Venous Thromboembolism (VTE)

How can we safely, properly and confidently care for patients who are diagnosed with a blood clot?

WORK AT
Mayo Clinic - Center for Innovation

TIMELINE
12 months

ROLE
Lead Service Designer/ Design Researcher

ACTIVITIES
Patient / Provider observations
Stakeholder interviews
Workshop facilitation
Design challenge creation
Prototype development and testing
Process mapping
Synthesis presentation
Secondary research / literature review


OUTCOME
We created new patient education materials and videos that were distributed across all Mayo Clinic locations. We created a successful crowdsource idea challenge that resulted in two ideas being prototyped. We reached consensus on treatment across providers at different Mayo Clinic locations.


I was the service designer on a three person team of a project manager and clinical coordinator. We provided funding and support to people within Mayo who had innovative ideas. The Chief Patient Safety Officer and Administrator of Quality Management came to our team to help create a smart, lean system to appropriately identify and treat patients with acute VTE effectively and efficiently. 

I started with understanding the current landscape by conducting an extensive literature review, interviewing 32 clinical staff, 31 patients and observing in multiple clinical units across Mayo Clinic locations (MN, WI, FL, AZ). I then mapped patient flows and synthesized insights from my interviews and research.

  Process mapping of emergency department in Mankato and how they treat patients who come in with a blood clot

Process mapping of emergency department in Mankato and how they treat patients who come in with a blood clot

One aspect I noticed was the lack of best practice evidence in the literature for using sequential compression devices to prevent acute blood clots while staying in a hospital. This lack of clarity led to varying uses and opinions on the importance of sequential compression devices that were ordered for every patient. The devices caused agitation to patients with lack of mobility, excessive tubing and disturbing sleep. Hospital staff viewed the devices as too much of a hassle and not worth the effort to convince an upset patient to wear them. There was also varying opinions that if a patient was walking or sitting that was just as good of prevention as wearing the devices.  

“My doctor said if I walked to the bathroom and hallway I could go without them (SCDs) at night.” - Patient

  Sequential compression device inaccessible under patient bed

Sequential compression device inaccessible under patient bed

I conducted my own usability test sleeping with sequential compression devices to gain a better perspective of what patients in the hospitals are feeling. I soon realized how cucumbersome the tubing was, how it made me feel trapped and how very little sleep I got from having my legs squeezed every 30 seconds. I presented my insights through a documentary style video of waking up every 30 minutes due to the machine to create empathy of what a patient's night is like in the hospital. 

  Getting ready to sleep with the SCDs, strapping the three velcro wraps around my leg

Getting ready to sleep with the SCDs, strapping the three velcro wraps around my leg

  A lot of tubing in bed at my feet plus uncomfortable stryaform

A lot of tubing in bed at my feet plus uncomfortable stryaform

  The time I finally gave up tired of being waken up and took the SCDs off

The time I finally gave up tired of being waken up and took the SCDs off

Based on our initial research multiple mini projects were created. To improve the use of sequential compression devices (SCDs) in the hospital, we found literature stating 18 hours a day was the best preventive measure. We created an 18 hour best practice standard and launched a crowdsourcing idea competition to anyone in the organization who could come up with a creative way to get patients to wear SCDs for the recommended 18 hours a day. We received 11,000 page views with 52 idea submissions. We took the top two feasible ideas to pilot. I provided design support and helped two contestants write an experiment plan and build their prototypes. 

  Get Your Squeeze On challenge website

Get Your Squeeze On challenge website

  Mayo Brother's supporting wearing SCDs

Mayo Brother's supporting wearing SCDs

 
  Winning idea for portable SCD, was able to find a company who was in the process of creating a prototype. Unfortunately was unable to pilot on patients as company went out of business.

Winning idea for portable SCD, was able to find a company who was in the process of creating a prototype. Unfortunately was unable to pilot on patients as company went out of business.

  Prototype for color coded timer for how long a patient has worn their SCDs

Prototype for color coded timer for how long a patient has worn their SCDs

  Idea submitted by nurses with a parody of the song "Whip It" to "Squeeze It"

Idea submitted by nurses with a parody of the song "Whip It" to "Squeeze It"

  Winning idea of tracking board in patient's room to track the 6 hours off instead of tracking the required 18 hours on, charting increased from 50% to 79% in unit where prototype was piloted

Winning idea of tracking board in patient's room to track the 6 hours off instead of tracking the required 18 hours on, charting increased from 50% to 79% in unit where prototype was piloted

Our team wrapped up the year with a summit that brought together the most important providers, nurses and quality change agents who would be able to continue the work forward. Myself, the Chief Patient Officer and Administrator of Quality co-facilitated various activities throughout the day. While patients were not able to be apart of the workshop we made their presence felt and referred to them frequently throughout the day through the use of posters hanging around the room.  

  Patient empathy map of a patient who has developed blood clots

Patient empathy map of a patient who has developed blood clots

  Individual provider mapping of key components of treating a patient with blood clots

Individual provider mapping of key components of treating a patient with blood clots

  Sorting activity at summit

Sorting activity at summit

Our project ended with the creation of standardized patient education material, staff training and implementation of best practice across the Mayo Clinic enterprise.