We assembled 7 nurses on CCHMC’s main campus to openly write and discuss solutions, which generated more focused & tangible ideas.
After completing the Refinement Share Out with the team, several solutions were identified as viable, ranging from low hanging fruit, to more long term implementation strategies. Although solutions were chosen to be beneficial to the institution, the team believes that an additional semester’s worth of work could be used in order to identify priorities and develop implementation strategies for these more complex solutions.
Cincinnati Children’s Hospital Medical Center (CCHMC) is collaborating with Live Well Collaborative to have design ideas using user-centered approach for collecting stakeholder insights that can be translated into opportunities for intervention is needed. There is a serious knowledge gap about aspects of continuity of care in pediatric primary care settings from the perspective of the caregiver. A fresh approach, collaborating with a design-led team that utilizes tools for co-creation with multiple stakeholders will help with improvement in continuity of care.
The first step of the project was secondary and primary research going simultaneously. For our primary research, we went to the CCHMC Pediatric Primary Care Clinic to observe how the clinic works and interviewed providers, experts, and patients to help us understand the journey from discovering the clinic to follow-up appointments. For secondary research, we pulled out the article about how the health system works and what different type of continuity is. After our interviews, we established key findings by using thematic analysis methods for the transcripts. It is a type of synthesis tool to map out the journey for providers and patients (Figure1) while understanding the trust cycle is the crucial part of continuity.
The second step was to identify the opportunity areas on how access, education, and continuity have strong linkage. Identifying the strengths and referring to case studies we leveraged that from our strength of education and familiarity we can achieve continuity. To establish we used affinity mapping techniques by listening back to the interview and pulling out major bucketing for opportunities areas. This method is distilled down to six opportunity areas that were call center optimization; care team; automation and systems; patients’ education and empowerment; human connection; and discharging patients. In our report out, we did a prioritization mapping of ‘must, could, and should’ to concentrate on where we can further investigate.
For this phase we wanted to achieve certain goal for increase in continuity of care as designing and identifying solutions for better health outcomes and workflow design for improvement. Going back to the interview and understanding active-passive engagement of caregivers of support need to active in child’s health, we developed personas. These personas reflect their needs, values and challenges they face when it comes to their child’s health care while also pulling key opportunities for the solutions. These personas were laid on the matrices where y-axis is medical needs and x-axis being social needs.
From our previous research phase, the bigger bucket of opportunity areas where further ideated with the help of three ideation exercise. The first is brain writing exercise where we each team member spent 7 minutes on each bucket then selecting 3-4 ideas and repeating the process again. The second exercise is analogous industries where we identified industries on previous ideation session having similar concepts. This helped us to pull out approaches for possible solutions. The last was brainstorming constraints where we played a video with constraint to help us with distilling the groupings from previous session. Here we spent 3 minutes on ideation per groups. The ideation session helps us to make system maps using the ACT (Analog, Culture and Technology) Framework to categories solutions. We used implementation timeline with our stakeholder to understand on how much time it would take to adapt the solution from 1 year to 10years with highest priority to least.
The refinement phase is where concretized the priority solutions from our previous implementation timeline. The solutions were back of door signage, provider’s visibility, health passport, Mychart implementation, scheduling rework and Nurse/MA Scheduler script where we further refined. Each of the solution were overlapped with the personas to understand how it will affect their access to health and improve continuity of care.
The team mapped out the current system journey map of provider and patients/caregiver on how the clinic works from scheduling to exiting the clinic. Of each of the solutions mentioned above we made implementation strategies by understanding the pain points, how persona will get affected, implementation strategy and how it might work. This helped us to pull out key focus, insights and benefits. All of our analog solutions i.e Passport, back of the door signage and provider’s visibility (placard) were prototyped. We were able to co-create a health & wellness passport with 10 healthcare workers to understand what edits or additions had to be made. We presented all other solutions and new improved system journey map with all the solution on our report out.
After our final report out, we had to polish some of the solutions and provide all the files to our stakeholder to co-create our solutions in the clinic. This project is not carried out in the next semester because we were able to achieve possible solutions to improve continuity of care.
Live Well has collaborated with Cincinnati Children’s Division of Palliative Care, StarShine Hospice, Courageous Parents Network and Parent Project Muscular Dystrophy over the past semesters to work on creating journey maps for the respective disease states. A journey map is a visualization that aims to inform and educate a user on how to navigate a journey, scenario or specific situation so they can better understand the experience and different touchpoints. The goal for this project was to create a scalable journey map that Cincinnati Children’s could use for different scenarios in their organization.
During the research phase, the Live Well team benchmarked journey maps from the Live Well archives, did a literature review and mapped out Live Well’s process of building a journey map and translating it into a final deliverable. Through this process, the team was able to identify core components and best practices for a successful journey map. Next, we brainstormed various methods of delivering a scalable journey mapping process, and presented three different concepts to the client team at the research report-out.
In the ideation phase, the team started diving deeper into the selected concept: a workshop. The team developed the overall flow and components of the workshop, starting with a consultation, providing basic design education, mapping a journey, and ending with a debrief and steps for implementation. Worksheets and templates were created for each part of the workshop. At the end of the ideation phase, we renamed the workshop to ‘journey mapping masterclass’, and built a narrative theme of ‘cooking’ to better explain the process of journey mapping.
For the refinement phase, the Live Well team tested the masterclass prototypes by running focus groups with the Courageous Parents’ Network and the Sickle Cell team from CCHMC. We were able to gain valuable insights from the focus groups and shifted away from using four journey map archetypes to a single template with customizable components. The team updated all the components of the masterclass to match the new direction and added appropriate branding.
At the end of the semester, the team handed off all the masterclass components and packaged documentation of the research to the client team. Next steps for implementation include: education of facilitators, piloting the masterclass and identification of ownership at Cincinnati Children’s.
IDENTITY for Caregivers is a Cincinnati Children’s project that aims to make foster children’s health information accessible for all types of foster caregivers. It is an extension of the Summer 2017 project with Live Well where the first version of IDENTITY was developed for HCJFS employees and Cincinnati Children’s clinicians.
IDENTITY is a web portal that combines information from two databases to show foster caregivers their foster children’s most updated information, including diagnoses, immunization history, appointments, and case information. This will allow foster parents to make informed decisions about their foster children’s health.
In the research phase, the Live Well team did activities with the client team and foster caregivers to understand their existing system of acquiring up-to-date health information. The team also did empathy mapping and card sorting activities to understand the most important information to foster caregivers. We found that caregivers cared most about current medications, current diagnoses, and appointments. We designed an information architecture based on the results of our research.
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In the Ideation phase, the team designed initial wireframes of the IDENTITY web application to test with users. We tested different layouts with varying complexity and the effectiveness of a dashboard to highlight key information. We did preference testing to determine which layout worked the best and identified gaps in our information architecture.We proceeded with the dashboard layout that most users found easy to understand – a single column of information cards. In the process of testing, the team discovered that a large percentage of users would prefer to use this application on their phones, so we began to design a mobile version of IDENTITY for Caregivers.
In the Refinement phase, the team built out the prototype and continued to test with users. We conducted a total of sixteen usability tests and prototype walkthroughs to see if people understood the application and were able to complete key tasks. We also tested the mobile version and 19 users out of 31 indicated that they were more likely to use the mobile version.
Download Refinement PresentationAt the end of the semester, the Live Well team handed off the final web prototype, a mobile prototype and supporting documentation (style guide, testing/validation results, developer notes). The sponsor team will identify a developer to build the application for release.
The Live Well has developed a unique depth and scope in integrating design thinking into the later stages (3&4) of translational research in clinical practice. The primary source has come from 9 years of work with Cincinnati Children’s Hospital Medical Center (CCHMC) with additional expertise developed with several other projects with UC Health, Hill-Rom, COA. Live Well has created a library of projects (product, service and system) for Cincinnati Children’s with demonstrated outcomes. It has been proven that the integration of design thinking methodologies/tools into the developmental process has helped PI’s get farther faster to meet their research or process improvement goals. Our goal was to document, organize, and identify the design process that the Live Well uses to solve a design problem and then visualize and present it in an understandable format. Live Well was the project sponsor because it wanted to identify what its process was in order to be able to present and market it to future clients and use it to teach new design fellowships.
The Live Well team’s initial goal was to review all CCHMC projects and identify key processes and deliverables that were valuable. The Live Well team conducted benchmarking research into other design studios to see how their process worked compared to ours. The team wanted to see the connections that ran through all the projects to create knowledge bridges.
The Live Well team also conducted interviews with the project partners involved to find out the current status of projects. During the Research Phase, the team focused on printing off all the project briefs and pinning them to a wall in order of the date of the project. Once on the wall we categorized the deliverables that we made for the project. We identified 9 types of deliverables and found sub deliverables as well. We used post it notes, print outs, string, and highlighters to make a large visual map on the wall of the studio. The Live Well team simplified each phase of each project by making bullet points of what we did during the research, ideation, and refinement phase. The design problem was written out as well. We then discerned what methods Live Well uses to complete the tasks of the project. All this information helped to visualize the scope of the projects that the Live Well team worked with Children’s Hospital. This data was then digitized on an excel spreadsheet to organize it and pull figures out of the data and create a code to visualize the value of the projects. This excel spreadsheet helped us make graphs and data sheets.
During the Ideation Phase, the Live Well team focused on ideas for visualizing the data and disseminating the information in an educational way to showcase the value that the Live Well process can do. The goals of this phase were to present the information effectively and educate future shareholders and design fellowships on the Live Well design process. Our ideas for how to effectively achieve these goals were to design a game about the Live Well process, and create a project value tool kit in the form of information cards. Taking all the data gained from the visual map was put into card format that was about the size of index cards. On the cards the Live Well team put the project title, description, design problem, the deliverables, the methods used, the lead shareholder, the faculty advisor, the patient and client value, and where the project is now.
The Live Well team decided that the best way to educate new people to the Live Well process was to play a game that reflected it. Research into gamification revealed the educational potential of this avenue as being very valuable because the interactive approach will leave a greater impression if the participants actually played through a simulated design project. The Live Well team took the data gained from the visual map and created elements for the game. We made cards for the design problem, the tasks involved, methods, as well as activators and inhibitors. We also made a board to follow the design process and give a visual for how the time progresses during a project. For this game we wanted to focus on the collaborative aspect of the Live Well process, so we benchmarked other cooperative board games in order to build our game in a game played as a team.
During the Refinement Phase, the Live Well team made a lot of changes to the information deck and the board game. There were 7 example projects that the team felt were the best representation of exemplary projects. Those 7 were flushed out to have a front and back card of information. Those cards were then sent to the lead shareholders for each to be edited and finalized. The Live Well Game had many play tests with players that were familiar with the Live Well process, as well as players that had no experience with the Live Well process. The game board and cards went through several variations using a tool called Figma and then ported over to Adobe Illustrator. Cards were printed out on card stock and the boards were printed on vinyl and stuck to cardboard. A rule book and facilitator script were also written.
The next steps are to begin implementing the game in kick off presentations for new projects. This game will give the shareholders a sense of what the Live Well process will be like and also be a team building exercise for the design team and the shareholder team to get to know each other better. This project will not be carried over next semester.
The sponsor of this project was Cincinnati Children’s Hospital Medical Center (CCHMC), Division of Patient Services. The CCHMC team had found that there are disparities in CPR training and learning needs. To help solve this, the team had created a CPR learning kit prototype for people with disabilities and tested it with IDD (intellectual or developmental disabilities) populations. They had found success in preparing people with alternative learning styles for a traditional CPR certification course. The goal of this project was to refine the existing prototype into a cohesive system, design a process as part of the kit that could be used to teach community trainers the basics of teaching alternative learners, and to provide greater awareness about CPR in the community. The main target audience was individuals with IDD.
During the research phase of the project, the team spent time familiarizing ourselves with the CPR toolkit and the overall process of CPR certification. We benchmarked relevant training tools and games that could potentially be leveraged to create engaging and fun ways to learn the information and skills associated with the toolkit and practicing CPR. The team conducted interviews with CPR instructors, IDD learners, a parent, and a special education interventionist to build a deeper understanding of the needs of all potential audiences and users.
The team also explored graphic styles and treatments for the toolkit to ensure that the style we moved forward with was inclusive, engaging, and could be easily understood by the different target audiences. To do this, we sent a sample survey out to the different user groups. By collecting feedback early on, we could focus on developing one selected style for all elements in the kit. Together, all of this research helped to further inform our development and prototyping of the toolkit during the ideation phase.
During the ideation phase of the project, the team held brainstorming sessions to more broadly explore possibilities for the toolkit. After brainstorming, the team then narrowed the ideas into twelve initial concepts. These concepts were visualized in the form of sketches, organized into the categories “no-tech, low-tech, and high-tech”, and shared with the Children’s team for detailed feedback. Based on the feedback, we selected the most promising and relevant parts of the concepts, created a bank of these ideas/parts, and used this bank to piece together three “remixed” concepts. The goal of the remixes was to create concepts that varied greatly from one another to cover a wide range of ideas. Again, the three concepts were sorted into “no-tech, low-tech, and high-tech”. The no-tech option used a large foam game cube as both the game dice and the compression piece, players would mark points earned with pegs and use the same peg board to complete the sorting activity. The low-tech option used RFID technology to incorporate audio which helps learners who struggle with reading while also providing a more realistic experience with the AED component. The RFID would be used in each of the toolkit's components, such as reading out the Perla story, providing a metronome for the manikin and compressions, and guiding learners through how to perform CPR and use an AED. The high-tech option was contained in a book with a magnetic spine so learning and game activities could be removed and used on a flat surface. Additional game pieces were held in a compartment in the book spine. We made physical prototypes of these concepts and held digital co-creation sessions with IDD learners, a special needs interventionist, three CPR instructors, and the Children’s team. The collective feedback informed our decision to simplify the many different parts and technical components in the high and low tech option and move forward with a learning book, manikin mat, and board game.
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During the refinement phase, the team did another round of prototyping to create a single refined model before creating the final kit prototypes. Both the Live Well team and CCHMC team conducted final rounds of co-creations with IDD learners using this refined prototype. From these sessions, the team made decisions to pivot on board game path style and make minor changes to the game cards, AED, and manikin to increase comprehension. The team met with vendors to discuss prototype cost and finalize the materiality of the kit’s different elements. Much of the refinement phase was spent designing and finalizing the graphics for all of the components. In the final stages of the project, time was spent printing and assembling parts and working on refining the presentation and recommendations for the CCHMC team moving forward.
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The CPR Toolkit project will not be carried over into the next semester but there is the possibility that the CCHMC team may choose to return to Live Well for further development in the future. We have handed off two working prototypes to CCHMC along with in-depth documentation of our process, decision making, and research findings. Some of the specific files requested by the Children’s team included all toolkit graphic files, a user testing guide for moving forward, and a document detailing all of the design decisions that were made and why. These resources will help guide them through their next steps, the ultimate goal is to create a marketable CPR basics learning kit. To reach this goal, we have recommended they subject the two provided working prototypes to user testing with the designated target audience and begin thinking about strategic decisions that will need to be made for the toolkit as it moves through development towards production. At where it stands now, the project could be taken in a couple of different directions, the team can opt to move forward in a licensing agreement or they can choose to forego licensing and attempt to self-publish their game.
The research phase of this project began with gaining a solid understanding of the prototype designed by Live Well in Summer 2021. An extensive review of all previous wireframes and prototypes, and user testing notes set the team up for successful refinement of the tool. Once the team felt comfortable with the work that had been done up to this point, it was time to plan for additional user testing phases of the Summer 2021 final prototype. The team outlined research goals for the first round of testing, revolving around functionality, user interest, navigation, and hierarchy. These goals were then translated into specific sets of task flows consisting of guided tasks to cover all pages being tested.
The ideation phase began with user testing. Through PPMD and CCHMC outreach, the team gained access to several Duchenne patients, caregivers, and clinicians. Remote user testing sessions were conducted, in which users walked through three different task flows. These testing sessions were also run with members of the Live Well Collaborative team for additional feedback on tool functionality.
The team synthesized insights and pain points from these tests into actionable goals for the final round of testing. The goals for the first round of refinement revolved around increasing clarity of graphic elements and reducing the amount of scrolling users must do to navigate through the tool. From these goals, the team created prototypes of a variety of different options solving each problem.
The next step was to conduct another round of user testing with the same individuals from the first round. This round of testing was slightly different than the first, as each session started with a set of A/B testing questions about the graphic elements the team was aiming to improve. Traditional task flows were used to test functionality improvements. Additionally, the team performed a round of testing with the Live Well team. From the insights of these tests, the team formulated goals for refinement of the tool.
During the refinement phase of the tool, the prototype was modified based on feedback from the second round of user testing. Graphics were updated to match user preferences and final touches were added to the functionality of the click-through prototype.
To prepare for handoff to PPMD’s development team, the Live Well team put together a set of Google Drive folders to organize text and graphic content based on the tool’s information architecture. This Google Drive also contained a Handoff Guide that went into detail about the organization of the content files and Figma prototype.
As of December 2022, the Journey Map Tool has been handed off to PPMD, who will in turn share it with their development team for production.
After handing off the prototype of the screens and user testing guide, Cincinnati Children’s team began the process for continuing user testing. They wrote a revised IRB for the specifications on how the user testing research would be conducted. The user testing of the prototype was handled by Cincinnati Children’s team with the intention of providing that feedback to Live Well, and then internally Live Well would make changes to the prototype as needed.
Cincinnati Children’s wanted to take the work done from Fall 2020 to Summer 2021 of 4 different journey map studios to help create a template of an interactive journey map that could be implemented to other disease states as well as operational processes. A brief pitch deck was put together to summarize the work done over the 4 projects, key themes found, and future potential.
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Duchenne Muscular Dystrophy (DMD) patients deserve high-quality patient and family-centered physical, psychological, emotional, social, and spiritual care to improve their lives at every stage of their illness. Our interactive, web-based Journey Map application will visually educate patients and families about DMD and its treatment path from childhood through adulthood. Once refined, built, and tested, the Journey Map application will offer an exciting tool to improve care in DMD and other progressive diseases. This semester studio is a continuation of the Fall 2020 Palliative Care project and seeing how the product lives under the PPMD (Parent Project Muscular Dystrophy) site.
During the research phase of the project, the team conducted secondary research to identify the biggest themes and needs among the stakeholders and understand building out the information architecture and mapping out content. The team also reviewed the existing PPMD website to understand the structure and organization of the content and annotate resources and materials. Website analytics were also reviewed to see which parts of the website got the most traffic. Afterwards, the team mapped out the timeline content to see where things connect or relate and fill in missing gaps, which helped with wireframe timeline overview iterations.
After the primary research, interviews were then conducted with both clinicians and patients and parents to understand user needs and the content they want to see. Additionally, the team also considered the early introduction and normalization of palliative care within the tool.
In the ideation phase, the team benchmarked microsites and website layouts to get an idea of how components are visually laid out to help guide the team in wireframing the screens for user-testing. Using previous (Fall 2020) existing wireframe screens of the Duchenne tool, the team interviewed patients/parents and clinicians to understand how patients/parents would interact with the screens as well as fill in any missing gaps of information based on their experiences with Duchenne and how clinicians would use the tool to guide families.
The team also engaged in card-sorting activities to see how patients/parents and clinicians would prioritize Duchenne topics and provide us insights on what was missing, as well as present them with different screen layouts to see which format of the tool was the most intuitive to use. From our interview insights, the team restructured the information architecture with new, proposed categories and flow of content. The team also did a, “crazy 8” wireframe sketching activity which helped to do rapid ideation and begin to generate different ideas. From these sketches, the team built out two distinct design directions of screens for the home page, category page, and topic page. These screens included what DMD is, how to use the tool as a parent, patient, and clinician, and educational topics within the Physical, Emotional, and Social categories. At the ideation presentation, the team user tested with the clinicians to get feedback.
The team continued user testing of the wireframes with parents, patients and clinicians. Based on the insights gained from the interviews, the team revised the designs and combined elements from the two different flows to get one. During this process, they also implemented more of the PPMD brand to the visual elements and pages to ensure consistency and make it all be cohesive. The screens were then prototyped in Figma to hand off to the Cincinnati Children’s team for continued user testing in the following semesters. Additionally, the team put together a User Testing Guide that would help them with this ongoing user testing.
The final hand-off to the Cincinnati Children’s team and PPMD were three finalized page type screens (Figma click-through and pdf) of the DMD interactive tool as its own microsite living within the PPMD website, along with a user testing guide.
