vet hospital operations research and visioning

Jul 2021 - Dec 2023

Above: conceptual diagram socialized throughout the engagement to communicate the goals and elements of the exploration process.

Opportunity

In the year following the start of the COVID-19 pandemic, veterinarian hospitals nationwide faced profound challenges, driven by increased demand among new pet owners, a contracting workforce in veterinarian services as many left the profession, and the introduction of new and often shifting COVID-related restrictions. In trying circumstances, the inefficiencies of processes and workflows of any organization would be more pronounced. At Foster Hospital for Small Animals at the Cummings School for Veterinary Sciences at Tufts University, services and supporting units across the hospital were struggling and in need of change for a highly interdependent organization. To help build an understanding of what type of change might be helpful from a systems perspective, Foster Hospital brought in Tufts Technology Services (TTS) Design Practice to help investigate and explore possible solutions to help improve clinical and business operations.

My Role

The client engagement, planning, research design and execution, synthesis, facilitation, and presentation of materials by the Design Practice were conducted in partnership between me and a Senior Service Designer on our team. My core contributions to the effort included:

Opportunity Shaping: Development of exploration process framework and synthesis of initial client discovery meeting into systems diagram and interactions for exploration.
Analysis: Processing and visualization of results of surveys and research data.
Vision Reports Development: Synthesis of output of futuring sessions and development of 4 detailed reports of findings.

Initiation

In July of 2021, following a three-month strategic planning engagement, leadership and key stakeholders at the Cummings School and Foster Hospital re-engaged with the TTS Design Practice to unpack problems they were experiencing in hospital operations. In response, the Design Practice processed what they heard and presented a framing of the situation through a systems diagram and a set of research questions to explore through design methods.

Above: slide presented to hospital leadership of diagram of stakeholders interacting with the hospital.

Above: slide presented to hospital leadership of types of interactions between the hospital and clients to explore

Research Phase

In the initial phase of research, the Design Practice conducted 19 interviews, a walkthrough of the hospital, and conducted a review of existing documents and work products to build a better understanding of the interactions identified from the initial meeting with leadership. Through these activities, it became apparent to the Design Practice that the hospital was comprised of passionate and skilled individuals with a design instinct, evidenced in their adaptations of existing workflows and quick prototyping of tools. However, with limited time and lack of interaction with other units, hospital faculty and staff did not have a shared view of the situation at the hospital and how their work related.

From the research activities, the Design Practice identified a set of opportunities to organize the attention of all hospital stakeholders for future visioning, presented to them in winter of 2022 under a framework of "Better Client Experience," "Improved Work Environment," and, "Streamlined Operations." Following the presentation of opportunities, hospital faculty and staff responded to a prioritization survey to identify the sequence in which the desired future state for opportunities would be explored first, which were later selected with hospital leadership following a presentation of the survey findings.

Above: framework of opportunities distilled by Design Practice from Research Phase.

Futuring Phase

Between March and July of 2022, designers from the TTS Design Practice met with 13 departments and units of the Foster Hospital for Small Animals at Tufts University in 60-90-minute visioning sessions, hearing directly from 68 members of the hospital. As much as possible, all roles within each department were represented in the sessions. The goal of the sessions was to hear from representatives of each department and unit what progress along a set of previously identified opportunities to improve clinical operations might look like to their locality. The methods for feedback included

A survey, completed during, following, or in lieu of the workshop online or in written form, and
Spoken contributions during discussion in the session

In surveys and in visioning sessions, participants were presented with prompts in the format as follows:

Imagine a few years from now, Cummings has made significant progress in... [insert opportunity area]. The client experience has improved, hospital operations are more efficient, and the work environment is better for faculty and staff. Thinking specifically about your role in the hospital, list 2-3 positive outcomes you would expect to see resulting from this progress. Consider positive outcomes in client experience, streamlined operations, and work environment.

Designers from TTS Design Practice collected and sorted each contribution from the workshop sessions retaining the contextual information of each contribution in the process. For contributions that expressed a similar interest in operational change, the designers crafted statements of desired outcomes. The key product of this synthesis activity was a set of desired outcomes that uses the Jobs-To-Be-Done methodology to express a direction of change without prescribing the solution to bring about that change. Desired outcome statements were collected into a categories that represent similarities in hospital or staff function. The desired outcomes were intended to serve as directional guides for subsequent design efforts. In total, over 350 desired outcomes were collected and grouped into categories for design ideation.

Above: Representative view of a portion of the synthesis board for the visioning sessions. Session quotes and notes (green and yellow) were tagged with their contextual information and sorted by like ideas. Desired outcomes (orange) were distilled from common ideas and specific ideas for interventions to consider (purple) were pulled out. Larger groupings (blue headers) were then formed.

As a product of the futuring sessions, the Design Practice developed four reports, presenting the findings at multiple levels of granularity to enable prioritization and further analysis.

Above: Example of a page of one of the four reports developed from the futuring sessions.

Impact

Though design sessions to identify and select specific interventions to bring about desired outcomes was conceived in the original engagement proposal, the Design Practice concluded its support of the Foster Hospital on this effort with the delivery of the four reports. The Design Practice hopes the leadership who received these reports were able to continue to engage hospital faculty and staff in working towards the identified desired outcomes and shift strategy to hospital operations.

In addition to the developed work product, staff and faculty throughout the process expressed appreciation for the opportunity to contribute their voice and participate in processes for change, an important contribution to culture of the hospital.

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