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Design Thinking for Nurses

A new course teaches students one of the most effective systems for  innovation.

Nurses are change agents. They innovate. They solve problems – and not every problem they face is clinical. A new course at Penn Nursing, drawn from the world of design and engineering, offers a practical method for rapid innovation.

Taught by Penn Nursing Director of Innovation Marion Leary RN MSN MPH FAHA, Innovation in Health: Foundations of Design Thinking introduces a methodology that begins by understanding the problem “through the eyes of people who are experiencing it,” says Leary. The five-step process starts with empathizing with those who face the problem you want to solve. When you can understand their problem you’re ready for step two: defining the problem. Think of this as a guiding principle to which you’ll return throughout the project. Next comes ideation–brainstorming–where team members share ideas for a solution. Then you build and test a prototype. “Those are the steps,” says Leary. “But they’re not linear. You’re always checking in with the stakeholders and community members affected by the problem.” In the hands-on course, teams of students learn Design Thinking by tackling real-world challenges. At the end of the semester, the teams pitch their prototypes to a panel of innovation experts.

One team in the inaugural fall 2018 session looked at a typical health care problem: Parents of children hospitalized with acute illnesses want to spend as much time as possible involved in their child’s care, but not all can afford the opportunity to stay bedside. Who can’t empathize with these parents? They’re stressed; many are rushing from the hospital to their jobs and homes, often caring for other children. According to team member Paige Madison Sinclair RN MSN OCN, a class of 2018 health leadership grad, they miss critical information about the child’s care plan, owing to conflicting schedules with busy clinicians.

Knowing that there had to be a better way for families and clinicians to communicate, the team designed a “virtual rounds” mobile app for families to access information from providers’ rounds. The app enables doctors and nurses to streamline their documentation, allowing parents to stay involved in their child’s care plan while away from the bedside.

“Innovation is not always creating new medical devices,” says Leary, “but reimagining existing systems and applying them to new areas.” Design Thinking works well in health care innovation, she says, because it’s faster-paced than the traditional scientific research process, which can take years. “Design thinking creates rapid prototypes, and allows you to fail fast and then begin again to find just the right solution.”

The course exceeded Paige Madison’s expectations. “I would say to a nursing student that while you may be focused on completing your clinical tasks throughout a shift, it is vital that you start to challenge yourself to look at the bigger picture of how we can improve patient care and clinician workflows through the intersection of technology and design thinking.”

Innovation in Health: Foundations of Design Thinking is open to nursing students as well as upper-level undergrads and graduate students from all schools at Penn.

Design Thinking in Action: Start with asthma, end with an app.

One of the teams in Marion Leary’s Design Thinking class took on a problem common in schools: Children with asthma tend to suffer attacks after running around during recess. Erin Kennedy, David Norris, and Lauren O’Malley used design thinking to create a teacher-friendly app. They describe the process.

1. Empathize

At the beginning of the course, we knew that our group wanted to focus on improving the health of elementary school students, and we all had some experience working with children in the past. However, we learned that it is really important to adopt a “beginner’s mindset” and try to view a situation from a different perspective. Our first instinct before meeting with the stakeholders was to focus on improving students’ nutrition. After discussing our ideas with them, we discovered some pressing issues like asthma, which we could make a greater impact on through simple design solutions.

2. Define

In class, we learned how to dissect the information that we gathered from our stakeholders about the problem of asthma in schoolchildren and define a specific part of the problem. All students diagnosed with asthma are issued an individualized asthma action plan by their care provider which contains important information about their asthma care. However, the action plan is filed away on paper in the nurse’s office making it difficult to access. Since teachers do not have easy access to the action plans and most have not received any medical training, they reported that they either didn’t know what to do if a student had an asthma episode, or they were hesitant to intervene. We wanted to improve teachers’ ability to administer treatment quickly and confidently.

3. Ideate

Through in-class activities, we brainstormed how we could address the lack of an organizational system for the action plans, the difficulty in accessing the action plans, and the teachers’ discomfort and fear about helping their students with asthma. Setting a short time limit, we each came up with as many ideas as we could. Then we collaborated, incorporating many aspects of these ideas into our project goal. Eventually we came up with our solution: place QR code stickers on each child’s inhaler that would link directly to their action plan and play audio instructions for how to administer an inhaler.


4. Prototype

We created a prototype by making a Dropbox folder, uploading a fake asthma action plan, and using a free QR code generating website to assign a code to the Dropbox link. We printed QR codes on a sheet of stickers and stuck one on an “inhaler” we made out of clay. Using our phones to scan the QR code, we were immediately directed to the action plan. Ideally, the QR code would scan to a customized asthma action plan that would have an audio component embedded. This audio component is the same idea as an AED and would walk the teacher through the process of administering the inhaler to the student. The name of “Q-Air” came from a fellow student in the class during one of our feedback sessions.

5. Test

We tested the prototype with our classmates and incorporated their suggestions. We made a video to demonstrate how the Q-Air system could be implemented in schools and how it could be used in an emergency setting. And we pitched Q-Air to our classmates, Professor Leary, our stakeholders, and a panel of judges who are active in the Penn innovation field. From here, we hope to further this project and continue to test it.