Live Well partnered with CCHMC and Courageous Parents Network to develop a journey mapping tool for parents of children with severe neurological impairments (via a microsite on the CPN main website). The tool gives parents information about the trajectory of the medical conditions that may arise, psychosocial support and resources, and a conceptual wayfinding method in the form of four phases. The main goal of this semester's work was to generate prototypes and conduct evaluative research in the form of user testing, interviews, and co-creation sessions.
This project was primarily an evaluative research project, so we started the semester with an initial low-level prototype that was developed from the previous semester.
The first four weeks of the semester were spent discussing and mapping the information architecture of the site and generating design assets to be used in later prototype versions.
We audited the existing site and developed a style guide that incorporated elements from the original CPN branding. This included typeface, iconography, color, image sourcing, etc.
We developed a version one prototype and begin compiling a list of users to test with.
The Live Well team began to test the prototype with users and discussed the results in weekly meetings and co-creation sessions with the CPN team.
Through this iterative process, the prototype was altered through several different versions, as new needs and pain points were identified. The team tested things like various pathways, content structure, image choices, color and word choices, page layout, graphics and animations.
We user tested and interviewed 15 users, including 12 parents of children with SNI, 2 parents with no SNI background, and 1 clinician.
The Live Well team held several co-creation meetings to assist the CPN content team in writing and implementing the content within the prototyped site. This content also went through rounds of user testing and tweaks were made based on users' reactions.
The prototype went through 6 versions before the final version for hand-off.
The team concluded our user testing and had discussions with the developer about the next steps of development.
At the end of the semester, the Figma prototype was handed off to the CPN developer. The CPN team also received a style guide, a documentation record of the testing conducted, assets, and synthesized research from the semester.
StarShine Hospice and Palliative Care provides home-based hospice and palliative care to patients at Cincinnati Children's Hospital who have life-limiting conditions. Live Well partnered with Starshine for another semester to continue refining the Duchenne’s journey map tool. The Duchenne tool gives an overview of prognosis, major interventions, and therapies, with the goal of making men with Duchenne more aware of what lies ahead and providing them with a resource to explain their condition to friends and family. The main priorities were to test the tool with Duchenne’s patients and explore broader applicability of the concept to the Starshine and Palliative Care teams at large.
The Live Well team kicked off the project by starting to validate the tool as it stood, with real stakeholders. However, the project soon shifted from focusing on mapping Duchenne’s to mapping children with Severe Neurological Impairment (SNI).
For the literature review, the Children’s team recommended many valuable documents and articles, especially Julie Hauer’s book “Caring for Children Who Have Severe Neurological Impairment: A Life with Grace.” Referred to as the SNI bible by the Children’s team, this book proved to be invaluable and provided the team with information ranging from specific medications for symptoms to advice to parents on coping with death and bereavement.
In order to gain more insights, the team interviewed parents of children with SNI, healthcare providers, and a social worker. All interviews followed the same format, which first included asking interviewees to walk through their child’s medical journey in the parents’ case or describe their experience working with neurologically impaired children in the medical providers’ case, so that the team could start to paint a big picture overview. The second half consisted of asking the interviewees’ thoughts on the tool as it stood and how they might change it. The team also sent out a survey to Cincinnati Children’s providers asking them their thoughts on SNI prognosis and how they relay sensitive information to patients and their families. Affinity mapping was used to identify the most common symptoms and key themes.
During the ideation phase, the Live Well team worked in two-week sprints which consisted of updating the prototype and then asking for user feedback. The team knew that interventions and phases would have to be grouped into broader buckets since SNI does not have as definitive of a timeline as Duchenne’s. Buckets were initially grouped by life stages such as infancy and early childhood, with medical interventions and psychosocial resources lumped in together. However, after showing concepts to the Children’s team and a few users, the Live Well team realized medical resources and psychosocial resources may need to exist on separate pages so parents would not be overwhelmed by the amount of information on the timeline.
The team continued ideating on the dual timeline idea for a majority of the sprint cycles while leaning on the Children’s team to write medical content. With the medical content at a good place, the Live Well team asked the Children’s team to help write initial psychosocial content for the ideation report out. Much of the psychosocial content included information on legal documentation, such as guardianship and entering school, as well as the many services available for parents.
Towards the end of the ideation phase, the Live Well team and Children’s team decided to move away from hosting the tool on the Children’s website, and instead host it on the Courageous Parents Network (CPN) website, a non-profit dedicated to supporting parents of children with disabilities. By making this switch, the tool would not have to adhere to Children’s branding and restraints.
The refinement phase began with a continuation of the 2 week sprint cycle, but ended with a few weeks of focused work on deliverables for this semester. To put a pin in the deliverables for this semester, the team organized the Children’s and CPN teams to collect first-draft content. The Live Well team used this content to populate the clickable prototypes with real world copy rather than filler text.
The Live Well team also worked individually on finalizing layouts, interactions, and styles for the prototype. This means visually implementing a revised information architecture, tuning navigation, actually linking up a clickable prototype and more. Visually, the team leveraged CPN’s existing style guide to create a prototype that would feel at home if it was dropped into CPN’s website.
Moving forward, the Live Well team will work with CPN’s in-house developer to continue refining the tool and have it ready to launch by the end of the next semester.
StarShine Hospice and Palliative Care provides home-based hospice and palliative care to patients at Cincinnati Children's Hospital who have life-limiting conditions. The nature of pediatric illnesses creates difficulty in prognostication and families' goals of care tend to shift over time. Most patients remain in the palliative care program for years. This program includes nursing visits every 60 days with an on-call nurse for sick visits care coordination, social work, pastoral care, child life therapy, music therapy, art therapy, holistic health, and physician visits, all provided in the comfort of the child's home. The goal of enrollment in StarShine is to improve the child and family's quality of life. The model for the program is based on our hospice program, which initially was designed based on CMS (Centers for Medicare & Medicaid Services) regulations for hospice care. Those regulations are driven by adult end of life care, which differs markedly from caring for children at end of life.
To kick off the Research Phase, the Live Well team began to do secondary research to fully understand what the journey of Duchenne's Muscular Dystrophy looks like. We mapped a journey map including all specialties, specific milestones, and possible interventions. In parallel, we interviewed staff members, patients and caregivers. After every interview we analyzed what we learned including the positives, negatives, quotes of the interviewee and opportunities for concept creation. Through this gathered insights from interviews we affinity mapped to understand the most popular and important topics for ideation.
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During the ideation Phase, the Live Well team went straight into concept creation focusing on the topics identified from our affinity mapping and research. Through this ideation we continued to cluster recurring themes and discovered our six directions which we were able to validate this with users and CCHMC. The Live Well team then proceeded to create more fully formed ideas taking into considerations main concept, stakeholders, type of platform, content needed and main features. There were a total of 8 ideas within 4 opportunity areas. During our Ideation report out, we had a discussion with the Palliative team at CCHMC where they voted on their favorite ideas.
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After the final concept was chosen, the Big Picture Journey Map, the Live Well team started improving our previously visually mapped Journey to understand milestones and symptoms. We benchmarked in order to understand what type of method this timeline could form into. The Live Well team decided on a web page interactive digital tool. We then started wireframing and considering graphic layout in order to best display the information as well as developing an Information architecture to increase the efficacy of this DMD timeline.
Download Refinement PresentationProject will be continued in Spring 21' to update content and connect with a developer.
After handing off the prototype of the screens and user testing guide, Cincinnati Children’s team began the process for continuing user testing. They wrote a revised IRB for the specifications on how the user testing research would be conducted. The user testing of the prototype was handled by Cincinnati Children’s team with the intention of providing that feedback to Live Well, and then internally Live Well would make changes to the prototype as needed.
Cincinnati Children’s wanted to take the work done from Fall 2020 to Summer 2021 of 4 different journey map studios to help create a template of an interactive journey map that could be implemented to other disease states as well as operational processes. A brief pitch deck was put together to summarize the work done over the 4 projects, key themes found, and future potential.
After handing off the prototype of the screens and user testing guide, Cincinnati Children’s team began the process for continuing user testing. They wrote a revised IRB for the specifications on how the user testing research would be conducted. The user testing of the prototype was handled by Cincinnati Children’s team with the intention of providing that feedback to Live Well, and then internally Live Well would make changes to the prototype as needed.
Cincinnati Children’s wanted to take the work done from Fall 2020 to Summer 2021 of 4 different journey map studios to help create a template of an interactive journey map that could be implemented to other disease states as well as operational processes. A brief pitch deck was put together to summarize the work done over the 4 projects, key themes found, and future potential.
According to Cincinnati Children’s Hospital Medical Center, Technology Assisted Language Intervention (or TALI) has a positive impact on language development in children who are deaf or hard-of-hearing, and parent engagement and participation is of central importance to the intervention’s effectiveness. Practice with strategies and target skills in isolated therapy sessions is not adequate to promote generalization of skills across all settings, and for that reason, with Live Well, CCHMC wanted to develop improved and robust family resources to support intervention. The team at Live Well created a variety of high-quality materials to be used with families across settings, with the goal of supporting families to be central and active partners implementing the intervention across environments, especially at home. This is critical during the time between therapy cycles that is spent practicing target language skills across settings. It is particularly vital that the families are equipped with resources to carry on the intervention more independently.
During the research phase, the Live Well team conducted interviews and created a digital survey to learn about clinician and patient family experiences with current educational materials and TALI usage. The team also created a mind-map, identifying key categories of content for the educational materials to cover.
Additionally, the team participated in two empathy scenarios to experience the typical introduction to TALI and to become familiar with TALI and the TouchChat software. The team benchmarked examples of educational videos and handouts, and they also conducted a brief literature review, reading more about TALI and Augmented and Alternative Communication (AAC).
Through the research phase, the team determined that they would create two educational videos in addition to print materials. The materials would include a general overview of TALI, as well as information about goal setting for TALI usage, skill development tracking, engagement at home, engagement at school, and device usage. The Live Well team also created a Persona Development Activity for the CCHMC team to complete.
During the ideation phase, the Live Well team developed a series of initial storyboards, outlining the content for the two videos: Teaching Your Child to Self-Monitor and Repair Language Mistakes and Encouraging Your Child to Verbalize.
The videos take a narrative approach, following the story of the child and caregiver, and depict several examples of intervention. The design of the videos included kinetic typography and character sketching exploration. The team finalized the written content in the print materials, which included three interactive worksheets—Daily Routine, Identifying Opportunities for Intervention, and Goal Setting. A 3-prong folder was determined to be the best choice for the format of the print materials. The implementation strategy was discussed with the CCHMC team.
During the refinement phrase, the Live Well team developed the two videos in Adobe After Effects, using a combination of graphic assets, kinetic typography, and timed narration. The team developed a Quick Reference Guide folder for parents and caregivers. The Quick Reference Guide includes three interactive worksheets about targeting language goals, information that covers the content categories identified during the research phase of the project, and graphics that match the two videos. After the refinement share-out with the CCHMC team, content revisions were made to the verbalization video (and corresponding content section in the Quick Guide), now titled Encouraging Your Child to Communicate Using Language.
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The two videos, interactive pdf file, and a few Quick Guide printed folders will be relayed to the CCHMC team. These materials will be used in their upcoming clinical studies and beyond. The project ends this semester.
The sponsor of the Sickle Cell Patient Empowerment and Advocacy through Knowledge (SPEAK) Educational Materials Design project was Cincinnati Children’s Hospital Medical Center (CCHMC) Division of Hematology. The main goal for the project was to develop a Parent SCD Handbook to provide comprehensive information and anticipatory guidance regarding a child’s SCD and associated treatments and possible SCD complications. The second goal was to develop a strategy to expand access to educational materials. Sharing of information and materials to the greater sickle cell community, including other providers who treat SCD, is vital. The team also wanted to explore the development of the handbook to be distributed electronically or be a part of a website.
CCHMC partnered with Live Well for this studio due to the fact that they have worked with Live Well on previous projects with great success. The users for the deliverables are the patients and age 0-10 and their parents/caregivers, as well as the CCHMC sickle cell care team.
During the beginning of the research phase our team tried to cast the net as wide as possible to find all of the gaps in resources that we could help fill. We did this in many ways including patient family interviews, CCHMC sickle cell care team interviews, benchmarking existing websites, books, experiences, and handouts.
The interviews we conducted were the most valuable for gathering insight on the problems faced by those in the community. We conducted a total of 5 patient family interviews and 10 CCHMC sickle cell care team interviews. After each interview, we synthesized what we learned and used these insights to create personas. The personas were used to help us better understand the different groups that were affected and to ensure we were considering all aspects of the population, not just who we were interviewing. We ended up with four different personas to represent the main four patient types we saw.
During the research phase, we also focused on benchmarking existing materials. We used the insights gained from our benchmarking to inform the future of the project and how we should continue. This also helped us better understand not only the content itself, but how it was thought about by those in the community. For example, how different topics were grouped together and how different things were talked about.
Based on our findings from the research phase, we did adjust the aim of the project to focus more heavily on the community portion of the education materials. We wanted to make sure people were hearing from those around them and not just the medical staff, as this is something many people we interviewed said they resonated with the most. For the same reasons, we also focused more heavily on creating engaging resources for the patients aged 0-10.
During the Ideation phase we split our focus onto three areas. We determined it would be helpful to as many people as possible if we created a print material, a digital resource, and a physical interaction. We talked with stakeholders weekly to help inform our decisions and narrow our focus during the process.
We started with 12 ideas we could pursue as final deliverables at the beginning of the Ideation phase and through more research, interviews, and sending out surveys, we landed on the three main ideas. A care binder (or whatever form that might take), a website resource hub, and physical toys/tools to be used in clinicals to help demonstrate and visualize key concepts to families. Although we had many valuable solutions in the survey, some were knowingly out of scope. Opinions on these ideas were still gathered to provide more insight for future builds or to be added into concepts we were already creating.
The print resource we created went through a lot of iterations during this phase. We knew what general information that needed to be captured, but were still figuring out the best way to make it digestible and not overwhelming. Our initial thought was to have the information in a binder that was split into different sections with easily understandable information. After consideration, we found that the idea of a binder was more static than we liked, had existing associations, and did not allow for easy transportation. We decided the best way to make sure the content could evolve and stay mobile was to create a physically smaller, more digestible booklet that had the ability to remove and add information easily.
The digital website tool as a whole did not change too much once we decided on it. We determined what content we wanted the website to house and then worked on how to best present/design the look and feel of that content. For example, we knew we wanted a way to visualize the body and show what complications SCD has on different areas of the body, but what that looked like evolved during the Ideation phase.
Lastly, the evolution of the physical toys/tools was mostly on the materials used and how to best convey the information we found most valuable. We tried many different sizes, materials, and configurations for both of the toys/tools we prototyped.
During Refinement, the team split into three sections focusing on the different print, digital, and human resources we had begun during the Ideation phase. While we did each focus on one of the three resources, we were always in constant contact and had as much communication as possible to make sure our three areas fit together well as a suite of products. We also helped one another on different areas and provided insight as well. The final deliverables were decided based on all of the information gathered from the previous stages as well as the constant communication with the CCHMC team.
The print resource (My Care Journey) evolved to become a 4 x 6 inch booklet bound by two binder rings and filled with 50 pages of information. Each page was made to be as easily understandable and as vital as possible. We wanted to make sure that this tool could grow and evolve with the patient and be used, not only by the patients themselves, but by their families, care teams, and other caregivers in their life. This helped ensure a unified team of support would be built around the patient. The order of the pages and the content outline evolved as we refined the booklet. The end result split the booklet into two sections, one focused more on the caregivers and the second for the patient and their clinical visits. The section designed for the caregivers has information about different medications, treatments, things to watch out for, as well as things for the child to fill in to help with the personalization of the booklet. The patient journey section discusses topics like: the care team, immunizations, testing, screenings, a place for stamps, etc. The stamp pages in the booklet were designed as a way to encourage the child to bring the booklet to visits and take more of an interest in their care.
The resource center website ended up containing five sections: a home page, a body map, milestones, a resource toolkit section, and links to outside resources. The home page simply describes the purpose of the site as well as showing the navigation menu on the side to show what the site contains. The body map section is an interactive map of the body that when explored, highlights different organs/systems and explains how they might be affected by SCD. The milestones portion of the site experienced the most change during the evolution of the site. The goal was to show community responses to different topic areas as well as a timeline of things families can expect. These two ideas shared many similarities and we tried many ways of connecting them before landing on the final design. The final design is a set of ten icons that represent different milestones most sickle cell patients will encounter. When selected, each topic has both scientific/formal information as well as a set of quotes from members of the community describing their experience with the milestone. The resource toolkit portion of the site contains links to 37 PDFs created by our team explaining different sickle cell related topics, elaborating on information from the My Care Journey. The last section of the site, Outside Resources, is a collection of seven links to outside resources/websites that were found to be the most valuable by those in the community.
Regarding the toys/educational tools, we created two different tools to help visualize SCD. The first tool is two tubes filled with water and 3D printed cells. One tube contains only healthy red blood cells, and the other, a mix of sickled and healthy red blood cells. When flipped, the cells float to the top in different ways (the tube with the sickle cells clogs up while the tube with only healthy red blood cells flows smoothly). The second toy/tool is a set of healthy and sickle shaped plush toys that velcro together to show how sickle cells clump/stick together in the body.
At the end of the project we partnered with a printer and provided the contact with the CCHMC team, as well as creating a plan for printing. For the website, all the web assets were sent to a developer to create the site. Educational tools were handed off to the care team to be used during clinical visits.
Maya Dewan implemented the Watcher System into the Cincinnati Children’s Pediatric Intensive Care Unit (CCHMC PICU) several years ago, later developing an Epic oriented component to go with the original paper signage. This sign is placed outside of every child's door in the PICU and used if they are a high-risk patient. While the system works well, the expected transition to the new tower in Fall 2021 has made the team want to prepare before that time comes. CCHMC PICU and Live Well joined up to update their current system and start planning on the move to the new building.
Research was focused on what situational awareness meant in a medical setting, how a PICU was different from other areas of the hospital, and interviewing the PICU team to understand the current system better. Interviewing so many different roles in the same unit allowed us to really understand what was working well and what could use a little improvement. The biggest complaint was that the current system didn’t fit into the workflow which lead us to look at a digital solution as well as an analog one.
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The ideation phase involved benchmarking everything that can be used to efficiently convey information; from sliding whiteboards to established patient boards. In the digital world, we also looked into other ways to create alerts/alarms without the classic alarm sound that can cause families stress. Finally, we continued working with the PICU team to gain more information on how they specifically treat patients with different medical problems and how they share that information with the rest of the team members. After speaking with the new tower coordinator we learned that keeping something similar to the current watcher board would be ideal and that while a digital solution should be developed it likely couldn’t be implemented for quite awhile.
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Refinement lead us to many different designs. Each one we sent back to the PICU team to test. We would get their feedback and go back to the drawing board to update and redesign. We ended up making a much larger watcher sign as well as a book with multiple pages that are color-coded and tabbed. This larger size allows for the PICU team to write in more information and read the text from further away. Multiple pages allows for there to be more specificity in their treatment plans so that they don’t have to fill out the same material constantly. Finally, we decided to add a hard whiteboard that the book can clip onto. This whiteboard has text that prompts for information like reassessment time and contacts.
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The PICU team lead was very happy with the final deliverable. Dr. Dewan has plans to move this project into more departments and implement the digital solution with their partners later on. We hope to have another project with them to update our solution after being tested in the unit for a little while. While the PICU team plays with the new book and whiteboard they will be able to see if there is any medical information that should be added and how the size feels for them to work with.
The Live Well team will examine the relationships between people (various stakeholders), places (environments), and things (communications, services, products, and experiences) to create a better understanding of a patients unique journey through each cancer survivorship team (liquid, solid, neuro) while also being aware of aspects of DEI
Initially we held a design thinking workshop to begin to understand the issues and strengths of the cancer survivorship team. We used research methods including secondary research, literature reviews, and weekly activities with the survivorship team to better understand the journey a patient goes on into survivorship. We started a process diagram mapping out each step of the patient's journey starting with the Liquid (Leukemia/Lymphoma) team and continue to add more steps, revising each week, and have started adding in the process for Neuro-Oncology.
The team began putting together a stakeholder diagram of all three cancer survivorship teams to understand who is involved where and to determine who the team would need to interview. We began interviewing various people involved in the Cancer Survivorship process including the scheduler for all three teams, the care manager for the liquid/solid team, the social worker for the liquid/solid team, and the intake coordinator for the neuro team. The team will continue interviewing stakeholders and begin shadowing in the clinic.
