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Service design for a virtual hospital

In November of 2019, Women’s College Hospital launched Women’s Virtual, Canada’s first virtual hospital. In preparation for this launch, WCH partnered with HHF to map their existing services, identifying opportunities for virtual transformation that matter most to both patients and providers.

Client

Women’s College Hospital

Services

Ethnographic Research, Service Design, Co-Design Workshops

Challenge

As health systems transform in pursuit of value-based care, sustainability, and exceptional patient and provider experiences, technology is often looked to as the answer.

Women’s College Hospital (WCH), a world leader in health for women, health equity, and health system solutions, has set out to become Canada’s first virtual hospital. As they build a virtual strategy for their organization, they sought to lead with people rather than technology. To this end, in partnership with HHF, a service design project was launched. Service design is the application of design thinking to the creation or improvement of a service. It blends systems thinking, human factors, and the designer’s toolkit to create cohesive and meaningful experiences through service provision. Our engagement aimed to understand the people, workflows, and technologies that enable the delivery of care and to identify the priority opportunities for virtual care and the implications they present for the people expected to adopt them.

Process

Discovery

The project began with immersive ethnographic research across perioperative and mental health services. Observing and interviewing patients and clinicians enabled the team to uncover the current processes, pain points, cultural norms, and attitudes towards change that exist in each clinical area. To expand the opportunity areas, primary research was also conducted in long-term care homes to understand the role that virtual care can play in supporting patients to age in place.

One of the key insights that stemmed from the immersion was that virtual care meant different things to different people. For administrative staff, it meant improving collaboration with family doctors to improve the referral process, and improving scheduling processes to improve access. For clinicians, it often referred to remote consultations and remote monitoring of patient care.

There are so many incredible people here and sometimes it feels like the programs end too quickly. So an opportunity to extend care into the home would be so appreciated.

Patient

Virtual care is about so much more than the video visit.

Co-Design

This research culminated in the co-design of a series of service blueprints that illustrated the patient journey, and front- and back-stage actions of the providers that make up the care team. The blueprints also highlighted the key pain points felt by patients and clinicians that could be addressed through technology and virtual service. Those pain points were translated into opportunities that were prioritized by key stakeholders, identifying those that would most impact the patient and provider experience. The implications and critical success factors for each opportunity were then discussed and debated.

Outcomes

By mapping the complexities of the people, processes, and technologies that currently make WCH services possible, we were able to create a people-centred framework that lays out for the priority opportunities for virtual care and the considerations that must be made as changes are designed and implemented. What the framework achieves is both a roadmap for WCH as they work towards their virtual strategy, as well as a foundation for an implementation and change management plan that is grounded in the needs of people.

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This map outlines the virtual care priorities as identified by patients, clinicians, and other key stakeholders. It is organized into the four components of Women’s Virtual model.