Ute Schauberger: January 20, 2020
In our latest blog, service designer Ute Schauberger, talks about the development and use of the Experience Map tool which helps different perspectives of health and care have a shared conversation and which she's recently used in the context of endocrinology.
The Experience Map is a design tool which you can use to explore and consider the experience of primary care and secondary care clinicians, as well as the people they care for. And like many aspects of design, it was born out of frustration.
As a designer and researcher working in health and care for several years now, I realised there were some consistent and persistent issues in how conventional service design tools – which typically originate from non-health and care contexts - were being applied:
The tool is made up of three sections, which each fit into each other: one covering patient/citizen experience, one covering Primary Care and one covering Secondary Care. Workshop participants are invited to move along key steps from first symptoms to discharge or follow up, and consider what works well and what does not for each group. The map visually organises the journeys of all three groups, makes clear where they intersect, and places the citizen at the centre of all health and care services.
This is a useful tool when a group of people from different parts of the system such as primary care, secondary care, lived experience, and third sector first come together. It gives space to different kinds of expertise, and allows the group to combine and visually organise what they know together as a collective. It also highlights gaps in knowledge or representation, which can then be addressed going forward.
The map works as a framework and prompts conversations around steps of a stakeholder journey that might have been overlooked. By focusing on how each step is experienced rather than carried out, there is no need to settle on what is the most correct or accurate version. While clearly positioning the citizen’s experience at the centre of all health and care services, this map gives space to clinician expertise and experience. Defining what works well and what causes frustrations for health care professionals is an important part of our work.
It is especially useful in the initial design phase, in a group with diverse sets of people, and when time with stakeholders is limited and the output can act as a compass for design research in the future. The completed map can highlight gaps of knowledge to be explored, and people to be included in future conversations. It can make visible areas where many issues cluster, areas which seem to be running smoothly, and allows to better define questions about underlying problems for the next phase of design.
Mapping a service can mean quickly diving into miniscule details, getting stuck with conflicting perspectives. This loses sight of the ultimate purpose of this activity: designing a better service. Using the Experience Map provides a framework for groups to work towards an overall model, include different voices, and consider other people’s experience.
NDS recently organised a kick-off workshop in the context of Endocrinology services with a range of different clinicians and the Experience Map was the main tool used, with this flow:
Step 1: Completing the three segments of the map in three groups
The attendees were split into three tables. At this stage of the process we only had clinicians and we invited them to join whichever group they felt most interested in in that moment. They filled in one journey and identified positive parts of the experience (marked with a green dot) and negative parts (marked with red). While you can do this with particular specialists e.g. only secondary care clinicians fill out the secondary care segment, we found it particularly useful to have each segment worked on by people from different professions, and different services which vary across Scotland.
Step 2: Bring the segments and the attendees together
We’d set up a spare table where we asked each group to bring their completed segment and we fit them all together. This is an especially nice moment since having worked on individual segments, most people haven’t realised how the three segments fit together to create a holistic view so it can be a fun reveal.
Step 3: Individual segments share highlights
The group then shared the key insights from their individual conversations. As the conversation flows, the map started to show interactions between primary care and secondary care, and where communication is difficult. And with the citizen at the centre of the Experience Map and Endocrinology services, it made clear how clinician experience matches or might influence citizen experience at each step.
Step 4: Have a holistic conversation
After going through the three segments, we invited any observations based on everything we’d heard. This sparked productive conversations around key opportunities, what works well elsewhere, and where a change could make the most difference. It also highlighted whose perspectives the people in the room knew little about, and the urgent need to identify and include people with lived experience who currently use Endocrinology services.
Step 5: Use the Map as a reference for future work
As we’ve progressed the early design phase, we’ve referred back to the Experience Map from that initial session to ensure we’re aligned with the understanding and ambition it articulated.
As our work evolves and continues, we look forward to sharing more of our tools and methods with stories of how they are used. In the meantime we’d love to hear any suggestions or feedback on the experience map and should you wish to use it in your own work, our only request is that you tell us a story of how you do.