After reviewing the research collected in the previous semesters, the team outlined what they wanted to learn from patients to develop personas.The questions identified were based on different areas of wellness, such as mental health & home life, and were translated into an interview guide. At the Cancer Survivorship Center, the team met with patients ranging in age and stages of treatment. From the first couple of interviews, the team was able to gain an understanding of the kinds of relationships CCHMC has with its patients. These conversations also provided an overview of different patients’ treatment experiences.
The LWC team brought members of the clinical team in individually to get their view on the current process & touch points by conducting a journey map workshop. Talking to nurse practitioners, care managers & doctors on the team gave the team a new perspective and helped clarify the insights from our previous patient interviews. Taking in all the information learned this semester, the team shifted away from creating personas and focused on creating detailed process maps in order to begin understanding areas where the transition success rate could be improved.
At the start of the semester the team began persona research and methods for interviewing to begin to understand how a persona is formulated, as well as how to properly interview patients to prepare for those interviews. Before interviews began, the team identified the target audience as patients of color who had not transitioned to survivorship or stopped going to survivorship. After each interview was conducted the team created individual timelines of each patient's journey to visualize the time periods of when they were diagnosed, when they were eligible to transition to survivorship, if they did or did not transition, and when they might have re-engaged.
The team used different research methods throughout the process including insight sorting and clustering, patient barrier diagrams, symmetric clustering matrix, and spider diagrams. These research methods aided us in the drafting of our current user personas as well as a research paper documenting the various methods used throughout our process. The team will continue developing user personas, determining the format of those personas, and creating strategies to combat the issues patients face when not transitioning to survivorship.
The semester started with continuing to develop patient personas and continued interviews with survivorship patients and clinical staff. The team held a validation session during the first report-out of the semester to confirm the narratives and timelines of the personas’ journeys to ensure the information was accurate. Adjustments to the narratives were made as necessary and the team moved on to the ideation phase of the project.
Ideation began by working to further understand the personas’ user journeys. The team started by analyzing the persona Samantha’s cancer journey in regards to context in her life, various pain points that occurred, and why she fell out of Survivorship in the first place. From there the team completed a rapid ideation session around her pain points and started story-boarding some of the ideas that the team came up with in order to begin evaluating their effectiveness and feasibility.
This semester was split into three different micro-projects surrounding the Survivorship experience: Reimagining Education, Reimagining Scheduling, and Reimagining Wellness.
For the scheduling component, the Live Well team met with the CCHMC scheduling team to understand the current and ideal scheduling processes. Together, they created graphics for both the current and ideal models, and analyzed pain points for both the patient and the care team.
Exploring the education component, the team began by clustering insights from summer interviews to articulate trends. Next, they ideated various interventions to respond to these trends. The team then worked through a series of methodologies to group solutions and define them into four subgroups: staff education, patient education, material creation, and optimized communication.
In the wellness component, the team expanded on the current wellness model by adding and refining the seven “pillars”: preventative care, physical fitness, nutrition, mental health, research, social wellness, and finances. These and their sub-services were arranged into a new graphic, shown below, and visualized for each persona to demonstrate their unique needs and desires from each category.
Reimagining Scheduling involved two “workshops” where the Live Well and CCHMC scheduling team walked through every step of the patient journey from on-therapy to survivorship care. This map involved outlining each key stakeholder and their role within the process. These workshops inspired multiple changes to the map outlined in previous semesters. To supplement the creation of an efficient map, the team created personas of patients at key ages that have significant intervention points in terms of insurance.
With regards to Reimagining Wellness, this semester the team made significant progress in defining CBDI’s survivorship pillars and champions. Live Well conducted multiple interviews with members of the survivorship team who spearheaded respective pillars and outlined their goals for accomplishment. Through interviews, the team was able to conduct an extensive SWOT analysis which exemplified both current services and pillar status as well as areas for change and/or improvement. This yielded “pillar cards” which outlined what the pillar focuses on, who their champion is and what they provide in terms of survivorship care.
Live Well presented a refined scheduling map that verified key stakeholders and now has an updated legend. Attention to detail allowed for a lower information load without subtracting meaning. The Champions and their pillars now have defined categories and explanatory cards for their services. Threats identified during the interview were also transformed into a concise list of solutions that may be taken forward in future semesters.
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Most of our Reimagining Wellness work occurred early in the semester. We met with nurse Stephanie Duncan, involved in Nutritional Wellness since Fall 2023, to refine a tool for structuring appointments. Stephanie had drafted a survey called “Eat, Move, Rest,” asking patients or caregivers about their progress in nutrition, movement, and sleep. We reviewed relevant online resources and discussed them with her to align content with appointment needs. The goal was to create a quick, friendly reference sheet to guide sensitive conversations within limited time.
In the Insurance and Scheduling sectors, we reviewed past research to identify support gaps for patients, families, and care teams. We benchmarked online insurance education tools—especially for young adults—and met with an insurance representative. A meeting was also set with Dr. Pillay-Smiley and Mike Behrman to ask CCHMC-specific questions.Proposal ideation began with user stories based on patient personas, evolving into phase maps outlining scheduling journeys. This helped us understand necessary features and avoid prematurely committing to one tool.
We created multiple versions of the Eat, Move, Rest survey to balance simplicity with useful data. We also explored app designs, developing wireframes and prototypes in Figma. The patient-facing app includes gamified features like experience levels and badges, while a second app uses a flashcard game to teach insurance topics. A third prototype for staff integrates task tracking with patient progress.
Our team began extensive research in Summer 2024 to understand the value of a health insurance education tool for pediatric cancer survivors, who range in age from 10 to their 40s. Critical transitions—especially at age 26 when individuals lose coverage under a parent’s plan—can be confusing, making confidence and knowledge essential. We conducted secondary research by benchmarking existing tools, analyzing educational materials, and studying Gen Z and Gen Alpha learning preferences. We found these groups favor concise, digestible content, often accessed via social media before visiting websites for more details.
To organize our findings, we created frameworks such as a “mother chart,” a persona-to-platform matrix, and a generational style chart. Shadowing the survivorship team at Cincinnati Children’s Hospital gave us insight into the appointment process and revealed key opportunities, which we mapped in an opportunity graph.
Initially, we proposed a mobile app, but feedback led us to pivot to a website—more accessible for casual users and usable across all devices. We explored wireframes, names, and design styles to match our audience’s preferences. For the insurance site, we built six core content sections, conducted user testing, and integrated an AI chatbot modeled after ChatGPT to offer real-time support.
The platform includes a gamified “Learn by Playing” section, approachable language, memes, and humor—making complex insurance topics more relatable to younger users while maintaining educational impact.
Using the first version of the Survivorship appointment map from Fall 2024, we began identifying patient and staff pain points. The waiting room, as the first interaction point, became our starting focus. We benchmarked hospital waiting areas and other youth-centered spaces like libraries, restaurants, and theme parks to understand what makes a space engaging.
To apply these insights, we conducted four observation sessions in both Pediatric (PEDs) and AYA/Survivorship waiting rooms, recording over 50 patient interactions. We observed that patients across all care phases shared the same space, some entered the wrong waiting room due to poor signage, and TVs were oddly positioned—suggesting discomfort starts before appointments even begin.
Informed by this, we refined the original appointment map to show phases (before, during, after), rather than individual care team visits. This better captured overlapping stakeholder roles. We then interviewed each stakeholder to validate their involvement and uncover additional details, using these insights to identify patient- and staff-facing pain points.
Our second focus was transitioning the wellness pillar model to a patient-facing system. We reviewed archived materials and developed five baseline questions per pillar, then interviewed each champion to distill their responses into accessible statements. These formed the basis for a layered information system: a wellness card with care team notes, a flyer, and an updated website hub.
As this project continues, we emphasized clear storytelling. Our goal was to frame the appointment map and wellness model as tools for Live Well and CBDI to use in crafting effective, personalized interventions.
During the research phase of the project, the team started off doing benchmarking and secondary research into the previous 2017 CBDI Informed Consent project. The team wanted to understand existing barriers to the biorepository informed consent process and why patient consent rates were low, and did additional literature reviews or existing articles as well as reviewing and annotating current Bio Tissue Repository informed consent documents.
Through interviews and discussions with the Cincinnati Children’s Team, our team learned eventually there were no problems with the current informed consent process in the Bio Tissue Repository bank from the patient point of view. Instead, there were many internal problems and the team found that miscommunication and lack of tracking patient consent were the biggest issues in the informed consent process, so the team shifted their focus to interviewing and gaining insights from clinical staff members, the research team, and physicians and attendings.
From interviews and the existing biorepository informed consent documents, the team was able to map out a process diagram of the current informed consent process, which includes the people and stakeholders involved, different methods and routes of the informed consent process, and pain points in the process.
Eventually, the team got to shadow over at the Cincinnati Children’s Hospital Medical Center at Burnet Campus and observe how a fellow would give the informed consent discussion to a patient’s family. The team also got to go into the clinic workrooms and see how the fellows prepare for the conversation with the family, what they take with them, the discussion that happens with family, as well observe the documentation process after the discussion.
After mapping out the opportunity areas and having a good understanding of the themes throughout the process, we began ideation of concepts. This included brainstorming possible solutions based on the themes and opportunity areas identified, further evaluating those concepts to see what fits into the scope of what the project objective is and getting some feedback. From there we benchmarked what already exists out there and created concept cards to frame the deliverables.
We began quick ideation with a HMW activity. For this activity we took each of the HMW questions we created and quickly generated ideas that would be possible solutions. From there were addressed any shortcoming the ideas might have in the second row, and then how we would elevate the concept to address any potential issues.
Taking those ideas we began to flush out the details of each concept. This included identifying the theme it addresses, a short description, what persona it meets the needs of, possible deliverables and content that would be utilized. While thinking more about each concept, we documented any questions or comments we wanted to discuss with the team and will be bringing those up during the concept slides.
We started with 16 initial concepts. 13 of these were generated from our ideation activity, and then were 3 added after our insightful discussion with an attending based on his suggestions. From there, we narrowed the concepts based on how much of an impact they can create and feasibility with implementation.
After discussion with the CBDI team, they decided the concepts they’d like to move forward with are the digitized process and the biorepository video. The digitized process will be pursued internally by the CBDI team. For the videos, this includes revising the existing “What is Research” video and creating a new “Biorepository video.”
Throughout Spring 2022, a rough draft of the script for the video animation was generated through conversation with team members and analysis of documents. The work will continue on into Summer 2022.
Throughout the years CBDI and Live Well Collaborative have partnered to create innovative solutions to improve the cancer patient journey to help understand diagnosis, navigate care, and assure lifelong success. For phase 20, we are creating an exclusive, responsive micro-site to showcase the portfolio of innovative projects created to improve the cancer patient's journey for medical center leadership teams, cancer care colleagues, and philanthropists.
During our kick-off call we were able to get a better understanding from the CBDI team about what they were looking for and who the main users of the microsite would be. We started out the research phase by researching existing websites that have a portfolio of projects and case studies to benchmark and gain inspiration for the CBDI microsite. We then created an information architecture flow for the microsite to understand what each of the pages needed to include.
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Developing the information architecture was key as we headed into creating wireframes. This process involved 15 initial sketches that helped us explore different layouts and ways to display information for the key pages of the microsite. We translated these sketches into digital wireframes after narrowing down to our top 3 ideas. In the digital wireframing phase we began to add in placeholder content to get a better idea of how information would look, and ideate on portions of each layout to add variation to the flow of the page. We then chose our final concept because of the effective storytelling, dynamic layout, and adaptability. With this final concept we added in the content for the ADL 123 device project and began to design the additional pages and link everything in Figma to create a workable prototype.
After the prototype was built and received approval the team worked on developing the microsite in Webflow. The template created for the ADL 123 Device project was used for the remainder of the project pages. Additional graphics and mockups were created for each project as needed. This included highlighting the key process moments within each project and visualizing the final outcomes depending on the usage scenario. Based on the structure of the project pages, layouts for the home and about pages were made. For the home page, three milestones from the cancer patient journey were identified to categorize the projects into. The about page provides a brief overview of the relationship between Live Well and CCHMC CBDI. For future expansion of the microsite a style guide was created.
Visit CBDI MicrositeThe Live Well Collaborative team aims to work with the CBDI team at Cincinnati Children’s Hospital Medical Center to increase the activity level of CBDI’s Adolescent and Young Adult patients while they are restricted to A5 during COVID-19.
During the research phase, the Live Well team designed and conducted surveys of the AYA population. We received a total of 23 patient responses ranging from ages 21–35 years old, with 39.1% responses by males and 60.9% responses by females. Additionally, a semi-structured interview was done via a remote video call with 2 OT/PTs at CCHMC to help put an expert’s interpretation to what we were hearing from the patients. The Live Well team then took the results from both and analyzed them to find common themes and then formulated those into insights for concept directions. At the end of it, the team had gathered 11 insights and identified three archetype groups.
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For the ideation phase, the team began by taking the insights gathered from the research and mapping them out from high priority to low priority for the archetypes: not motivated patients, apathetic patients, and motivated patients. After this the team took time to ideate on different concepts and ideas for each insight to explore various directions. From there, ideas were narrowed down based on the scope of the work to make sure it adhered to COVID guidelines and could be put into implementation by end of semester. The concepts were then roughly designed, and sketches made for them. A total of 6 concepts were presented to the Children’s team to get feedback on before moving to the refinement phase.
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In the refinement phase, the Live Well team revised the concepts based on the feedback received at the Ideation Report Out. The team also met with the OT/PT from the CBDI team a few times to get additional feedback, suggestions, ideas for implementation and a better understanding of the A5 layout as they couldn’t visit in person. The final 3 concepts included: Trail Map, QR Routes and Virtual Reality. The Live Well team built out these concepts to be handed over to the CCHMC team. For the trail map, an interactive trail map was made to be hung in the hallway, a personal trail map for users, a personal tracking sheet and instruction on how to use it all. With the QR Routes, the team delivered an example unit route map, instructions for the activity, a personal unit map, a total of 36 QR markers and content generated for all of them in a repository. The VR Physical Activity included instructions, tracking document and VR equipment. Creating instructions for all of the concepts was integral to make sure they could be handed off and implemented by the CBDI team.
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After the final presentation, the Live Well team finished all the content creation for the QR codes to put into a repository. The printed 3' x 2’ trail map, 36 QR codes and instructional documents will be handed off to the CBDI team so they can begin implementing the concepts.
Improve cancer care delivery and navigation for young adult patients.
The team researched various opportunities for improving the cancer journey for young adults. The primary focus was on the incorporation of technology.
The team presented various technolgy to the CCHMC team during a brainstorming presentation. Some of the concepts presented included pedometers, virtual reality, smart signs, and smart excercise equipment.
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Further discussions were held about the potential concepts and incorporation of technology.
Download Refinement PresentationClick below to download an overview presentation:
Download Overview PresentationAbout 2 years after the successful implementation of the original 1-2-3 Device, Cincinnati Children's Hospital expressed interest in exploring the possibilities of a 2.0 device. Live Well and CCHMC developed a brief outlining goals including understanding the experiential deficiencies of the 1.0 device and developing a prototype that begins to address some of these areas of improvement. This semester was a continuation of designing the 2.0 system.
The Live Well team began research by interviewing CCHMC staff about the ADL program. Nurses also helped by engaging in usability testing of the current 123 app design. Receiving excellent feedback on the usability of the app, the team then moved on to addressing the difficult challenge of youth incentivization.
Getting quality information from a young interview respondent is very difficult by using traditional qualitative methods. The Live Well team needed to innovate in order to gain a better understanding into what motivates young demographics in gamified scenarios. The team then designed play-based interview tools to gather information on specific gamified motives that could be incorporated into the ADL app.
During the ideation phase the team used insights from the play-based interview sessions to base incentivization concepts. Multiple paths were explored but the most effective was a concept rooted in story. The protagonists of this story were the ADLs and your immune system. The goal was to defeat the antagonist…Germs!
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The final “germ boss” concept was deeply thought out in this phase. User flow maps, interactive prototypes, and game mechanic diagrams were created to explain the app. Personas were also created to frame the concept components back to the problems they were solving.
Download Refinement PresentationThe CCHMC team expressed their interest in pushing the ADL app into possible development. Both the Live Well and CCHMC are currently assessing what next steps should be for the ADL app.
The goal of this phase was to work with children’s hospital to do QI oriented testing of a 1-2-3 device application. Live Well and Cincinnati Children’s hospital planned to work together to get in front of patients and nurses to get direct feedback about app features and provide insights about their understanding of ADLs and infection prevention.
During the research phase the team decided to adopt the CBDI quality improvement (QI) approach to developing the 123 app. The goal was to implement a minimally viable ADL tracking app that could be given to patients for a short duration. The team planned to onboard patients to a functional QI prototype of the 123 app, allow them to use the app, then use data and interviews to gain an understanding of how patients would likely interact with an ADL app. While the app was being developed, the team also conducted interviews with patients currently on the 1.0 device to understand their possible barriers and understanding of the ADLs.
The team was able to develop a structure for the QI app, visualize concepts for data summary, and interview 3 patients and families on the 1.0 version of the ADL device.
Over the course of the ideation phase the QI 123 app was developed and tablets were purchased to conduct the trials. The app was hosted on the Live Well’s website and loaded onto 6 iPads purchased by Cincinnati children’s hospital. The devices were ready for implementation by the end of this phase. While the app was being developed, the team also conducted more patient interviews.
One of the emerging problems discovered from these interviews was that patients were unfamiliar with the term “ADL”, what activities were included in this term, and why the activities are important for their treatment. An opportunity to fix this problem was to find out how the video library developed by Live Well could reach patients better.
During the refinement phase the team focused on implementing the QI prototype that was developed in the ideation phase. The team was able to get two families to use the prototype for a two-week period. The team then took the data from app usage and conducted exit interviews to gain insights on if patients would engage with a basic ADL app, if they would use other apps on the iPad, or if they would ignore the iPad all together and prefer to use their own devices.
The team was also able to conduct usability testing with a paper prototype of an ideal version of the ADL app. The nurses were then asked to perform tasks like logging an activity, editing an activity, and looking at the data summary. These interviews gave the team a better understanding of what features a nurse likes and doesn’t like. It also helped the team understand the types of interactions the nurses would be willing to use during their workflow.
The team identified education as a pain point for increasing adherence in patient populations. The next project will examine opportunities to better utilize the Live Well video library, which can educate patients and families on aspects of their journey, but are largely not viewed by patients. Development on the 123 app will also continue with a focus on the least adherent patients.
About 2 years after the successful implementation of the original 1-2-3 Device, Cincinnati Children’s Hospital expressed interest in exploring the possibilities of a 2.0 device. Live Well and CCHMC developed a brief outlining goals including understanding the experiential deficiencies of the 1.0 device and developing a prototype that begins to address some of these areas of improvement.
The Live Well team began by researching elements of gamification, interviewing members involved with the design and implementation of the original 123 device. They began to understand the full scope and potential impact the device could have on patients, families and CCHMC staff.
The team outlined the pros and cons of the 1.0 device through the research. The team also began to benchmark devices and apps that patients engage with currently to create ideas that could increase patient and family engagement.
The team began to understand that it would be important to look at how the device would operate outside of an ongoing study as some resources would be unavailable after the study was complete. The team began to start to outline what stakeholders would need to be understood, setting them up to gain richer insights in the next phase while developing visual language.
The team also used this time to make improvements to the 1.0 devices currently in use in order to sustain them for the rest of the study.
During the ideation phase the team interviewed multiple stakeholders in the 123 device including HUCs , Child Life, and Nurses. The team became more aware of each of the stakeholders' roles within the hospital system and began to layout how they could interact with the 2.0 device using personas and stakeholder maps.
The team began to conceptualize features and tie these features to the individuals in the stakeholder map. The needs of each were outlined and recorded. This clearly outlined what the 2.0 device should do and why. The results were a combination of opportunity areas and specific features. Rough wire frames were developed and presented.
After developing the list of stakeholders and their needs, the team focused on refining the core features of the 2.0 device and the other possible development routes. The visual language and user flow was tested with 3 patient families through a prototype and feedback was taken.
A range of other features and ideas were also outlined. These features were captured in a design history file.
The team delivered a clickable prototype, 3 areas for further ideation, and defined next steps for the following semester.
123 Device development will continue into the fall of the 2019-20 school year. The goals will be to refine features under “Activity Entry and Approval," continue to explore features under “Feedback and Shared Decision Making,” and “Incentivization and Approval.” The team will also continue to evaluate what it would take to implement a the 2.0 device along side CCHMC.
