Compassionate Design: Utilizing Design Thinking to Preserve Sanctity, Dignity, and Personhood When Children Die

Grossoehme, Daniel H.; Mark, Melissa; Lane, Blake; Rednour, Allison; Thienprayoon, Rachel

doi:10.1097/pq9.0000000000000317

Cited by 5 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 Additionally, we hypothesize that home visits can build the child’s dignity and personhood, cementing their position of value in the discipline and practice of HBHPC, especially as a child approaches their end of life, as well as for their caregivers in the immediate postmortem period. 29…”

Section: Discussionmentioning

confidence: 99%

“…6 Additionally, we hypothesize that home visits can build the child's dignity and personhood, cementing their position of value in the discipline and practice of HBHPC, especially as a child approaches their end of life, as well as for their caregivers in the immediate postmortem period. 29 Social components and the emotionally safe environment the caregivers described may prepare for and facilitate future decision-making conversations. When providers assume the travel burden and meet children and families in their environments, demonstrating a personal relationship with the child and family, caregivers can recognize the providers' valuation of their child and themselves to a greater degree than in ambulatory or inpatient settings.…”

Section: Reducing Family Travel Burdenmentioning

confidence: 99%

See 1 more Smart Citation

“It’s a Different Conversation”: Qualitative Analysis of Pediatric Home-based Hospice/Palliative Care Visits’ Perceived Value

Grossoehme,

Sellers,

Accordino

et al. 2023

Pediatric Quality &Amp; Safety

Self Cite

View full text Add to dashboard Cite

Introduction: Home-based hospice and/or palliative care (HBHPC) is an important and increasingly utilized aspect of care for children with serious conditions—those with high mortality risk, which either impacts their quality of life or carries a significant caregiver burden. Provider home visits are a core feature; however, the travel time and human resource allocation are significant challenges. Balancing the appropriateness of this allocation requires further characterization of the value of home visits to families and identification of the value domains of HBHPC for caregivers. For study purposes, we defined a “home visit” as an in-person visit by a physician or advanced practice provider to a child’s residence. Methods: The methods include a qualitative study using semistructured interviews and a grounded theory analytic framework enrolled caregivers of children aged 1 month to 26 years receiving HBHPC from either of 2 U.S. pediatric quaternary institutions between 2016 and 2021. Results: Twenty-two participants were interviewed; the mean (SD) interview duration was 52.9 (22.6) minutes. The final conceptual model has 6 major themes: communicating effectively, fostering emotional and physical safety, building and maintaining relationships, empowering the family, seeing the bigger picture, and sharing burdens. Conclusions: Caregiver-identified themes demonstrated improved communication, empowerment, and support from receiving HBHPC, which can facilitate enhanced family-centered, goal-concordant care.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Reducing Family Travel Burdenmentioning

confidence: 99%

“It’s a Different Conversation”: Qualitative Analysis of Pediatric Home-based Hospice/Palliative Care Visits’ Perceived Value

Grossoehme,

Sellers,

Accordino

et al. 2023

Pediatric Quality &Amp; Safety

Self Cite

View full text Add to dashboard Cite

show abstract

“…This DT project was facilitated by the Live Well Collaborative (LWC), a non-profit organisation run by a multidisciplinary team of faculty and students with design expertise from the University of Cincinnati, mirroring previous collaborations with other groups at our tertiary paediatric institution. 19 20 LWC team leads engaged healthcare providers (nurses/nurse practitioners/physicians from anaesthesia, pain, pectus/spine surgical teams and behavioural medicine, physical therapy, integrative care and hospital medicine), and partnered with them to identify and invite adolescents and their caregivers who underwent Nuss procedure or spinal fusion (for idiopathic scoliosis) between June 2016 and June 2018, and their caregivers, to participate in this project.…”