This studio project is a continuation of work from previous semesters.
This studio project is a continuation of work from previous semesters.
Near the end of February the devices were cleared for production, and were submitted for printing at the end of March.
Andrew Jajack finalized a complete inventory of parts, and is currently building the internal electronics for the completed prints.
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Next steps: Device implementation at Liberty Campus for testing.
Further steps for next stage: User Experience / Patient Adherence Evaluation Study, applied for R21 grant funding to support evaluation study.
Work on the 123 Device continued this semester with CCHMC.
Device Updates:
Modified device to accommodate Children’s custom designed metal plate that fits into headwall mounts
Switched to tactile push buttons for activity selection since mount allows free-rotation, making touch-free sensor calibration difficult
Blocked internal debug lights from showing through the case
Increased volume of piezo-speaker by providing a pinhole on side of enclosure to allow sound waves to escape better
Added ability to control the backlight to reduce light pollution in patient room at night
Modified footprint of interface label to accommodate hardware changes
Improved durability of label to withstand frequent cleaning/sanitization
Updates:
Modified device to accommodate Children’s custom-designed metal plate that fits into headwall mounts
Adjusted the firmware to better support the new touch-interface
Improved the user interface
Grounded the interface around a central dashboard
Simplified screens to aid understanding
Added screens to celebrate accomplishments
Added screens to visually show the accumulation of points
Fixed mount dimensions and resubmitted print
AYA focus group
Updates:
Delivered two assembled prototypes
Updated enclosure design
Submitted four additional enclosures for print
Transitioning device from demo mode to using CCHMC's API
Next Steps for Live Well:
Assemble 4 final prototypes & deliver to CCHMC
Spring Term: Troubleshooting (as needed)
Next Steps for CCHMC:
Install/Implement 6 devices at Liberty Campus
Evaluate devices
Compare the efficacy of the automated, device-based system vs the manual, paper-based system
Evaluate devices
This studio project is a continuation of previous semester work. The device concept was developed by students at the Live Well Collaborative, who determined the opportunity for improvements in the reward system already in place at CCHMC that encourages patients to bathe, be active, and engage in oral hygiene.
The Live Well team researched and sketched possible concepts for the device.
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The Live Well team ideated several different iterations and possibilities for interface and interaction.
The Live Well team incorporated feedback from stakeholders to refine the 123 Device and tablet features.
The device concept was developed by students at the Live Well Collaborative, who determined the opportunity for improvements in the reward system already in place at CCHMC that encourages patients to bathe, be active, and engage in oral hygiene.
The Live Well Team researched current strategies to find areas of opportunity for the 123 system.
The team ideated various forms of automation for the 123 system.
The team refined the automated device and created renderings of possible construction.
Over the course of this semester, two separate videos were developed: "What Is Research?" and "Patient Reported Outcomes."
Munazza and Maddie, accompanied by Todd Timney, met with several clinicians who were experts on the video subject matters. Using this information, outlines were created that were then developed further into scripts.
Download Research PresentationAfter getting the scripts approved, voiceover actors were sourced and recorded and the Live Well team started developing storyboards. These storyboards started out in an analog state and once approved, were translated in a digital space. This included the creation of all assets that would be needed to make the final video.
Download Ideation PresentationThe digital storyboard was combined with the voiceover to create an animatic to get the final look and feel of the video and to suss out pacing. From there, animating started and was finished by the end of this phase.
Download Refinement PresentationWhat Is Research?
This video was created to explain the goal of research, its benefits, and voluntary participation. The word “cancer” was removed by the Live Well and CCHMC team so the video could be used more broadly for all patients at CBDI including before diagnosis.
Patient Reported Outcomes
The Patient Reported Outcomes video provides patients/families with an explanation and overview of all the questions patients are routinely asked. It also explains that immediate benefits such as more personalized care or connection to various resources.
“What is Proton Therapy?” is a video for patients and caretakers of patients who have been recommended Proton Therapy as the next step in their cancer journey. Using an empathetic and empowering tone of voice, patients will learn about what Proton Therapy is and what benefits the Cincinnati Children’s Hospital provides. Patients and caretakers will feel reassured that they’ve made the right choice in choosing Cincinnati Children’s while feeling a bit more calm going into the first treatment.
Cancer patients are often readmitted soon after receiving treatment for cancer because they are at a higher risk of infection and must treat a fever immediately in order to safely move forward with their recovery. Unfortunately, this readmission is very rarely preventable, because despite the care team and patients’ efforts to reduce their risk, the immune system is just extremely susceptible to these symptoms. In order to ease the patient’s experience with this readmission, we are arranging a video to explain the admission and reassure the patient’s efforts in preventing infections.
Our process to develop an outline and script for the video uses both primary and secondary sources of research. By working directly with the team at Cincinnati Children’s, we are able to accurately and effectively communicate the topic of the video.
In order to start developing an outline, we narrowed down our specific audience, overall focus, and tone of voice for the video. The audience is readmitted cancer patients who are immunocompromised and at the risk of becoming infected. The purpose is to inform the patient and their family of the reasons for the likelihood of fever (immunocompromised) and the steps to stay well during this time. We want to reassure the patient that there is only so much to prevent fever during this stage of recovery and they are not alone. We also want to communicate the urgency of treating a fever right away, and express the support of the hospital in preparing you for this experience.
The final script and storyboard were assembled into an animatic. This part of the process focused on making sure the patient was able to understand infection, the readmission process, and continue to feel motivated to reduce their risk for infection. A fever happens because the body is immunocompromised; it is not a result of something the patient did or did not do. We want to make sure the patient understands this, so that they do not feel discouraged or even guilty upon admission.
Fevers are very likely for immunocompromised patients and it is important to treat them immediately. By supporting the script with strong visual elements in the storyboard, we were able to better suggest this urgency. (1) Call, (2) cream, and (3) clinic, distinguished the 3 immediate actions that must be taken upon the first sign of a fever. We also visually represent an hour timeframe to arrive at the clinic.
We felt that the video needed to give the patient a realistic expectation of the time of their stay. we achieved this by clarifying that blood cultures must be negative for 2-3 days, and giving time in the animation for the days to pass.
Revisions following the ideation presentation were applied to the final script and storyboard before recording the final voiceover. The animation process offered opportunities to use pacing as a tool to emphasize certain parts of the script in order to suggest a very important message in the video: time.
At the first sign of a fever, the clock starts, prompting the patient to call their care team. At this time they apply EMLA cream so that is has time to numb before they arrive at the clinic or emergency room. It was also important to show that blood cultures must be negative for 2-3 days and that the patient must be fever free, feeling well, and have rising blood counts before returning home. Allowing time for these things to happen gives the patient a more realistic expectation of their time in the hospital. The final video helps the patient become more familiar and comfortable with a likely fever admission, so that they know exactly what to do at the first sign of a fever.
In the hopes of creating a more consistent visual style throughout the Cancer Journey video library, the “What is Leukemia?” video received an update.
No revisions to the script were made, instead, this redesign focused solely on improving the visual style and resolution of the animation. A new voiceover and updated CCHMC branding contributed to the improved quality.
Reconstructed assets and animation led to more consistent and appropriate transitions and movements throughout the video. More specifically, we focused on making sense of the abstract idea of cells and we were able to more accurately depict the central line.
The video demonstrates the importance of continuous clinical-care for cancer survivors to promote lifelong health and wellness. It simultaneously welcomes current patients into the program and influences former patients to re-start clinical care.
This is a serious conversation with the patient. Being earnest about late effects is done out of respect to them. The message needs to be honest and empathetic. This situation is difficult for a person to go through. We need to demonstrate we care.
During the first couple of drafts, the teams worked on the balance of being too dense or too general. One school of thought had the video being the beginning of a conversation, introducing the patient only to the immediate key points they would need to know when learning about the program. Another set wanted the video to dive deeper into some content, really helping the patient understand the situation.
The teams also worked on crafting the right language for this video. Early on, we explored the possibility of acknowledging a patient’s more negative feelings as a way of being honest with them. We wanted the video to feel human and empathetic. However, it was decided that this led to a feeling of negativity, and we did not want to start this new chapter on a negative note. So we moved away from this language direction.
The final draft focuses the fact that the nature of treatment is improving everyday, and that patient is not alone in their journey. The language reflects the importance and seriousness of the issue, while showing that the patient has the ability to be active and in control of their health. This was decided to be the best way to balance being earnest while also being positive.
The teams developed storyboards that followed the journey of two characters, a boy who grows up to be a man and a girl that maintains a young age throughout the video.
The man character targets the young adult audience by doing physical activities, such as hiking and riding his bike, showing that he’s able to be healthy and do those things because he’s in the survivorship program.
The girl character shows targets younger patients, who might still be under the care of their parents.
Working with a CBDI team at Cincinnati Children’s Hospital, Live Well is developing a new animation for the Cancer Journey video library in order to introduce the remote patient monitoring program.
The audience for this video will be patients who are recommended for the program, as well as their families.
The goal of this partnership is to introduce and explain remote patient monitoring and elaborate on how it works and what involvement looks like.
In developing the outline for this video, the Live Well team consolidated a few main ideas:
Introduce the Situation
There is a new Remote Health Monitoring program at CCHMC to keep patients as healthy and connected as possible.
It is designed to keep patients from having frequent visits and long stays.
Gives the patient a sense of empowerment over their health, and a feeling of control.
The patient will use a mobile device of their own, or have one provided to them.
They may be provided tools such as a thermometer, scale, or blood pressure monitor to record their condition.
The technology is designed to increase patient connection to the healthcare team from outside of the hospital.
How It Works
Even small changes in health updates could mean that the patient is too sick to continue treatment.
The kit provides the health care team with information to help make informed decisions about the course of treatment.
It also enables daily check-ins.
The program helps the care team ask questions, give updates, schedule check-ups or appointments with patient.
How It Affects Them
Live a more hospital-independent lifestyle.
Reduced stress and added convenience of less hospital visits.
Once the script was approved, we started sketching out storyboards in order to find ways of visually narrating the ideas that will be presented in the video. The theme of this original script and storyboard focused on the extension of the hospital’s care, and the strengthened relationship between the care team and the patient.
Upon the presentation of the first animatic during the ideation phase, we received feedback which had us revisit the script. Suggestions from the CCHMC team led us to reconsider the name of the initiative. Remote Patient Care was named from the perspective of the hospital, so by giving it a name by which the patient could refer, it could start the shift in tone of the entire video. From here, we also explored ways of offering more patient empowerment through edits to the script. This revision also included a shift in audience from children and their families to young adults. We hope to emphasize how the technology puts the patient in charge of their healthcare.
Download Refinement PresentationIn the first week of September the Live Well team met with both the Fertility Preservation team and HPV team from CCHMC to talk about the videos planned for this semester. Participants discussed the target audiences for each video and specific focus points to be included. The team wanted to focus on the specific options for female fertility preservation through the Fertility Preservation video. Their target audience included newly diagnosed or female cancer survivor patients and the general female population curious about fertility preservation options. The HPV team wanted their video to focus on the importance of getting the HPV vaccination and key facts surrounding HPV. The target audience includes parents of preteens, parents of older teens, and adolescent young adults.
Throughout the first week of the ideation phase, the Live Well team developed scripts for both videos. Once initial scripts had been approved by both CCMHC teams, the Live Well team began sketching storyboards. On October 7th, all teams met to go over the initial storyboards. Live Well then began to create digital versions of both storyboards. The team also finalized scripts at this time. On October 20th, the final scripts were sent in to the Clinical Content Review Committee and approved.
After the ideation presentation, the Live Well team made some minor changes to the storyboards. On November 4th, the team reviewed these changes with the Fertility and HPV teams. Changes were approved and the team moved forward with animations. On November 11th two CCM students from the University of Cincinnati recorded final voiceovers. From November 14th-28th the Live Well team worked on developing animations. On November 28th both CCHMC teams reviewed final animations before showing them at the final presentation.
Download Refinement PresentationThe Live Well team focused on the topics of nutrition and fertility for this semester’s educational animation work.
The animation team conducted research on the specific topics of cancer survivor fertility and IV nutrition.
The animation team created sketches and digital storyboards, as well as scripts, and character development. Co-creation sessions were held with stakeholders to help develop these aspects.
Download Ideation Presentation
The Live Well team presented the two final videos, “TPN Feeding” and “Post-Treatment Female Fertility,” to CCHMC at the final meeting.
Download Refinement PresentationSpecific focus areas were identified by the team, including:
Motion Project
Nutrition: Feeding Tubes
Fertility Preservation: Sperm Banking
Meet Your Care Team
Family Connection Center
1-2-3 Initiative
Virtual Reality Technology
Insights
We met with CCHMC experts for Fertility Preservation, Nutrition, and Care Team every week to check progress. Each team detailed what information they wanted to be in each video. The Fertility Preservation video is about Sperm Banking, so we created an outline detailing why someone would want to invest in this option, how the process works, and what the patient should learn from the information. The Nutrition video is about Feeding Tubes, so this outline described why someone would need a feeding tube, how to use it, and how a patient could function while having it. The Care Team video was let by social work and nurse care managers to outline all the main people new patients come in contact with and what their function in the hospital is. After meeting with the experts, the Live Well team conducted secondary research to see how other resources handled this same information.
Outlines
We combined all the information to create cohesive flows of information in the form of outlines. These were edited in 2-3 rounds by the CCHMC teams and the Live Well team.
Scripts
After the outlines were approved, the Live Well team created drafts of scripts with language that each target audience would most easily understand. These scripts were then edited by the expert groups and content committee to ensure proper literacy levels and accurate wording.
Storyboards
The Live Well team drew storyboard frames by hand to visualize the narrative that accompanies the scripts. These frames also included transitions and helped separate content between what is said and what is shown. The Nutrition, Fertility Preservation, and Care Team experts all gave feedback on these boards as to what made sense in the narrative.
Asset Creation
The team created characters and other visuals to fit the aesthetic that was established last semester. Each video has a hero character that represents certain topics throughout the video library. The Care Team video needed to create characters for nearly every field, so these characters will be used in the future when the CBDI team expands the library into different topics. The illustrations were edited based on feedback from the expert teams.
Audio Recording
We recorded the voiceover based on the script. These voiceovers were then edited and mastered for the video, where they are sequenced together.
After concept phase, the Live Well team began to animate the illustrations they created. They synced up animation, the voiceover, and background music. The animation process took about a month to fully flush out each video’s time span.
Download Refinement PresentationThe first kickoff meeting was held. This meeting went over feedback from the videos that were created last semester. There was also discussion around the liberty campus and its role as an innovation lab. After the meeting there was a correlation activity that focused on content and idea creation.
This presentation went over the research that was gathered and feedback from the two videos that were made. The presentation also went over research and benchmarking for the two new videos, Insights that were gained from the research, and research on the different roles that healthcare kiosks play to educate, entertain and comfort. At the end of the presentation was a brainstorming activity to come up with different ideas for what the innovation lab would be and what the functionality of the kiosks would be.
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The team went over the ideation sketches and storyboards for both videos. The team also went over family feedback on what topics and what animation styles communicate the best. Proposed character styles were shown within their style frames. The innovation lab became known as the family connection center and the team went over communication goals and areas for growth around the center. The team then went over additional benchmarking and possible solutions.
Download Ideation Presentation
The final presentation began with a recap of the semester and co-creation feedback for the family connection center. The team went over some user scenarios that focused on the families of liberty campus and how technology can play a role in preparing the family before the visit as well as engaging the family throughout treatment process. Final storyboards were displayed for the videos as well as their branding strategy. Both of the videos were viewed and some feedback was gained.
Download Refinement PresentationThe Opportunity
With the redesign of Cincinnati Children’s Hospital Medical Center (CCHMC) website comes an opportunity for the Live Well to collaborate and help CCHMC to expand their video presence. When families are navigating the journey after their child is diagnosed with cancer, videos have proved, through research and insights, to be a great educational and secondary resource for them to refer to after receiving information from their medical team. The Live Well team had the opportunity to further explore this and design video materials for CCHMC to implement.
The Challenge
When a child is diagnosed with cancer, families are left feeling overwhelmed and confused, sometimes frustrated at the vast amount of information thrown at them so quickly. After their doctor and medical team explain their diagnosis to them, they go through what is sometimes called “information overload” and are in need of a supplemental source of information that they can access both at the hospital and once they return home.
Literature reviews and various categories of benchmarking were used to better understand how videos could be an effective method of communication to patients and their families. Benchmarking covered: how other hospitals are implementing video use, what various video styles exist and how we could best use them, and what video content was most relevant to patient experience.
Synthesis of benchmarking results led the L team to structure interview activity sessions and an online survey to understand what patients, families, and CCHMC staff felt were best appropriate.
When synthesizing survey results, it was noted that responses switched from negative to positive around age 6. The Live Well team deduced that this likely signaled a cognitive leap from the time a child passed this age. Parents were very attuned to the appropriateness of small details in the videos, and felt it was highly important for their child to be able to identify with the characters portrayed in the video.
The Live Well team conducted interviews with CCHMC staff, as well as various patients and their families, to better understand how videos could improve the patient experience. The team interviewed 9 families total, 7 of them being inpatient and 2 outpatient. The team also interviewed 4 CCHMC staff members from Child Life and School Intervention.
Patients liked the idea of using video content to hear about diagnosis and procedures from someone they could relate to. Families mentioned that videos offer a source of bonding as they try to digest new information together. CCHMC staff added that children like seeing other children go through procedures before they do. They also mentioned that capturing critical information in the beginning and summarizing this critical information at the end is helpful.
The Live Well team interacted with four children: two patients and two siblings. The activity sessions included various methods of information retrieval:
1) The “Draw-It” technique: the participants were asked to draw what they thought of when given certain prompts.
2) Video preferences: the participants were shown various videos and were asked to identify what they liked and disliked about them.
3) Character styles: the participants were shown various characters styles and were asked to choose which styles they preferred.
Video directions were chosen for both videos and were outlined for CCHMC. Analogy options and storyboards were also shown to CCHMC for feedback.
The Live Well team presented final video animations to CCHMC for validation. Edits were suggested by CCHMC and implemented for further feedback. Videos will be sent to patients and families for additional response.
Download Refinement Presentation
The fall semester rounds notification project was a continuation of the work from the last two semesters. Between summer and fall semesters, the LWC team supported a week-long proof of concept pilot for the CBDI liquids and yellow teams. The LWC team worked closely with the CCHMC rounds implementation team to identify project champions and determine clinical ownership for different tasks. The pilot goals were to (1) introduce the digital scheduling process to workflows and (2) gain buy-in from clinicians before beginning to notify patients/families.
About a month after the initial pilot, a second pilot was conducted with modified ownership roles. The LWC team provided hands-on support as needed but primarily shadowed both teams. Informal and formal conversations were conducted with the CCHMC rounds implementation team and clinicians during rounds. The LWC team spent about 50 hours on the floor facilitating the pilots, observing, and collecting information.
The LWC team developed specific concept requirements and started fresh with sketches inspired by benchmarking. Each element of the final three concepts was vetted for technological feasibility and adjustments were made to ensure usability. The following three concepts were shared at clinician focus groups:
Open Layout:
Straightforward process is ideal for more advanced users and allows users to see the progress of scheduling patients.
Step-by-step:
Clearly delineated steps provide multiple checkpoints in the process and provide additional guidance for new users.
Calendar Style:
Ability to see up to 20 patients at once by switching between list and calendar views.
The close partnership with CCHMC allowed the clinicians to see how their feedback impacted the development process. Clinicians preferred the open layout with the addition of elements from the other two concepts. Several changes were made as a direct result of this feedback including the following:
+ Adding green/red dots beside patient names to show who had opted in/out of the SMS notifications
+ Not allowing patients and time breaks to overlap
+ Adding yesterday’s actual rounding time to provide more accurate time estimates for today
The Live Well team prepared usability testing materials to evaluate the final prototype. The prototype was tested with eight clinicians during a mix of one-on-one and small group settings. Many of the usability testing insights remained consistent with feedback the team received throughout the process (i.e. the importance of striking a balance between system and user control).
Finally, the Live Well team prepared the pixel perfect versions to transfer to CCHMC for internal development. These screens corresponded with an API specs, brand/style guide, and clinician education materials.
The Live Well team debriefed together after meeting with the CBDI core team and decided to move forward with the rounds notification project. In order to gain insight into what this type of system should look like and how it should function, the team performed benchmarking research and analysis.
The team researched existing rounding software to see what systems already help to aide the challenges of rounding scheduling and notification.
Unfortunately, the team found that the existing software was focused on note taking and building, lacking their core desires and needs. The team narrowed the desires down to three different buckets (Scheduling, Tracking, Notification). This conversation inspired further benchmarking with these three buckets in mind. The team gathered research, sorted through it together and then pinned it up on the wall creating the universe (shown left).
The team also shadowed two different rounding teams, CBDI liquids and Internal Medicine yellow team, during this time. The team gathered insights into what challenges the stakeholders faced during the rounds time each day, what their communication looks like when delays occur and how the rounds schedule, as it exists, is distributed among participating members.
In the Ideation Phase, the Live Well team continued to shadow both teams, distributed a questionnaire to nurses and families, mapped out the process including major pain points, and created wireframes that later inspired a preliminary demo.
While shadowing, the team observed patients/families and nurses who are all external users of the rounding schedule in some way. While shadowing, the team distributed a questionnaire with the goal of collecting data on how, where and when the stakeholders would like the information presented. This gave the team the necessary information on how to move forward with the interface.
The team also took the time to map out the entire rounding process for both CBDI and the Yellow team. The map showed common pain points and how they affect the overall day, how multiple stakeholders intersect with one another throughout any delays, and where any overlaps lie. After analyzing the teams separately, the team put together an ideal rounding schedule chart and a chart comparing all three together.
After going over the data collection and the whole rounding process, the team wireframed and created a preliminary demo. The demo was then presented to the core team at the Ideation presentation. The team had everyone present text to “enroll” into the system that would essentially allow them to receive updates about their patient. The demo was very well received and the core team decided to pilot the demo with the CBDI team after making a few adjustments. The Live Well team started putting together their list of initial edits to make.
After transition into the next semester, work was continued on the Liberty Campus Virtual Tour. Since the previous meeting, all of the 360 images have been optimized and the website runs a lot smoother. The bugs in the maps and navigation have also been fixed.
Additionally, more 360 photos have been taken of Liberty Campus. For example, photos have now been taken of the CT Scanner and Research Gantry. The next steps are to are to:
+ Create loading page for the website.
+ Develop feedback form.
+ Conduct interviews and write scripts.
Draft loading page with a link to a Google form for feedback has been added to the Liberty Campus Tour. With this addition, we can now move into user testing. We plan on user testing the site heavily for one month while we continue to develop the scripts and fix any small bugs revealed to us. Following the user testing, the next steps are to:
+ Finalize scripts and possibly work on voice overs.
+ Redesign the loading page.
+ Incorporate a few popular user-suggested features we learned from the user testing.
As the second semester working on the Liberty Campus Web VR Tour comes to a close, there has been a lot that has been accomplished with a little bit left still to go. In terms of accomplishments, we recently redesigned the loading page and created custom shareable tours. The custom tours, which can be created on the loading page and shared via a link, were a highly requested feature from the user testing we conducted. However, still to go is:
+ Adding Protoman to the tour (at least the cyclotron section).
+ Recording voice overs.
+ Ongoing bug fixing.
With the Android App version of the Liberty Campus Tour completed in the previous semester, Live Well and Cincinnati Children’s Hospital now turned to moving the VR tour to more easily accessible mediums, foremost of which is the web.
Objectives over the course of this semester include:
+ Working with A-frame Javascript framework to get scenes on the web in VR.
+ Identifying the best UI/UX and navigation method in VR.
+ Connecting all of the scenes in a way that doesn’t cause nausea.
+ Finding a way to keep users oriented to where they are located in the tour.
+ Understand the most appropriate way to deliver additional information in VR.
The Live Well team used residential VR tours available on the apartments.com website as a benchmark to create a VR solution for Children’s Hospital. After exploring the various current web VR solutions, the team settled on A-Frames as the most flexible and best choice. Multiple proof-of-concepts were then developed to demonstrate that the VR tour could be recreated on the web. These were successful and were demoed to Children’s Hospital at the Research phase meeting on February 10th, 2017. After great feedback from the Children’s team, Live Well moved forward with backend development, planning, and optimization.
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After producing multiple proofs of concept, the VR Tour team moved on to the ideate phase to begin brainstorming possible changes for the transition of the app to the web. We explored other web VR tours built with A-Frame, like the one on iStaging, to gather ideas. From this, we determined that we needed to change two things. This first was that we need to change the way users navigate around the virtual building (between 360 photos). Previously rotating arrow buttons were used, but it seemed like having a dot in the position of the connecting location would work better. The second was that we needed to update the UI elements. We concluded that both the maps and the virtual assistant, Robbie, needed a redesign and that addition maps need to be created to accommodate for the new areas. Therefore, we split the work up into three parts, Aaron on UI updating, Jack and new area mapping, and Ivan on navigation redesign, and got to work.
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After demoing the progress made on the web VR Tour and the placeholder UI at the Second Children’s Hospital meeting on March 24th, 2017, the team moved into the refinement phase. In debriefing this meeting, it was evident that a few things needed to be changed. For starters, the concept of dragging around a cursor to interact with the VR elements proved to be too confusing again. Therefore, we are going to try to move the VR cursor to the mouse pointer, which will allow users to click on elements in the same way they do on traditional web pages. Additionally, with the growing number of 360 images in the tour file sizes, are becoming a larger and larger problem. As a result, we are exploring the possibility of creating a duplicate set of images with a lower resolution and size.
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In the final presentation to Children’s Hospital on April 26, 2017, a full VR Tour was demoed. The tour included all of the new UI assets and all of the Liberty campus locations. However, it was still far too slow to be deployable and had yet to be integrated with Children’s analytics. Therefore the next steps for the studio include:
+ Optimizing the 360 images for web VR delivery.
+ Integrating analytics into more of the website.
+ Debugging the Map and other navigation elements.
This project is a continuation of the VR Tour of the Liberty Campus from previous semester work.
VR Tour criteria to address:
+ Replace low resolution images.
+ Create a new navigation map for the area.
+ Replace the robotic voice.
+ Add navigation buttons.
The Live Well team benchmarked virtual and augmented reality platforms to gain insights for the Liberty Campus VR Tour project.
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The Live Well team continued to benchmark virtual reality systems to gain insights for the Liberty Center VR Tour.
Next steps:
+ Document remaining environments
+ Main Building, reshoot exterior, 1st floor
+ CBDI Building
+ Script
+ Identify voiceover
+ Finalize & record
+ Finalize production
The Live Well and CCHMC identified the opportunity to develop a web version of the VR Tour of the Liberty Campus.
The layout of the Liberty Center was researched in depth to create a map to accompany the VR Tour.
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The Live Well team used feedback from stakeholders to further conceptualize the VR Tour.
Download Ideation Presentation
The VR tour was refined to include: a reduced file size, faster loading time, and placeholder images for new scenes. The script was also finalized.
Download Refinement PresentationThe Virtual Reality Tour studio project was introduced to the Live Well team to allow stakeholders to view hospital facilities before visits and at their convenience.
The team conducted in depth research about the benefits and appearance of the VR tour.
The Live Well team ideated various sidekicks to accompany users on the VR tour. They narrowed down their options through interviews with stakeholders.
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The team developed a refined sidekick character and VR tour demo.
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The goal of the project is to materialize the research findings from Spring 2017 about the original oncology binder. The content was narrowed and focused into what families deemed most important. Our objective is to develop a resource that is more accessible and cherished as indispensable.
The original handbook was bulky, letter-sized binder thick as a brick. We were asked to redesign it to be smaller and pocketbook like. We were also told some families would not use their binders, leaving them sitting in the back of their cars, forgotten. The redesign needed to elevate the handbook, highlight the importance of its contents, and become a cherished resource.
The Live Well team decided to dive deep into the exploration of what a small and cherished book could look like. Rather than assume the best solution and start designing the final handbook, the designers developed two different concepts each and generated just enough content to show their design intent. This process took about 5 weeks. The concepts were then presented to the CBDI team, comparing the design benefits and trade-offs of each. The CBDI team was able to use their insights from working with patients to select the most resonant ideas to develop further. Along with low-fidelity prototypes of the four concept layouts, Live Well also brought different booklets and a pocketbook to demonstrate sizes, materials, and binding methods. The Live Well team also brought post-its and sharpies and encouraged the CBDI team to mark their favorite design decisions. By writing their ideas down, we were able to create a tangible list of deliverables that wouldn’t be forgotten after the discussion. The type of exploration stage allowed each designer to explore possibilities creatively. Some concepts were more focused on typography and print/graphic design while others focused on realization and usability. This gave the presentation a wide breadth of content.
After presenting our ideations with the team and the caregivers that work with the current binder, we finalized the concept and entered a refinement stage for layout and content of the handbook and physical book itself.
The Live Well team shared the visual design progress of the design through PDF’s for clarity, and the progress of the copy writing in a Word document for easy editing. We used email as communication channel with the Children’s team to gain feedback and do user testing.
The Live Well team met with the Children’s team on January 11, 2017 to discuss details of the studio project. The Children’s team expressed that their current Oncology Parent/Patient Handbook is not an ideal way to transfer information. There is an opportunity for Live Well to provide insights on how to translate the current content into more engaging and informative formats.
Throughout the course of this semester objectives are:
+ Understand patient/caretakers relationship with the binder content
+ Understand care managers relationship with the content
+ Understand institutional relationship with binder content
+ Identify opportunities to translate content into more engaging + informative formats in an effort to improve patient/caretaker utilization of content
+ Prototype examples of new content/format concepts – an “ecosystem” of information delivery that delivers on the conceptual theme of “right information, delivered the right way & at the right time”
+ Construct an overall “roadmap” of what kinds of content would be most appropriately delivered in what format
After the kick-off meeting, the Live Well team began to dig into the content of the current handbook. On January 20, 2017 the team spoke with Barefoot Proximity, who had previously done work translating some of the handbook content into a web format. On January 25 and February 2, the team conducted meetings with some of the institutional stakeholders at Children’s, including:
1. Content Creators (those who are responsible for developing the content contained in the current binder)
2. Content Managers (those who are responsible for updating content/keeping content up to date)
3. Content Distributors (those responsible for introducing the content to patients/families
The team used this meeting to help understand how the binder/handbook was created, why it was created, and how Children’s Hospital imagines it moving forward. These meetings provided a lot of insight. Meanwhile, the team also looked at other examples of handbooks and resources from other institutions, which enabled team members to begin imagining the possibilities of improving the current resource at Children’s.
Additionally, Live Well developed a survey for patients & caretakers that can be sent digitally. The Live Well team presented our latest findings and insights to the Children’s team on February 10. The immediate next steps are to gain insights from patients & caretakers, as well as beginning to identify formats through which content can be translated.
The Live Well team created a digital survey to send to patients and families, developed through Typeform. This survey helped gain important information for the Ideation Phase. It was sent out on March 7th to 269 patients and families with an e-mail address on file. In total, 55 responses were collected, which provided in-depth insight into their experience with the oncology handbook.
Meanwhile, the Live Well team and the CCHMC staff continued to work on understanding the handbook content, and identify information as “must have,” “nice to have,” or “not needed.” Comparing clinical staff perceptions of the handbook and patients’ and families’ feelings about the importance of content helped define key distinctions that the team could use for further development.
Additionally, the Live Well team began to look at the content and brainstorm possible media opportunities for each section.
On March 24, the Live Well team presented the survey results, key insights, content breakdown, and initial media brainstorming to the CCHMC team.
During the refinement phase, the Live Well team continued to analyze the survey results, looking into age, demographics, etc. Our findings from the survey as well as insights from the CCHMC Staff helped us develop recommendations for continuing the project. In addition to revising content, we recommend that the handbook be redesigned, containing only core information—information identified by patients, caretakers and care managers as critically important. The rest of the information currently contained in the binder would migrate online.
The Live Well team developed preliminary ideations of the core content to be included in the updated binder. The purpose of these were to give the Children’s staff an idea of what the new pages could look like. A website map was also developed, beginning to organize the additional content for migration onto cincinnatichildrens.org.
The Live Well team presented to the Children’s team on April 26th and the next steps are to be determined!
The Live Well team researched ways to keep families connected to events at the hospital.
The Live Well team had many factors to consider in the ideation of the Activity Calendar.
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The team outlined various possibilities for implementation of the Activity Calendar during the final presentation.
Download Refinement PresentationThis project served as a continuation of previous semester work.
The team researched the goals of the Family Connection Center to improve the patient and family experience.
The team ideated several options for the direction of the Family Connection Center.
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The Live Well team along with the CCHMC team determined options for displays of the Live Well/CCHMC collaboration.
Download Refinement PresentationThe first kickoff meeting was held. This meeting went over feedback from the videos that were created last semester. There was also discussion around the liberty campus and its role as an innovation lab. After the meeting there was a correlation activity that focused on content and idea creation.
This presentation went over the research that was gathered and feedback from the two videos that were made. The presentation also went over research and benchmarking for the two new videos, Insights that were gained from the research, and research on the different roles that healthcare kiosks play to educate, entertain, and comfort. At the end of the presentation there was a brainstorming activity to come up with different ideas for what the innovation lab would be and what the functionality of the kiosks would be.
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The Live Well team toured liberty campus to get a further understanding of the space and how it relates to a family going through proton therapy. This tour helped The Live Well team develop user scenarios.
The team went over the ideation sketches and storyboards for both videos. The team also went over family feedback on what topics and what animation styles communicate the best. Proposed character styles were shown within their style frames. The innovation lab became known as the family connection center and the team went over communication goals and areas for growth around the center. The team then went over additional benchmarking and possible solutions.
The final presentation began with a recap of the semester and co-creation feedback for the family connection center. The team went over some user scenarios that focused on the families of liberty campus and how technology can play a role in preparing the family before the visit as well as engaging the family throughout treatment process. Final storyboards were displayed for the videos as well as their branding strategy. Both of the videos were viewed and some feedback was gained.
Download Refinement PresentationThe Opportunity
The goal of the project was to improve the existing Patient Therapy Plan used in the Cancer and Blood Disease Institute (CBDI) at Cincinnati Children’s Hospital Medical Center (CCHMC). The original Patient Therapy Plan was handed out in the form of a calendar print out created in Microsoft Word that did not provide sufficient information for families and was inefficient for the care teams to create and manage. In collaboration with the CBDI, the LWC team enhanced the Patient Therapy Plan to provide a more holistic solution to improve the cancer journey experience for stakeholders.
The Challenge
Cancer treatment for a child spans over months, if not years. Moreover, it can change several times in a short period of
time based on the patient’s condition. The current process for updating Patient Therapy Plans leads to unnecessary mistakes, which causes confusion and uncertainty for families.
The Live Well team presented initial prototypes of patient-specific interface to the CCHMC team. Based on that, the team discussed further about functionality and information that need to be provided from the interface.
The initial prototype was well received by the staff. The Live Well team started to design the printout.
The Live Well team presented refined prototypes of the patient-specific interface and the family printout to the CCHMC team. The developer team explained back-end development and the timeline.
The L team outlined a new system for the updated calendar, which included two provider portals and three patient/parent portals that meet the needs of different stakeholders.
The Live Well team had an in-depth interview with a care manager, Rachel Wilp. Rachel explained how she worked with patient therapy calendars, she also cleared some questions from the Live Well team regarding information and function of the new calendar system.
The Live Well team had feedback from three families on the family printout. The Live Well team also got useful insights from the care manager. The families responded favorably on the printout.
The Live Well team introduced the proposed calendar system to the CCHMC team, which included two provider portals and three patient/parent portals.
The Live Well team presented three distinct interfaces: Patient-Specific Protocol, Read Only Calendar, and Family Printout.
The Opportunity
An emerging trend of fitness and nutrition tracking (being used for more medically-driven purposes) lends an opportunity that Live Well was able to explore with Cincinnati Children’s Hospital Medical Center (CCHMC). This opportunity aimed to explore uses of fitness trackers for in-home patient monitoring. Benchmarking of current fitness and nutritional trackers led the Live Well team to offer insight to support the research already being done at CCHMC. Live Well was able to map out Children’s current working model and offer areas that could be further considered and explored.
The Challenge
Many times, children and their families leave the hospital with questions and concerns that arise at home. This especially happens if the child develops unexplained symptoms at home, when they are not in the comfort of being surrounded by their medical team at the hospital. To allow doctors to spend as much time as they can helping the optimal amount of patients, remote patient monitoring can be used to check vitals and monitor the child’s nutrition, allowing the medical staff to check on the patient remotely without them having to come to the hospital.
The Live Well team met with various members from CCHMC to discuss goals of the device project and what CCHMC was looking to accomplish over the course of the term. HIPAA compliance and current CCHMC strategies were brought up with significant importance.
Key questions to consider when looking at existing monitoring devices included: 1) have the current fitness monitoring devices been medically validated; 2) are they validated in pediatrics; 3) has there been any current research done that could be relatable? Current devices were most likely validated with adults, so going forward, validation in pediatrics is of high importance.
The Live Well team met with members from CCHMC’s IT department, and were able to get a better understanding of CCHMC’s current methods of researching and benchmarking monitoring devices. The LWC team presented their current findings and cross-compared them to those being done by CCHMC.
Additional areas of consideration were discussed, and the Live Well team began mapping current and future practices that CCHMC was utilizing in monitoring devices, including their partnerships and connections. The Live Well team also began benchmarking products and services in other industries to broaden their research margin.
*These findings were turned over to CCHMC at the conclusion of the Research Presentation, and were utilized to further CCHMC progress.
The aim of this semester was to create a VAD handbook, an educational video about waiting for a heart transplant, and an ACTION rebrand of a CBDI video, titled Patient Reported Outcomes.
The Live Well team benchmarked existing handbook solutions, and created a first round of prototypes at the office. We utilized card stock, tabs, pockets, folders, and different methods of binding. We also began sketching out storyboards according to the video script given. Additionally, the team identified opportunity areas for design improvement in the Joomla module system.
The Live Well team compiled the content given, continued to prototype, and determined a style for the handbook. The team also developed a set of icons corresponding with different topics, in order to help communicate large concepts that are relevant for patients and their families. The team continued developing storyboards, and created an animatic for the video.
In the last phase of the project, the team completed the layout and content of the handbook. Physical copies were given to the Children’s team. The video, called “Waiting for My New Heart” was completed as well, along with the rebranded Patient Reported Outcomes Video.
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Continuing on from 2018, Live Well developed a new education module titled “The ABC’s of VAD.” This module was designed to break down all of the aspects of life with a VAD into an easy to access and well structured education plan. By using a glossary style set up, the user can jump to specific sections that they need more help with or navigate linearly through the whole module, starting “A” and ending with “R”. The ABC’s and what they stand for are as follows:
A- Anticoagulation
B- Blood Pressure
C- Communication
D- Driveline
E- Equipment
F- Fluids
G- GI Bleeding & Beyond
H- Hemolysis
I- Infection & Inflammation
J- Jobs & School
K- Keeping you safe
L- Learning Alarms and Troubleshooting
M- Medications
N- Neurological Events
O- Ouch
P- PI & Pump Parameters
Q- Quality of Life
R- Ready for Discharge
The Live Well hosted the research presentation with CCHMC on October 1st, 2018. The research presentation started off with the Live Well team explaining how we can effectively educate families, patients, and clinicians using age and developmentally-appropriate resources.
During the first round of research, we dedicated much of our studio time benchmarking multiple industries on their current and future techniques exploring multiple methodologies in interactive education. Not only did we gain insights by primary research, but we spent in entire day at CCHMC interviewing clinicians, patients and families. The Live Well team discussed noticeable recurring patterns from the research and translated the data in several different ways to explore opportunities that would create a successful educational platform and interactive activities for all stakeholders.
The Live Well team presented their synthesized findings into visualizations including journey maps, statistics, quotes, and interactive examples. This information was presented to help CCHMC understand stakeholders needs, experiences, and goals. The presentation came to an end with a productive conversation with the CCHMC team about what digital platform to pursue while taking the CCHMC team a tour of Live Well’s VAD studio.
The Live Well hosted the ideation presentation with CCHMC on November 1st, 2018. The ideation presentation started off with the Live Well team using Adobe XD to show a clickable walk through of course 1.1. The first unit in this course is “1.1A: What is a VAD,” which is the introduction of the care journey and continuous flow devices. The Live Well team used simple animations and static images in this unit because we wanted to prevent families from being exposed of too much information too early in the care journey.
In the next unit, 1.1B is focused on the decision making process for getting a VAD. From the full day of interviews with multiple stakeholders on October 17th, the Live Well team gathered it would be best to translate this content into a animated video. The warm characters in this video will generate a welcoming and transparent experience for the patient and family to make the decision on whether to get a VAD or not.