Section: Methodsmentioning

confidence: 99%

Design and implementation of a novel patient-centered empowerment approach for pain optimisation in children undergoing major surgery

et al. 2022

View full text Add to dashboard Cite

BackgroundPaediatric surgery is a stressful experience for patients and caregivers. While standardised protocols are the norm, patient-centred approaches are needed to empower patients/caregivers for an optimal perioperative pain experience. To address this gap, we employed a patient-centred approach using design thinking (DT) methodology to develop insights, map processes, identify opportunities and design solutions for individualised empowerment tools.MethodsIn consultation with DT experts, a multidisciplinary team of stakeholders (healthcare providers, patients who underwent pectus excavatum/scoliosis surgery and their caregivers), were invited to participate in surveys, interviews and focus groups. The project was conducted in two sequential stages each over 24 weeks—involving 7 families in stage 1 and 16 patients/17 caregivers in stage 2. Each stage consisted of three phases: design research (focus groups with key stakeholders to review and apply collective learnings, map processes, stressors, identify influencing factors and opportunities), concept ideation (benchmarking and co-creation of new solutions) and concept refinement.ResultsIn stage 1, mapping of stress/anxiety peaks identified target intervention times. We identified positive and negative influencers as well as the need for consistent messaging from the healthcare team in our design research. Current educational tools were benchmarked, parent-child engagement dyads determined and healthcare-based technology-based solutions conceived. The ‘hero’s journey’ concept which has been applied to other illness paradigms for motivation successfully the was adapted to describe surgery as a transformative experience. In stage 2, patient and caregiver expectations, distinct personas and responses to perioperative experience were categorised. Educational tools and an empowerment tool kit based on sensorial, thinking, relaxation and activity themes, tailored to parent/child categories were conceptualised.ConclusionDT methodology provided novel family centred insights, enabling design of tailored empowerment toolkits to optimise perioperative experience. Adapting the hero’s journey call to adventure may motivate and build resilience among children undergoing surgery.

show abstract

“…Our clinical team, with internal funding, collaborated with the Live Well Collaborative, a design research group, to actively employ a validated design thinking process [19][20][21][22][23][24] to prepare for the new clinical space and reduce risk. Throughout a 15-week period, we advanced through research, ideation, and refinement processes to identify the target of improvement efforts.…”

Section: Design Thinking Processmentioning

confidence: 99%

Use of design thinking and human factors approach to improve situation awareness in the pediatric intensive care unit

Gifford,

Butcher,

Chima

et al. 2023

Journal of Hospital Medicine

View full text Add to dashboard Cite

BackgroundOptimal design of healthcare spaces can enhance patient care. We applied design thinking and human factors principles to optimize communication and signage on high risk patients to improve situation awareness in a new clinical space for the pediatric ICU.ObjectiveTo assess the impact of these tools in mitigating situation awareness concerns within the new clinical space. We hypothesized that implementing these design‐informed tools would either maintain or improve situation awareness.Design, Settings, and ParticipantsA 15‐week design thinking process was employed, involving research, ideation, and refinement to develop and implement new situation awareness tools. The process included engagement with interprofessional clinical teams, scenario planning, workflow mapping, iterative feedback collection, and collaboration with an industry partner for signage development and implementation.InterventionImproved and updated communication devices and bedside mitigation plans.Main Outcome and MeasuresProcess metrics included individual and shared situation awareness of PICU care teams and our patient outcome metric was the rate of cardiopulmonary resuscitation (CPR) events pre‐ and post‐transition.ResultsWhen evaluating all patients, shared situation awareness for accurate high‐risk status improved from 81% pre‐transition to 92% post‐transition (p = .006). When assessing individual care team roles, accuracy of patient high‐risk status improved from 88% to 95% (p = .05) for RNs, 85% to 96% (p = .003) for residents, and 88% to 95% (p = .03) for RTs. There was no change in the rate of CPR events following the transition.

show abstract

Compassionate Design: Utilizing Design Thinking to Preserve Sanctity, Dignity, and Personhood When Children Die

Abstract: Supplemental Digital Content is available in the text.

Cited by 5 publications

References 10 publications

“It’s a Different Conversation”: Qualitative Analysis of Pediatric Home-based Hospice/Palliative Care Visits’ Perceived Value

“It’s a Different Conversation”: Qualitative Analysis of Pediatric Home-based Hospice/Palliative Care Visits’ Perceived Value

Design and implementation of a novel patient-centered empowerment approach for pain optimisation in children undergoing major surgery

Use of design thinking and human factors approach to improve situation awareness in the pediatric intensive care unit

Contact Info

Product

Resources

About