After sorting through the content, it was decided that 1.1C is all about the implant procedure. In this unit, the Live Well team designed a step by step task analysis to prevent stakeholders from watching a gruesome video of the actual surgery.
Finally, 1.1D is focused on the next steps after the implant. Live Well presented this unit through a gamified journey map. The journey begins with the patient being discharged from the hospital to making the move back home in the most successful way focusing on education, necessities, and preventions of VAD.
The presentation came to an end with a productive conversation with the CCHMC team about edits for course 1 and what next steps need to be taken for the refinement phase.
Live Well Collaborative hosted the refinement presentation with CCHMC on December 7th, 2018. The refinement presentation started off with the Live Well team using Captivate to present the final learning modules, 1.1A through 1.1D. The work that the Live Well team has created will be implemented and shared with stakeholders on an eLearning platform called Joomla.
Revisions following the ideation presentation were applied to the final modules and content before moving forward. The biggest challenges that Live Well faced was mostly in 1.1C. The decisions that were hard to make was: how to show the sternotomy of the VAD surgery and how to show the patient after the operation including the adverse events and risks. Animating and describing the surgery was something the Live Well team made sure to ask during the full day of interviews at CCHMC in November.
The animation process could utilize pacing and interaction as a tool to emphasize certain parts of the script in order to suggest a very important message throughout 1.1A through 1.1D. The main message is, the care team is always with the patient and every patient's journey is different. The presentation came to an end with a productive conversation with the CCHMC team about edits and what next steps need to be taken for next semester.
As a follow-up after the Refinement presentation, Live Well Collaborative is continuing this project with the CCHMC VAD team. During the Spring semester, Maddie Lee, Sarah Grunkemeyer, and new graphic designers will continue to build out course one and two through Captivate.
From there, Live Well will hand the final modules off to the CCHMC VAD team and Dave Davis and his media team to input into Joomla to send out to all stakeholders. Meanwhile, CCHMC is creating new content for future sections/units and collaborating with the Action network.
On May 15th, the Live Well team met with the CHECK Center project team to kickoff the Healthcare Engagement and Relationship Optimization through Effective Services (HEROES) project for foster families. As many as 5% of children in Hamilton County Job and Family Services (HCJFS) protective custody have profound mental and behavioral health needs requiring high intensity mental health resources, such as inpatient psychiatric admissions. While inpatient psychiatric admissions can be a successful acute treatment intervention, these highest risk children often experience frequent and repeated admissions which can result in poor treatment response. Furthermore, because of their behavioral and mental health issues they are at an increased risk for placement disruptions following psychiatric emergency department visits and admissions, which further exacerbate trauma and mental health concerns and result in longer inpatient stays than medically necessary as new placements are identified. A new approach is urgently needed for us to improve the lives of these uniquely vulnerable children that matches the high needs of this population with the level of care provided and addresses both the medical and social risks at play. The Live Well team would be designing 20 stand alone and mix-and-match worksheets for the psychologist in the CHECK clinic to use with foster youth and their families.
From the Kick-Off Presentation, the Live Well team conducted interviews, developed personas and benchmarked existing products and brands. 6 foster families were interviewed in this phase. Some insights that emerged from those interviews were that:
1. Parents use binders or folders they buy themselves to keep all the child’s information.
2. Children are most drawn to cartoons over live action television shows.
3. The parents face many challenging including the emotional toll this process takes and navigating the child’s complex behavior.
The personas embodied various types of foster parents who might be interacting with the therapy sheets. Lastly, the benchmarking showed brands that Gen Z kids are drawn to and where color trends are headed in the coming years.
Taking all the information from the research phase, the Live Well team started exploring colors, fonts and layouts. Four colors were decided on and taken to foster parents and children for feedback. Fonts were chosen based on the brands Gen Z are drawn to, so bold, modern typefaces were also tested. Colors and fonts were then combined into a series of early layouts that were also paired with early iterations of icons and drawings.
Download Ideation PresentationOn January 16th, the Live Well team met with the CCHMC project team to kickoff the Electronic Health Record project for emancipated foster youth. The Children’s team broke down the problem statement and the envisioned solution: an electronic health record designed to improve health outcomes and promote healthy behaviors in foster youth experiencing a transition from pediatric to adult health care systems. This meeting also included input from emancipated foster youth, who were present at this kickoff presentation. These individuals gave initial feedback on the proposed EHR solution and provided the Live Well team with early ideas to consider moving forward.
On February 13th, the Live Well team presented research outcomes from the first phase of the project. This presentation and discussion outlined the Live Well research methodologies for this project, including the benchmarking of existing EHRs and user interviews. The team discussed insights gained from this research, concluding that the solution must:
+ Find a balance between professional and user-friendly
+ Be responsive to both mobile and web platforms
+ Employ the use of iconography and color
+ Utilize information bulking and previewing
The presentation concluded with a co-creation session using a rough prototype that the LWC team had created based on research insights. This led to initial discussions with the BMI team concerning feasibility, features capability and content. Next steps include developing a brand identity, refined prototyping and user testing of these refined prototypes.
On March 20th, the Live Well presented outputs from the ideation phase. The team reviewed two EHR prototypes and detailed user testing protocols used during the ideation and initial refinement of concepts. Each user was asked to navigate the click-through prototypes during testing and was given a set of tasks to complete. The team would then ask the user to rate each task in terms of difficulty, which led to subsequent discussions concerning the overall usability and features of each prototype. High-level insights included phraseology, user interface changes, and navigation alterations. The team then worked to combine the successful elements of each prototype into a single direction. This merged prototype was presented to the CCHMC team with discussions on how it might translate to a desktop interface and what further refinements and details will be added in the refinement phase of the project. The Live Well team concluded the presentation with a quick branding exercise, designed to generate initial discussions on potential names and overall brand ethos for the EHR. Next steps include the creation of a style guide, a final round of user testing, finalization of interface processes and final branding elements.
Download Ideation Presentation
On April 24th, the LWC team presented results from the refinement phase of the project. During this phase, the team executed adjustments and alterations to the prototype based on final rounds of user testing. Additionally, a variety of icons were generated to be used throughout the interface. During final rounds of user testing, the team tested these icon variations and made necessary adjustments based on user feedback before incorporating them into the prototype. Finally, the team developed a brand that would encompass the health portal: HealthHero. HealthHero empowers emancipated foster youth, making them the champions of their own health. It is through a multi-category electronic portal that emancipated foster youth can view their medical history, comment on diagnoses, share medical information with a trusted viewer and gain more information on health as well as life topics.
Concluding the presentation, the team outline areas of potential future development for the portal based on user testing. These areas included the ability to share individual diagnoses instead of a ‘blanket’ sharing function, the information in the Life Skills section living locally on the portal instead of external links, ability to print Authorized Representative paperwork, and support for child medical records if the primary user is a parent. The team then fielded follow-up questions, hand-off logistics and discussed future timelines. HealthHero is set for development and coding during Summer 2019, a subsequent pilot program during Fall 2019 and hand-out at the end of the year.
On January 14th, Live Well met with the Patients Partnering with Others in Decision-making (P-POD) team from CCHMC. This kick-off allowed for the team to be introduced to the project, “Inflammatory Bowel Disease 101: Ulcerative Colitis”, along with the fundamental research and relevant insights that had been gathered during the first phase of the CCHMC’s project. Taking the information from this first phase and applying it to the crash course of ulcerative colitis (UC), the Live Well team is going to be working with patients and clinicians to begin researching what the best solution is for creating a patient-centered decision support tool.
The Live Well team delivered the Research Presentation on February 12th to the P-POD team. The insights that were the driving force behind this presentation were gathered from seven focus groups, some with patients and others with clinicians. During these interactions, we had the participants complete a decision mapping and journey map activity. The key insights gathered were that treatment options were a big portion of this tool and that the patients’ main concerns were:
+ Their mental health, specifically their stress/anxiety
+ Their diet/nutrition
+ Handling school/work/extracurriculars
+ Their support system
+ Handling transitioning from Children’s to adult care
Taking all of the data that was collected from the focus groups, the LWC team created two mind maps, one focused on the patients’ responses and the other on the clinicians. Alongside presenting the team’s insights, the benchmarking that was completed in this first phase was also discussed. The team benchmarked existing shared decision tools, education tools, and decision aids for topics outside of the medical realm. From these, the team learned:
+ Shared decision tools help the user determine the best answer for them instead of the “right” answer and can be a catalyst for conversation
+ The importance in the use of color and iconography
+ A digital platform allows for a dynamic solution
Taking all of the insights from the focus groups and benchmarking, the LWC team’s next steps are to begin working on wireframes, clarifying a brand, finalizing content, and creating and testing prototypes to use in the next round of focus groups with patients.
During the Ideation phase, the Live Well team took all of the insights gathered from the focus groups and the working session with the CCHMC team after the research presentation, and began applying them when creating an information architecture and wireframes.
After creating the architecture and wireframes, the LWC team presented the concepts to the focus groups. The goal of this was to generate conversation with the participants about what they would really want out of this app. With pens in hand, the participants took an active role by marking up the architecture and wireframes with what was working and what could be improved. The team also proposed multiple moodboards to get a better understanding about what the look and feel of the app will be. This was done by printing the boards out, along with adjectives, that the participants were able to create word associations with.
Taking all of this feedback from the focus groups, the LWC will begin to finish wireframing, conduct usability testing, input content (as available), create a brand and style guide, and work on an implementation strategy.
On April 23, 2019, the Live Well team presented for the final time of the semester to the CCHMC. During this presentation, the team recapped the research and ideation phases, covering the evolution over the semester. This included reviewing the information architecture, the feedback of the usability testing, and the insights gathered. After recapping the previous phases, the team presented the most recent phase, refinement. During this phase, the team finalized:
+ The information architecture.
+ Conducted the final round of usability testing.
+ Putting together the final prototype.
+ Creating branding for the interface.
During the usability testing, the team discovered the final look and feel of the app, what the best way to navigate through the different sections is, and how the treatment generator would function. This round usability testing allowed the team to work out the kinks that led to the idea of using a chatbot as the treatment generator, because it provided a more personalized and conversational tone. At the completion of the generator, the user is prompted with a review of their answers to see what their priorities are when it comes to their treatment. This insight wouldn’t have been possible without the focus groups. Alongside with revising the prototype screens and organizations, the team worked to create a brand for this application.
IBDecide is an application that addresses the need for autonomy while simultaneously facilitating decision-focused conversations with others. This tool also helps to empower the patients to participate in the clinical decision making in-step with their healthcare team.
On August 31st, Live Well met with the Pectus Excavatum team at CCHMC. Coming off the research conducted last semester, the team touched on the data collected and the framework of the Hero’s Journey. The team learned more about the value of the family when it came to the patient’s Pectus Journey, and reiterated the fact that caregiver stress is an extremely important component. Concepts of mindfulness, meditation, and breathing techniques were discussed as alternative strategies to reduce anxiety. We also identified the differentiators that distinguish Children’s from other institutions and competitors.
Live Well delivered the research presentation on September 21st. The team first spoke about the comparative analysis conducted, ranking CCHMC against other hospitals in the “Big 7” including, CHOP, Atlanta, LA, Texas, Boston, and Seattle. The team presented the visuals created that illustrate the Pectus journey through a framework of the Hero’s Journey. This visual narrative was a hike where anxiety points in the journey were represented by mountains. The LWC team reiterated that the parents and patients have separate but related journeys with different obstacles. The team also discussed some of the possible intervention tools that the hospital could leverage to improve the overall experience for the families.
Download Research Presentation
Live Well delivered the Ideation Presentation on October 26th to Patrick Edmunds and Camille Woods at the Live Well studio. On November 14th, the Live Well team had a second Ideation Session with the entire Pectus team at CCHMC.
The Ideation Presentation included insights gained through interactions with patients and parents. The key insight about the Hero’s Journey was most patients and their families wanted a jungle theme for the visualization of the Hero’s Journey.
As for the empowerment tool, the Live Well team created a series of personas for patient and caregivers based on qualitative feedback. The personas were placed along a spectrum that fit into the scope of the empowerment tool. Further, the team presented a collection of cards that included all the resources available for patients and parents at the hospital and beyond. The Live Well team presented a preliminary strategy for when to use these resources.
The Live Well team delivered the refinement presentation on December 7th to the Pectus team at CCHMC. The presentation was divided into four sections. The first section was the Hero’s Journey Video (see above). The second sections was the empowerment toolkit. The third section was the implementation strategy. And the final section was the web strategy. The team first went over a recap of the goals and deliverables for this semester and later talked about the video. The empowerment toolkit was first introduced to the audience and then, attendees were invited to visit one of the ‘stations’ where we had prototypes of the deliverables for them to touch, feel and interact with. The prototypes included a booklet, a card set, an interactive site, and an education binder. Later, the CCHMC staff went back to their seats and the presentation kept going. The implementation was introduced right after. This section included detailed diagrams presenting three implementation plans: low, medium, and high. Each of these plans was later introduced in detail. The last part was all about web strategy. The team presented the overall findings and recommendations for the Chest Wall Center website to improve. The last ten minutes were dedicated to questions and discussion.
On December 11th, the Live Well team delivered a one-on-one presentation to Dr. Garcia. Dr. Garcia and Patrick Edmunds came to Live Well's studio to get a comprehensive overview of this semester’s work. The team started off by going through the goals and deliverables to later introduce the hero’s journey process and ended up that portion of the presentation with playing the final hero’s journey video. The second section of this presentation focused on the empowerment toolkit. All components were presented including binder, booklet, card set, and interactive site. The LWC team had the prototypes at hand for Dr. Garcia to go through the materials and interact with them. Later, we talked about how to implement the empowerment toolkit and more specifically, who will own each component, production cost, and timing. Last, we provided an overview of the work that was done for the web strategy and introduced key findings and recommendations. At the end of the presentation, we had some time to discuss and answer questions. Overall, the Live Well team got very positive feedback from Dr. Garcia and he showed excitement in moving forward with what we created.
The Live Well team packaged and sent all final files to the Chest Wall Center at CCHMC for them to work on production and implementation. The Live Well team suggested having a structured research study to test the empowerment toolkit. Also, the Live Well team recommended using the Chest Wall Center as a case study to scale this project across the different departments at the hospital. The Live Well team will be presenting this semester’s work to the Anesthesia team on February 6th, 2019.
Live Well hosted the kick-off meeting with CCHMC on January 10, 2018. The meeting began with Nathan Grant sharing his story as a sibling coping with his brother’s chronic illness, as well as a brief description of his organization; Siblings with a Mission. CCHMC then proceeded to touch on the importance of implementing ways to support siblings battling with their sibling’s chronic illness within the hospital. The Live Well team then shared their kick-off presentation, which broke down the 16-week semester into different phases in which the project would be completed and presented.
The goal of the project is to improve the understanding of the experiences of siblings and families. This will then inform the development of services and programs that will meet those identified needs. Live Well’s design thinking process will translate siblings’ needs into recommendations for multi-modal services, virtual and in-person, on-demand and scheduled, individual and group. Also through engagement with all members of the psychosocial team, we will leverage existing resources in innovative ways.
Live Well hosted the research presentation with CCHMC on February 7th, 2018. The research presentation started off with the Live Well team explaining how they conducted primary and secondary research on current techniques and methodologies that engage siblings in and out of clinical settings. The Live Well team benchmarked how large corporations handle the care of individuals, current and future technologies for care, and what sibling care currently looks like at CCHMC. The insights gained from the research phase provided the Live Well team with a foundation for identifying design opportunities.
From the research, the Live Well team presented their synthesized findings into data visualizations, personas, and insights. The personas were created to help CCHMC understand stakeholder needs, experiences, behaviors and goals. Personas help to recognize that different people have different needs and expectations.
The presentation ended with the Live Well team discussing noticeable reoccurring patterns from the secondary research, as well as different design opportunities that would create a sibling support system for siblings, parents, and clinicians.
Live Well hosted the Ideation meeting with CCHMC on March 14, 2018. The ideation presentation started off with the LWC team describing the two different tools that were developed for the stakeholder interactions throughout this phase. In the first interaction, the team used emotional memory worksheets to discover common patterns in experiences. In the second interaction, stakeholders selected from engagement mechanisms and psychosocial activities to craft their ideal sibling space. The insights gained from using these co-creation tools informed concept development direction. After discussing the results from the data collected, the LWC team presented the insights that they translated from the emotional memory exercises to create possible roadmap solutions.
The Live Well team then identified the design guidelines that emerged throughout the ideation that will assist in the creation of a successful sibling platform. Following this, the Live Well team presented the four possible platforms that could be a potential solution, along with the features and components that would make these platforms successful. During the refinement phase, the Live Well team will translate insights and feedback from the stakeholder co-creation interactions to detail final solutions.
Live Well hosted the refinement presentation with CCHMC on April 18th, 2018. The refinement presentation started off with the Live Well team breaking down the qualitative approach that they utilized in order to recognize patterns and refine the look, content, and rules of the sibling game through leading co-creation sessions with stakeholders. The Live Well team then described their 3 part interaction utilized during this phase; the first activity focused on the game, the second activity focused on aesthetics, and the third around the sibling space.
During the co-creation process, the Live Well team gained insights that enabled them to improve the simplicity and mobility of the game, as well as establish the aesthetic of the game. The Live Well team stated that the goal of the game is to create a method that will allow CCHMC parents and siblings to learn about emotional milestones, drive conversations, offer bonding moments for families, and foster inter-family empathy through a neutral platform. In addition, considerations and criteria for a successful sibling space at CCHMC were developed in order to ensure the space will be utilized.
This project brought necessary attention to the emotional journey of siblings dealing with a brother or sister’s chronic illness. The research uncovered needs within the opportunity areas of a tool for parents, a designated space for siblings, and different engagement mechanisms for siblings.
The work of the Live Well team addressed the needs of siblings and families and offered solutions, such as a prototyped game, that can further be implemented by CCHMC. Opportunities such as a designated space for siblings can be implemented in the future through funding and an expansion in research.
The Game: TYS is an advantageous tool that can be used as a support tool for parents and siblings by offering a fun and meaningful experience, while bringing repressed emotions to the surface. This game includes cards that promote story sharing and meaningful dialogue between family members, enabling parents to measure the emotional wellbeing of their child and assisting siblings in their emotional journey. Not only is this game beneficial, but entertaining for everyone involved.
The Needs Assessment: The needs assessment was developed in collaboration between Cincinnati Children’s Hospital Medical Center and the Live Well Collaborative. 74 different stakeholders (siblings, parents, and clinicians) were interviewed to generate the qualitative research for this needs assessment. The assessment is meant to help individuals from an outside perspective understand and empathize with this diverse and broad population of siblings.
The Sibling Space: The criteria and considerations for the sibling space were developed through qualitative research collected from stakeholder interactions over the course of the 15 week project. The purpose of the criteria and considerations is to ensure a successful implementation and utilization of this space for siblings.
The Live Well Collaborative will work with CCHMC’s Pediatric and Orthopedic surgery center to develop an optimal perioperative pain management experience for Spine and Pectus surgery patients. The goal is to bridge an easy to understand patient/family education system with rehabilitation efforts while at the same time improving the manner in which prescriptions are disseminated to patients and families for use.
CCHMC hosted the kick-off meeting on August 25th, 2017. The meeting began with Victor Garcia presenting the brief and secondary information for Pectus Excavatum. Then the CCHMC team proceeded to answer questions of the Live Well team to further understand the Pectus Excavatum and Spinal Fusion Surgery.
During the research phase the LWC team conducted 7 focus groups with 11 clinicians and 7 families for both pectus excavatum and spinal fusion. The research phase focused on understanding the processes the patient and their families, and clinicians go through perioperatively. This information was gathered using a chart, breaking the journey into 4 time periods (pre-op, post-op, op, and home care) where patients, parents, and clinicians filled in information. We focused on how the patient and their families were thinking, feeling, saying, and doing during each step of their journey.
After our initial research and interviews we were able to identify the level of influence the stakeholders had on the patient as well as the positive and negative factors that influence the recovery process. We then created an anxiety journey map comparing the levels of stress the patient and their parents were feeling during each step of the process. After journey mapping, we found moments of high anxiety for either the patient, the parent or both, which then highlighted windows of opportunity.
The LWC team identified 5 areas of opportunities: Patient engagement, defined role of parent, right info, right time, resource options and connectedness. After a discussion on how to move forward with this project the CCHMC team came to an agreement that the ideal level of exploration is a broad system approach.
During the ideation phase the LWC team worked with the clinicians and families to co-create an ideal pain management system to span across the patient’s entire journey. The ideation phase focused on how to impact the patient and their families during each milestone. This information was gathered by having stakeholders participate in activities that sparked conversation and creation of a system.
After our initial concept ideation and co-creation sessions we were able to identify that a website, app, pocket guide, and a wearable would be most helpful to a patient and their families while going through the perioperative journey. After a discussion on how to move forward with this project, the CCHMC team determined that they wanted to see the system of tools in the context of a hero’s journey. For immediate implementation, the CCHMC team decided that the LWC team should improve the spinal fusion and PECTUS excavatum classes.
During the refinement phase, the LWC team developed the 4 tools identified as the components for the ideal pain management system. The LWC team created rough prototypes to show how each tool could be visualized. Visual prototypes of the website and app were created as well as tangible prototypes for the pocket guides.
The refinement presentation was setup like a poster forum, giving the CCHMC team the opportunity to walk around to different stations and see how each component of the system could impact the patient and their families throughout the perioperative experience. The CCHMC team also watched a video that contextualized the ideal pain management system through the lens of the hero’s journey.
The CCHMC group is very excited to continue with pain management into a second project. Internally, everyone sees merit in the project work and their next move is to secure additional funding.
The direction for a possible summer 2018 project is to fully design the AIM website, incorporating BMI involvement. Once the content is established for the website, a pocket guide could be created in tandem that same semester.
After funding is secured, people from various teams in the hospital would be tasked with figuring out the content of the website. A representative from holistic, PT, OT, pain team, etc. will identify pertinent content.
The spaces at CCHMC for end-of-life and post-mortem care are typically small and clinical, and the end-of-life process focuses on the hospital as an institution, not necessarily the people involved. The memories that families have of the last moments with their child are in a clinical environment with little privacy or comfort.
The Live Well team was tasked with improving the end-of-life experience for patients, families, and staff at CCHMC to foster a beautiful, dignified, peaceful environment for everyone involved. The design thinking process translates understanding from family and staff experience to identify opportunities to design improved delivery methods of pediatric palliative care. The project focuses on both the process as a whole as well as the physical space.
The research phase involved a combination of primary research (stakeholder interviews) and secondary research (literature review and benchmarking). With the help of resources from the CCHMC team, findings from the literature review provided a solid platform for the team’s initial understanding of end-of-life care methods.
Following the secondary research, the Live Well team moved into stakeholder interactions, where they met with 5 parents and 20 CCHMC staff ranging from hospitalists to bereavement specialists. These interviews were conducted using a tool called experience mapping. This tool utilized a general outline of all significant points along a journey and required interaction participants to map out their experiences along that journey. When conducting the interviews, the team took notes on what each stakeholder was seeing, experiencing, feeling, and thinking along the end-of-life journey. After the interviews, theme clustering on charts helped the team synthesize the information and identify patterns among the interviews.
To present the research, the team created a thorough outline of the journey based on the interviews, identifying all the stakeholders as well as positive and negative experiences the stakeholders face at each step of the process. Five overarching areas of process improvement were identified, which provided grounds for opportunity areas. The team also created 5 spatial design considerations for improving the physical space during the journey.
The ideation phase consisted of concept development that stemmed from findings in both the research phase as well as second interviews with 15 stakeholders. To drive ideation, the Live Well team used the top 3 key themes chosen by the CCHMC team at the research presentation – privacy, transition to legacy building, and parental control. These themes drove interactions with stakeholders and uncovered primary intervention areas. The team also conducted a mood boarding activity to help stakeholders describe the ideal EOL experience from their personal perspective through image and word collages. Mood boarding revealed not only spatial design criteria for new ICU and palliative care spaces, but also drove deeper insights into how the parents and staff would like the experience to feel. The top three chosen adjectives in the word collaging were: dignity, comfort, and peaceful. The top nine images chosen reflected symbols of nature, privacy, spirituality, and softness.
A week before the ideation presentation, both teams visited the styrofoam mock-up of the ICU rooms for the new tower. This tour provided clarity and insight into how to interventions may fit into the new rooms. At the ideation presentation, the Live Well team presented the 3 themes, the stakeholder mood boards, and the resulting areas of intervention: providing options, relationship building, “eye of the hurricane” moments, discreet cart, walk to the morgue, and spatial design. Each area of intervention related to at least one key theme of privacy, transition to legacy building, or parental control.
The presented concepts included:
+ “Little reminders” in quiet moments
+ In-room tablets
+ Privacy communication methods
+ Methods for facilitating family-staff discussion
+ Projectors in rooms
+ Memory-making discussion cards
+ Child Life carts
+ Discreet cart covers
+ Morgue gurney redesign
+ Comforting transfer quilts
+ Symbolism in the hallway to the morgue
+ Lighting notification system in the hallway to the morgue
Both teams discussed the concepts, and each member of the CCHMC team placed stickers on concepts that they felt were priority areas. Based on the sticker activity, the Live Well team will work on designing “little reminders” throughout the hospital, room/privacy communication methods, and strategies for obtaining transfer quilts for deceased patients.
The refinement phase consisted of further developing the best concepts from the ideation phase as determined by the Live Well and CCHMC project teams at the ideation presentation. The final concepts to refine were the transport or comfort quilt, walk to the morgue and memorial space, privacy communication system, little reminders, and spatial design considerations. The team conducted a third round of interviews with the project stakeholders to show preliminary concepts and accept feedback for further development. CCHMC staff interviews were conducted in pairs which led to more discussion and yielded more insights than individual interviews. In the interviews with staff and parents, the Live Well team brought the moodboard that was inspired by the results of the stakeholder moodboarding activity. Interviewees reacted to the moodboard and shared what they liked and didn’t like about it. Insights and quotes from these interviews served as the team’s guide in making refinement decisions.
The team did additional research of hospital workflows, individual staff responsibilities, hospital relationships with other organizations, and site visits to ensure all concepts presented have a comprehensive plan for future refinement and implementation.
Attendees at the final presentation included the Live Well and CCHMC teams, as well as three parent stakeholders, and a number of CCHMC guests. After a brief recap, the Live Well team presented the seven areas of intervention:
+ Privacy lights
+ Comfort quilt
+ Little reminders
+ Announcement lighting
+ Spiritual lighting
+ Remembrance garden
+ Spatial consideration
After the presentation, the CCHMC team began the discussion by asking for feedback from the parents. The parents felt that the privacy lights would aid communication between families and staff, but that the color of the light should not be blue since it could be inaccurately associated with code blue situations. The concepts of the announcement lighting and spiritual lighting in the morgue hallway were perceived as “lipstick on a pig” in relation to the overall effect on such a negative experience. The discussion that followed revealed that there should be a continued focus on improving the morgue hallway, especially with the construction of the new G tower. The rest of the intervention points were positively received.
This project brought much needed attention to the taboo and unglamorous topic of child death. The research has uncovered needs within the opportunity areas of privacy, parental control, legacy building, staff care, spatial planning, etc. Our work addresses these needs and offers solutions that are either immediately implementable or have a plan for their successful implementation in the current and new ICU spaces.
Keeping in mind the design and construction of the new G tower at Cincinnati Children’s Hospital, there are more opportunities for continuing and expanding upon this research.
The CCHMC and Live Well teams are discussing plans for the continuation of this project in summer 2018.
Hamilton County Job and Family Services (HCJFS) and Cincinnati Children’s both use Electronic Media Databases in order to record important information surrounding foster youth. While the databases will continue to be separate from each other, exploration around the idea of a web portal to allow each organization access to the other’s information could greatly improve the care facilitated by each organization.
IDENTITY will allow Cincinnati Children’s to share critical medical information with HCJFS caseworkers. On the other hand, it means Cincinnati Children’s will have access to the most up-to-date information pulled from HCJFS’s SACWIS system, including case information, history, and contact information, for more reliable decision-making during encounters and CHECK clinic visits. The sharing of this information should be a safe and effective solution to better understand individuals in the foster care system.
The LWC team conducted primary research in the form of interviews to figure out what information points are most important to both entities. The insights gained from the research phase provided the LWC team with a foundation for the information architecture for the web based portal.
Download Research Presentation
The goal of the ideation phase was to test how efficiently stakeholders moved through the organized content.
The goal of the refinement phase was to fine-tune the final screens, ensuring that placement and aesthetics meet all stakeholder needs.
Download Refinement PresentationDr. Todd Florin briefed the team about the project, which involves a redesign of the informed consent document for CARPE DIEM, his research study on pneumonia, and his hopes of application to other studies. Dr. Florin identified the three main issues with the ICD: readability, length, and missing elements. Our next step is the research phase. The goal of the research phase is to understand the current informed consent process for CARPE DIEM and essential elements for an improved ICD. The Live Well team will conduct qualitative interviews of prospective research participants, their parents, research coordinators, clinicians, and investigators.
The team began their research by looking into plain language. Books and online resources provided information regarding ways to make a document easier to comprehend. The team also conducted several interviews. The first interview was with Dr. Bob Frenck, and he discussed the IRB and the process of getting an ICD approved. The second interview was with two CRCs. Questions focused on their process of speaking to the patients, and about how they are educated as CRCs. Finally, the team interviewed two MDs to gain further insight into the ICD, and identify areas of opportunity. The research of Todd Timney and Tara Foltz, who have been working on simplifying the ICD since 2011, provided additional insights for the team.
The team identified many challenges and opportunities based on research for redesigning the ICD, along with other opportunities for improvement throughout the entire ICD process. The team presented research findings and possible project directions to the CCHMC team on 2/13/17. The group decided that in addition to a simplified ICD, Live Well would also address the ICD process and develop a “kit” of different tools to assist the CRCs.
The Live Well team and CCHMC team met on March 20th, 2017, for the Ideation presentation. During the ideation phase, the team conducted interviews with Dr. Frenck and Tara Foltz, held a focus group with research coordinators, and shadowed research coordinators in the ED. Live Well created initial design iterations of the shortened informed consent document and the CRC “kit,” which included an version of the take-home brochure, a rough script for an introductory video for research studies, and a door hanger concept. The team will conduct user testing with the research coordinators and the RPAC, and refine concepts for the final presentation.
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During the refinement phase, the team continued interviewing, user testing, and developing the deliverables. When we presented to the RPAC we gained the participant’s perspective of the re-designed ICD and brochure. We held a focus group with the CRCs for feedback on the ICD, brochure, and video. The CRCs helped us to make the final adjustments to the designs. Lastly, a CRC and a volunteer participated in a simulation utilizing the our new ICD and brochure design. The CRC said the new design was comfortable to use and reassured them that they had covered all of the material.
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Our team found that informed consent is a process that goes far beyond just the document. Therefore, we presented 7 deliverables at the final meeting. These deliverables can be integrated at various points throughout the process and are listed here in the order in which they would used:
+ Research Portal: ICD generating website
+ “What is Research” Slide: Slides used in waiting room explaining clinical research
+ Door Sign: Used by CRCs to help prevent interruptions
+ “What is Research” Video: An animated video explaining research
+ Shortened ICD: Redesigned ICD condensed from 8 pages to 2
+ ICD App: Interactive version of the ICD
+ Study Brochure: Supplemental handout with additional information
Next steps will include getting IRB approval on the documents and further research on developing the Research Portal.
On January 11th, 2017 LWC and Cincinnati Children’s Hospital Medical Center’s Anesthesia Induction team met to kick off the studio project. The teams discussed the project timeline and goals for the semester.
In research phase, the Live Well team explored secondary research and benchmarked existing products, environments and experiences that help with stress relief, distraction and education. Three team members followed three families through their induction process from check in to the completion of induction at Children’s. They also interviewed 17 clinicians and 6 families regarding their induction experience, and turned insights from secondary research, observation and interview into two induction scenarios that help pinpoint improvement opportunities.
One tool that was used in interviews with clinicians was a card sorting game. Clinicians were provided with cards showing currently used distraction techniques to help highlight those that are most effective in mediating anxiety during the induction experience. The team then analyzed the chosen methods of intervention and proposed “what must be true” design criteria for an ideal solution.
The Live Well team presented to the Children’s Hospital team on March 15th, 2017 regarding the four main concepts for mediating anxiety. The meeting also covered analogue products, interaction feedback, tools to visualize stress levels, as well as a series of metrics to measure success against. The Children’s team expressed interest in seeing exploration in both the physical and digital directions for the next phase of the studio project.
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On March 19th, the Live Well team presented their refinement report and deliverables at Cincinnati Children’s Hospital to an audience of about 30 people from different departments. The report included recaps of previous phases, key insights during the refinement phase, a digital role play game concept that encourages deep breathing and a physical prototype which displays dynamic light patterns when the user breathes through a mask. Live Well attendees for this presentation include Blake Lane, Edson Cabalfin, Brad Young, Shay Xie, Jenny Zhu, Gabi Lang, and Andrew Jajack.
The presentation and concepts were received very well by the audience, and the presentation was followed by a smaller team meeting with the induction team led by Abby Hess to discuss the project’s contribution to the study, project handing off, future testings of the concepts in the hospital, and so on. The smaller meeting attendees include: (Live Well Team) Blake Lane, Brad Young, Shay Xie, Jenny Zhu and Gabi Lang; (CCHMC Induction Team) Abby Hess, Anna Varughese, Lauren Hill, John Brophy, Jason Long and Susie Hull.
Going forward, the next steps for the Induction team at CCHMC include:
+ Determine partners for development
+ Construct plan for clinical testing
+ Identify future and sustainable funding
The Live Well team will follow up on patent filing and other activities.
The Asthma Team from Cincinnati Children’s came to Live Well on August 24th to discuss the details of the “TVDI” project with the design team. They elaborated on the goals of the project, talked through their existing prototype and process, and discussed the improvements they hoped to accomplish. Specifically, the team was in need of a quicker and simpler process of creating personalized videos for asthma patients. The main goal of the videos would be to further educate patients to help reduce hospital readmittance rates for asthma exacerbations.
Following the kick-off meeting, the Live Well team began the research process in order to deeply understand the problem at hand. The team created Interview Guides with the help of Shaunak Sastry and sent them over on August 26th for the IRB to review. These were approved on September 12th, and with the help of Erik Hoefgen, the team scheduled several interviews with clinicians as well as patients and families. These interviews revealed lots of information regarding experiences and challenges with asthma.
Live Well also conducted secondary research around asthma, tailored messaging, health literacy, and existing solutions for asthma education and inhaler use. On September 21st, LWC presented research to the Asthma Team and discussed plans for the Ideation phase, which would explore several possible solutions.
Research findings uncovered a lack of understanding of the disease itself, a huge barrier in developing more effective asthma education. Health literacy and clinicians communicating at a high level were also barriers in patient understanding. The Live Well team decided that focusing on standard education first would lead to a more effective tailored solution. On September 29th, the team met with Erik to develop a Patient Journey Map to better understand the full journey a patient experiences from the time they have an asthma attack to the time they are discharged from the hospital.
For the next few weeks LWC began developing solutions that would focus on specific stages throughout the patient’s journey — specifically the “Admittance” stage and the “Waiting” stage. The team also developed an assessment tool along with outlines for educational videos to be used in these stages. Live Well presented these ideations on October 26th and explained the reasoning behind these developments. The design team determined that a truly effective tailored tool could only be created after being able to evaluate the depth of patient knowledge. After a long discussion, the Asthma Team agreed that there was a larger systemic problem, but that at this time focus should be placed on enhancing a tailored video prototype.
After the Ideation presentation, the Live Well team switched gears and began creating a new tailored video prototype for the Asthma Team. The goal was to be able to fully create the video on an iPad utilizing the iMovie application. The team spent a few weeks creating rough prototypes in order to learn the abilities and restraints of iMovie. The team met with met with Teresa Baker and Andy Hare on November 22nd to record sample footage and audio for the final prototype, with the template LWC developed. Over the next week the team finalized the prototype and recorded a tutorial video for users. iMovie contains some significant restraints, so the team created a PowerPoint template as a second template option. Live Well also created short sample animations that could be used in the beginning of the iMovie videos or could live on a public YouTube playlist. On November 30th, a meeting was held to present the final “Tool Kit” to the Asthma Team.
Download Refinement Presentation
The Live Well team utilized three methodologies throughout the research phase: benchmarking, journey mapping, and interviewing. The benchmarking process identified and analyzed current education programs. Journey mapping helped the team to identify crucial tension points created by lack of knowledge or communication, and the interviews with families and clinicians were used for help with development and validation throughout the process. The team also identified which educational tools (a booklet and an app) to move forward with.
There were a total of 7 interview sessions with families and clinicians throughout the two semesters. Each session was split into 2-3 days of interviews held at CCHMC in order to accommodate to their individual schedules. The information gathered in each session varied with each week; topics spanned from journey map development to app testing. In October, the team also went to an information session at the Cincinnati Zoo, held by the Children’s Cardiac team, in order to test the app with more families.
During the ideation phase, the team worked to develop the organization of information in the booklet and the app, as well as gathering finalized content from the CCHMC team and designing the presentation of the content. The icons, pictograms, pathways, and app went through several iterations of development, testing, and refinement.
During the last sessions, the LWC team tested and refined the app, pictograms, and booklet pockets. Through discussions with the study team and the CCHMC coders, necessary modifications were made to the booklet pockets and the app due to financial constraints. The team took booklet prototypes to several printers, and moved forward with Wendling Printing. The booklet, app, and pathways were refined and finalized.
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The project will move forward in Spring 2017 with the printing of the 250 booklets for the small study conducted by Dr. Staveski. The mobile website design and content have been handed off to the CCHMC coders for development.
The Live Well Collaborative worked with CCHMC’s Heart Institute team to develop a formal, structured home care education program for parents of children with CHD and their healthcare team. The proposed home care education program began at the child/parents first introduction to the CCHMC HI and continued through ongoing outpatient follow-up. The program included web-based provider education and diverse parent education opportunities. For example, individual teaching, group teaching sessions, educational materials (such as pictograms for parents with low literacy), visually appealing documents, cardiac specific educational videos, and other electronic training materials were included.
Benchmarking Education Systems
The LWC team began by benchmarking existing education systems and seeing which elements would be incorporated into the new home care program. Three main categories were explored: print, web, and face-to-face materials. Similarities, pros, and cons were then identified.
Focus Groups
During the first phase of the project, the LWC team met with clinicians and family members to discuss the current and ideal education process. The LWC team met with 12 clinicians and 13 family members over the course of three weeks. The interaction lasted about an hour and thirty minutes and was broken into three main segments:
Journey Map: Each participant filled out a treatment timeline detailing the different stages of the process. It included various procedures, key touch points with stakeholders, and when education was performed.
Educational Material Cards: Participants were given cards with a variety of print, digital, and face to face resources. First, they were asked to pull out the resources they currently use and then select their top five ideal resources. The groups discussed after each selection.
Prioritizing Information: Educational content from the current system was written on cards. Participants were asked to prioritize the information and write in any additional information that they felt was missing. This organizational system became the starting point for creating the print resource.
Data Analysis
After completing the first round of focus groups, the LWC team analyzed the data to identify themes. There were many overlapping barriers and aspirational goals between each group. Some of these included time limitations, overwhelming amounts of information, environmental stress, and the need for reference material. Next, the Live Well team began crafting two scenarios to incorporate their learning from the journey maps and the conversations with group participants.
Research Working Session
CCHMC team members Sandy Staveski, Sam Hanke, and Barbie Giambra attended the research report out on May 31st. The presentation followed the LWC team’s process through benchmarking, interviews, and data analysis. The LWC team created two scenarios to highlight some of the frustrations and opportunities parents and clinicians have with the current educational process. The scenarios allowed the project team to empathize with the stakeholders and not lose sight of their stories within the data.
After the presentation, the CCHMC team organized the information included within the new education system. The teams also discussed logistical steps for the next phase of the project.
Initial Prototyping
The team moved forward creating four print material prototypes — a binder, pamphlet, pocket guide, and flip book. The goal was to test the structure, size, organization, colors, and paragraph and graphic style of each. A matrix was created to show which elements would be contained within each prototype. The goal was to discover which elements clinicians and parents responded the most to and incorporate these into a single prototype.
Focus Groups
The focus groups included three sections: a prototype co-creation session, questionnaire, and image and icon testing. The majority of the time was focused on discussing the prototypes — what elements were working, what elements were not working, and how the content should be represented. To accompany the qualitative co-creation session, the Live Well team created an eight question survey designed to collect quick data on participants’ preferences about structure, information presentation, and design preference.
After receiving feedback from the clinicians, the Live Well team refined the prototypes before meeting with the families. The families were presented with both versions so that they could see the progress and determine if the design was moving in the right direction.
Insights
The Live Well team utilized both the conversations and questionnaires to determine insights from the initial prototyping. Looking broadly, the clinicians felt that the amount of information received and kept by the parents should be minimal and direct to avoid confusion and information overload. The families wanted all of the details and felt that they needed to keep and process all of the information (verbal, digital, and analog) they received. The Live Well team analyzed the questionnaire data in conjunction with pros and cons from the conversations to better understand each group’s preferences. The three main takeaways were:
Sustainability — The tool needs to be continually updated and personalized for different patients.This makes the ability to add/remove pages critical. Custom tabs and printing costs need to be considered as well.
Usability — The new tool needs to be contained and sturdy so that it does not get ruined going back and forth from the hospital. The information included needs to meet both clinician and family needs without being overwhelming.
Visual Language — Clinicians and families are both looking for simple elements that convey caring and comfort. Visuals should make the tool easier to understand and navigate.
Camp Joyful Hearts
The Live Well team attended Camp Joyful Hearts — a week long camp hosted by the Heart Institute for kids ages 7-16. This year, nearly 150 children attended. The camp is fully supported by the Heart Institute staff and features everything you would normally find at summer camp — swimming, arts and crafts, canoeing, ice cream, and field-day type games. The Live Well team volunteered with the kids for an afternoon and had fantastic time!
Ideation Working Session
CCHMC team members Sandy Staveski, Nicolas Madsen, Barbie Giambra, and Christine Alvarez attended the ideation working session on July 5. The Live Well team presented their data findings supported by conversation insights before completing two different interactions. First, the Live Well team asked the CCHMC group to further refine the icons they created for the tool. Then, the group discussed which direction the project should take — an all inclusive, binder-like archive or a quick reference “survival guide.” Ultimately, the group decided to move in the direction of a survival guide because it fills an unmet need for families and clinicians and is a more novel idea.
Next steps:
Utilize universal design while refining prototypes to meet the needs of high and low literacy families. Determine a final design language to make the tool exciting and inviting for parents and clinicians. Create a final implementation strategy after gathering more feedback from clinicians and families.
RPI Graphics Tour
The Live Well team toured RPI Graphics, a print and marketing company on Cincinnati’s West Side, to see samples of different print materials. The trip allowed the LWC team to see more innovative prints, understand the printing process, and test paper samples and binding styles.
Parent Phone Calls
After the ideation presentation, the Live Well team reached out to parents to receive their feedback on the new direction. This information was incorporated into the final design and implementation strategy.
Critical elements — The Live Well team asked what content elements would be essential for them in a “survival guide.” All of the parents mentioned needing a place to keep the most current information including test results, medication, and diagnosis information.
Meeting an unmet need — Each parent had their own system for maintaining current information and passing it on to other important people such as babysitters, grandparents, and schools. This included creating Word documents, making copies of handouts, and making individual folders for different things.
Need for archive system — Every parent kept their child’s files in some way, most in a binder. This archive system contained all of their child’s medical records, was available for reference as needed, and was used to identify patterns in their child’s behavior.
Children’s Hospital came to Live Well with a unique challenge regarding sickle cell disease and hydroxyurea treatment education for providers. Currently, hydroxyurea is a treatment option that has great potential to increase the quality of life and expectancy of sickle cell disease patients. The challenge, however, is that many providers who have sickle cell disease patients and are not hematology specialists are not well educated in hydroxyurea treatment protocol and the NHLBI guidelines (National Heart Lung and Blood Institute).
Live Well Collaborative partnered with Children’s Hospital and the STORM network (Sickle Treatment Outcomes Research in the Midwest), to create an educational toolkit that would help providers effectively learn about hydroxyurea treatment protocol. Over the span of 15 weeks, the Live Well team would interview 20 providers and specialists, host a co-creation session of 30 participants, and develop an arsenal of tools that would provide a holistic education of the hydroxyurea treatment process.
Interviews
The Live Well team accomplished 20 interviews which included a mix of hematology specialists, pediatricians, and blood/sickle cell disease researchers. The team focused on questions that provided insight into hydroxyurea protocol and its obstacles, patient obstacles with hydroxyurea treatment, and range of knowledge of the NHLBI guidelines. These interviews provided the team with an in-depth understanding of the obstacles and goals that providers are currently facing with hydroxyurea protocol.
Interview Activity
Each interview was concluded with an activity that was designed by the Live Well team. The objective was to learn what preferred learning methods were most prevalent across all interview participants, as well as what they perceived as their patients' preferred learning methods. The team later synthesized this data in order to start breaking down potential tools that would later be integrated into the toolkit.
Key Takeaways
After all the interviews were concluded, the Live Well team synthesized all of the activity data and found that most providers prefer learning tools that include face to face interaction such as seminars and lunch and learns. The drawback to these learning tools is that they are very time consuming and not practical for daily education. The team decided that the ideal tool needed to be something that providers could access quickly and easily throughout the day.
Research Presentation
The Live Well team presented their interview findings and insights to the CCHMC and STORM team at the end of the research phase. The presentation featured a combination of research including benchmarking of different tools, their strengths and weaknesses, and synthesis of interview insights. The team concluded the presentation with an activity for the CCHMC and STORM team, where they were asked to use game cards to organize how specific tools related to web-based learning, face-to-face learning, and paper based learning. This helped the team brainstorm how tools could be transformed to accommodate different learning styles. At the end of the presentation the Live Well team and CCHMC decided that a website would be the best platform for the hydroxyurea toolkit.
Ideation Presentation
The Live Well team presented the co-creation analysis and ideation toolkit to CCHMC and STORM in late October. The presentation included all quantitative and qualitative data gathered at the session, and expanded on the development of the website HELP SCD (Hemoglobinopathy Education and Learning for Providers). The website would be organized by visit time (before, during, and after) so that providers could easily navigate the site to find relevant tools. When designing these tools Live Well identified three major goals that emerged out of the co-creation session. These goals were education, communication, and treatment optimization. All tools that were to be designed would accomplish these goals.
In addition, design of supplemental tools that would work with the website, such as a pocket guide and interactive pamphlets, was also presented.
Co-Creation Session
The Live Well team hosted a co-creation session with the CCHMC/STORM team, and 30 participants who represented various stakeholder groups (providers, patients, and administrators). The goal was to gain both quantitative and qualitative data about learning tools, and how these tools help patients and providers overcome obstacles and accomplish goals. The team achieved this by creating the Hydroxyurea Depot, where participants chose specific tools that they preferred and ranked them on their tool belt from most preferred to least preferred. Afterwards, participants were separated into groups and had to collectively choose their five favorite tools to make a toolbox. Lastly, all groups used their tool boxes and belts to accomplish three scenarios. Groups were asked to identify each scenario’s obstacles, what tools would best be used to overcome the obstacles, and what the goals were.
Co-Creation Session Analysis
The team began by synthesizing the quantitative data from the tool belt and boxes. We took each provider’s tool belt and gave each tool points depending on the priority of the tool on the belt. For example if “website” was in the first tool slot, and was first on two tool belts, “website” would have a total of 10 points. This weighted and prioritized preferred provider tools. The same was done for the group tool boxes. After provider tools were analyzed, the team examined how providers utilized tools in the three different scenarios. This gave the team qualitative data about how and why these tools were important, and also showed the team how the tools could be organized to optimize education. The team created a series of diagrams to illustrate which goals were accomplished by different tools, and how they would be organized on the website based on the timeline of the patient’s visit.
Benchmarking Tools
The Live Well team started designing the toolkit by researching how existing institutions and companies had interpreted these tools. After the team had researched several different strategies of creating the tools we held a conference call with CCHMC and STORM teams to identify which tools they felt would work successfully with the HELP SCD website. After the benchmarking was identified, production of the tools could begin. Tools that were studied included: learning modules, frequently asked questions, pamphlets, website layouts, and checklists.
Final Presentation
The Live Well team presented the HELP SCD website prototype and supplemental tools to CCHMC and STORM in early December. HELP SCD was developed using marvelapp.com and was composed of almost 100 images that depicted how one may use the site. The style of the website was designed to appear reliable, credible, and intuitive. Many unique features were included such as a note taking box, various ways to save and print material, and a newsletter that providers could sign up for to receive content updates. The team also showed how the website could be translated into a binder for providers who prefer to not use a computer during patient visits. The final Pocket Guide and Pamphlet design was also presented and coordinated with the branding of the HELP SCD website. Live Well was not responsible for any content on hydroxyurea protocol, but instead focused on how various tools could be organized within HELP SCD and work cohesively together.
During this phase, the team focused on the design of the user interface based on the previously constructed wire frame.
Parents were requested to complete several surveys on both a paper platform and a digital platform.
Parents navigated through four different visual concepts through a digital prototyping tool called Marvel. These prototypes served as the basis for testing the look and feel of the app. The team asked parents to perform specific tasks and requested that parents give their feedback on how easy or difficult it was for them to complete those tasks. Each parent scored the efficiency of the prototypes.
Then the team laid out the icon testing materials, color schemes and background images for parents to compare and score based on readability.
Updates:
+ Concept Results: A concept with a familiar navigation and live feed was desired. The calendar feature should provide appointment information, location, time, what to expect, and who they will be seeing. The app should be able to sync with other calendar and organizational apps.
+ Icon Results: Icons read easier when using a similar graphic language. The calendar icon should incorporate a live date feature.
+ Color Scheme Results: Families wanted a cool color palette with high contrast notifications.
The LWC team presented the five prototypes and the testing processes to the CCHMC core team and developers. The team also showed the analysis of the results from the research co-creation sessions.
Updated:
+ The CBDI Calendar will sync into the IMPACT app.
+ We synthesized the results from the five concepts and made a strategic design plan moving forward into the refinement phase.
We combined key features from our five conceptual prototypes into one layout. We refined that layout to incorporate functions from apps that we previously benchmarked.
The team asked parents to perform different tasks and give their feedback on how efficient the refined concept was and what kind of functions and information they preferred to see on the home screen.
Updated:
Two rounds of co-creation with parents helped further refine the concepts.
The original problem statement, solution and goals were recapped. The final information architecture was presented.
The refined layout and icon system was shown. The functionality and interactive features within the final IMPACT prototype were highlighted.
Updated:
+ Education sub navigation needs to be modified.
The Opportunity
PhD Ahna Pai from Cincinnati Children’s Hospital is the head of the Uncertainty Study and wants to create an educational app that helps parents who are suffering from the initial shock of learning that their child has cancer. Pai wants the app to introduce the information currently presented to the parents in a less intimidating manner that can empower them to face and fight cancer with their children.
The Challenge
Currently, when parents are told that their child has cancer, they receive a large, intimidating binder filled with all the information they need to know about the treatment process. Most parents do not use the binder after they receive it, thus creating a feeling of uncertainty. This in turn can affect the child, making them feel more stressed.
The team researched various articles on the topic of uncertainty, along with the article provided by Ahna Pai of her findings. We looked into other medical apps to see how they mediate the issue currently, along with other apps that have similar information to deliver.
The team conducted various one on one interviews with staff from all departments of the hospital related to cancer, as well as interviews with the parents of children in different stages of treatment. We asked them a series of questions to better identify what some of their difficulties were and how they led to any feelings of uncertainty.
A presentation on our findings was given. It contained the data we collected from the interviews as well as our secondary research. We then conducted an activity to determine which challenges were of highest priority for the app to address.
The app will be information based with a few areas of personalization.
Parents were asked to complete a few surveys on a digital platform that recorded their preference of functions and navigation types for the app. They were also asked to describe what they liked and didn’t like about various apps we benchmarked outside of healthcare.
The team created wireframes based off of the feedback from all the surveys and discussions from the families. These wireframes served as the base of the next activity with the families and were presented at the Ideation presentation. There were 3 different concepts that showed different types of navigation, as well as different hierarchies of the functions from the priority activity.
A presentation was given comparing the priority activity from the staff with the priority survey from the families. This data was then translated into the initial wireframes. At the end of the presentation, the core team further discussed the functions of the app and how interactive they might be, along with feasibility of coding.
Updates:
The team would like the app to be interactive with the patient’s schedule and treatment.
Parents were asked to group the categories defined by the priority activity in ways that made sense to
them in reference to the app. They were also asked to give these categories names. The team took this data
and quantified it across all families to decide how many groupings will be on the app.
Parents navigated through four different wireframe concepts through a digital prototyping tool called Marvel. The team asked the parents to perform different tasks and give their feedback on how the concepts worked for them.
Updates:
The families seemed to identify the different functions in different ways. Some of the functions could perform in a purely informative way, while some could also perform in an interactive way. All of them seemed to want an app that they could manipulate more and that could update with their information automatically.
The final presentation showed the official architecture for the app, as well as the final proposed wireframe. The wireframe showed how the app can be informative with educational materials and how it can adapt to an interactive function for some of the features.
Updates:
All the features presented were well received; the team will wait to hear from the developer team on feasibility
of the interactive portion. The wireframe will continue to be tested and added to. The client team will provide a list
of features they want to be shown through a new feature describing the Uncertainty Study. The main feature
the client wants to be interactive is the My Journey section.
The Opportunity
Currently, preparation of foster youth for entry into independent living focuses on a broad range of skills and occurs 6-18 months prior to aging out of foster care in three settings: foster placement, classroom didactics, and mandated healthcare visits.
• It is the expectation and responsibility of adults in a teen’s current placement (i.e., foster parents, staff in group homes, caseworkers) to promote independent living skills in all youth ages 15 and older.
• Second, there is a required classroom-based curriculum that all youth must complete before they are moved into their own apartment.
• Finally, there are mandated visits with the CHECK Foster Care Clinic at CCHMC, which provides comprehensive health evaluations concurrent with a move to independent living.
The Challenge
There are not systematic education materials provided to youth that addresses:
• Health
• Access to healthcare
• Healthcare utilization
• How to navigate the healthcare system
Stakeholders in all three settings are eager to implement training and educational materials that will assist youth with developing the knowledge base and skill-set needed to maintain their health and appropriately engage in the healthcare system.
The team researched various articles on the topic of healthy living, education, demographics of foster youth, and information provided by the CHECK center. We looked into other medical websites to see how they mediate the issue currently, along with other websites that have similar information to deliver.
Download Research PresentationTo kick off the Foster Care Healthcare transition project, the first task was to go and learn the foster care system from the inside. The team met with several professionals that were target stakeholders, which included social workers, non-profit organization leaders, independent living specialists, as well as foster youth themselves.
The design team presented their Foster Care Research Presentation to the Children’s core team, showcasing the full spectrum of research conducted. After the presentation, the team conducted a driven discussion to determine which design solution to pursue. During this discussion, the teams collaborated and decided to pursue the “flip book” option.
Download Research Presentation
After the team had a clear direction on what type of product to design, it was then time to start prototyping. The team decided to create a variation of prototypes to take to various stakeholders within Hamilton county. We came up with 3 size variations:
1. A small index size with 1 corner ring
2. A flip book with one corner ring
3. A small 3-ring binder
Through these collaborative efforts during co-creation sessions we could make accurate design decisions that were inspired by our users.
When showing the different prototypes to our audience, we created a way to record their thoughts through the use of questionnaires. By filling out the questionnaires, we were able to come up with full-proof statistical data on what the majority of the stakeholders felt to be the most successful design.
After showing off our prototypes, we were able to get feedback from 12 youths in foster care, 11 foster parents, and 4 agency workers. The results showed that the youth and the agency workers preferred the small index size for its discreteness and portability. The foster parents preferred the binder because of its space and functionality. Since the foster youth were our main target audience, we decided that their opinions were the ones that were most valuable.
The next step for the design team after presenting our final concept was to refine our design. Through co-creation the team received feedback from youth in foster care along with the other healthcare professionals on content, color, and imagery.
Major changes included:
1. adding and editing content
2. changing icons
3. using CCHMC branding color palette for different sections
After the design had been finalized and approved by all members of the project, the next step was to find a printing company that had great quality, customizability, and could produce 250 guides for around $8 a guide.
The company that matched the criteria was RPI Graphics, located in Cincinnati’s west side. Through collaboration with their design team, as well as additional sponsorship, the team was able to decide on a price of $2972 for 250 guides, or $11.88 a guide.
The printing features included:
1. front and back cover lamination (2-sided)
2. 8 die-cut tabbed pages
3. single-side lamination for tabbed pages
4. hole punched
5. 5 cover variations printed and packaged separately.
While simultaneously working on getting the final guides printed, the team also gave their final presentation of the CCHMC Healthcare Guide. They presented the foster care journey through the semester, and received support and funding from additional CCHMC members to help with printing and implementation.
As a learning tool to help our our audience understand the benefits and functionality of the design, the design team created a video demonstration that highlights a few of the useful features that the healthcare guide provides.The story is about a character named “Chris,” an 18 year old young adult who just has been the foster care system for 5 years and just entered independent living. He realizes living on his own and balancing his healthcare is no easy task, so he relies on the guide to help him out when he doesn’t know what to do.
After working for 15 weeks, the team (in collaboration with Cincinnati Children’s Hospital) debuted http://sicklecelltrait.org/ , a fun, educational website directed at teens, young adults, families, and athletes, for teaching the community about sickle cell trait. Through education comes smart decisions!
Follow-up on summer studio from last year with the goal of developing patient self-management tools to improve the transition from pediatric to adult care for patients with sickle cell disease.
Goals
1. CCHMC team to obtain hands-on experience implementing the Live Well Collaborative’s design thinking model via participation in follow-up studio around the transition from pediatric to adult care for individuals living with sickle cell disease (SCD).
2. Develop patient self-management tools to improve treatment adherence (medications, clinic visits, tests/procedures, healthy lifestyle behaviors) for adolescents and young adults with SCD.
3. Understand the most effective ways to use these and existing self-management tools (e.g., web-based interventions, mobile interventions, etc.) to improve treatment adherence and transition readiness.
4. Prepare interventions/solutions developed for dissemination and evaluation.
Four concepts were presented at the initial concept presentation.
Explore patient-provider tools to improve the transition from pediatric to adult care for patients with sickle cell disease.
Goals
1. CCHMC team to obtain hands-on experience implementing the Live Well Collaborative's design thinking model via participation in a studio around the transition from pediatric to adult care for individuals living with sickle cell disease.
2. Conduct a stakeholder analysis (15 consumers) to better understand the most significant problems in transitioning from the pediatric to the adult health care system.
3. Benchmarking: identify leading edge examples of other transitions if there are any already in place.
The team developed a storyboard and video for the personas.
For Phase 1 of the research, our team conducted three observations and thirteen in-person interviews across six disciplines (MD Attending, MD Fellow, APN, PCF, RN, and RN) within the PICU. The purpose of these interviews was to enhance our understanding of the PICU unit and the roles and responsibilities of each discipline. Additionally, the LiveWell team had the opportunity to conduct three in-person observation sessions in the PICU—two in the morning and one at night. The goal of these observations was to gain firsthand insight into the PICU workflow and the collaboration between teams.
Download Research PresentationDuring the ideation phase, the Live Well team analyzed information gathered from our observations and interviews in the research phase. We worked as a team to ideate how to best organize this information visually, in a way that was thorough and accurate for current and knowledgeable PICU staff members, as well as straightforward and easy to understand for those who are being educated about how the PICU works.
The team created a “mother map”, which covered the day to day tasks of each PICU team member, as well as scheduled events on the PICU floor. This included Hand-off, Rounds, Summary, and Huddle. It also highlights the different communication methods and “sources of truth” that each team member relies on when going about their routine.Next, we worked on mapping out the unscheduled events that happen on the PICU floor, including different types of admissions, as well as emergency code events for deteriorating patients. These were visualized based on our observations of these events during our time on the PICU floor. We also witnessed an eCPR code blue simulation, which proved very helpful for accurately representing the process and communication flows of that stressful, fast-paced event.
During the refinement phase, the team restructured some of our maps and visualizations and continued to expand on the insights we gathered from our feedback sessions in the Ideation phase. We also went back to the PICU and gained personal feedback from team members in each position. Additionally, we held a validation workshop after a huddle session where we received more feedback from other positions we hadn’t talked to at length before. This was also helpful because they were able to look at our maps and make suggestions that could immediately be implemented and confirmed right there. The team also worked on scripting and finalizing the animation videos for the final report-out.
Download Refinement PresentationAfter our final report out, we handed off the project to the PICU team to be implemented internally.
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