Post on 25-Jan-2017
Helsinki Livework © 2015 9 March 2016
We’re having a baby! March 2016
SD IN GOV
CASE STUDY
Alice Ainsworth
Head of Digital Strategy
Department of Health
@aliceainsworth
Alex Nisbett
Senior dervice designer
Livework
@alexnisbett
#SDinGov
TODAY
Context & background
Project story
Stakeholder engagement
Project story
Project conclusions
Next steps
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DH
Digital services as
things – Alice has
slides
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TODAY
2. Project story
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The DH would like to adopt a user needs approach, to a major life transition, as the basis for service improvement
THE PROJECT
The digital team at the DH, working with GDS, want to develop a ’user needs
platform’ based around a key life transition, as a resource to inform service re-design.
The project includes:
1. Understand needs mapped to the current experience of a transition - having a
baby - and interacting with government and health services
2. Develop a target ‘better’ user experience that responds to users needs and
supports government goals
3. Develop prototypes for ‘quick win’ improvements, with a focus on digital.
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Project overview and timeline
Prepare Understand Imagine Design Present
Field research
Kick-off
Generative workshop
Analysis
Review and validate
Develop and refine concepts
Test and validate
Prototype
9 June 13 July
Research review
17 September 27 October 19 August
Final presentation
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How to get going…
Become an expert in the subject area
Get to know your stakeholders
Identify the do-ers
Understand the decision points
Keep it simple
Go to where the people are
Commit to your project objectives publicly
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What is the experience for families interacting with the health system and government as a whole, before, during and after their child's birth?
RESEARCH QUESTION
The question we’re looking to answer:
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What do they need and value during this life-changing experience?
Also…
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Qualitative, empathic, design research
RESEARCH APPROACH
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Qualitative research Aspect Quantitative research
Discovery,
understanding and
inspiration - ‘why’
Purpose Specific questions, test,
validate ‘what’
Empathic Approach Measurement
Free-form or
semi-structured using
design tools and probes
Data collection Rigid structure,
pre-categorised
Researcher intimately
involved, results
subjective
Researcher Researcher detached,
results are objective
Small samples,
in natural setting
Sample size Large samples to
produce generalised
results
FAMILY STORIES
Victoria and Nic Gemma, HV, London Angela, MW, Leicestershire Victoria, MW, Cambridgeshire
Julie (R), MW, Cambridge Diane and colleague, MW, Wigan
Joanne, HV, Hounslow Anne, MV, Carolyn & colleague Anne, HV, Sidcup
Onye, HV, Hackney
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1. Search For The Truth
2. Grey Boundaries
3. Milestones
4. Continuity of Care
5. Bureaucracy
Insights from HCPs
1. Search for the truth
FROM HEALTHCARE PROFESSIONALS
“It’s like being a detective!”
On the part of the midwife, there is a need for a continuous effort in building the trust of mum to allow her ‘real’ story to reveal itself.
EXAMPLE INSIGHT
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FAMILY STORIES Victoria & Nick An established long term couple who have
been together 10 years and married 6. They
have come to realise that life cannot be
controlled so it is better to be relaxed and
pragmatic. They already have a 2 year old son.
Key Challenge: An awful pregnancy
overshadowed by morning sickness.
Needs
Learning the sex of the baby as soon as
possible allows you to buy the right clothes,
toys and appropriate colour scheme. A private
4D scan cost £500 – money that was not easy
to find. They are very keen to buy their house.
Values
What will be, will be. She has not made a birth
plan or lists for this pregnancy as they “never
go right.”
Information and support
The Bounty Bag came too early. It was stored
away then later opened too late and some
products were out of date. Some of the offers
are irrelevant to them.
Belief
“Nothing is more rewarding than carrying your
own child.”
“Don’t be hero… take all the drugs you can”.
project.
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FAMILY STORIES Nadia A rare medical condition meant that there was
a very high risk that Nadia may not conceive or
be able to carry the baby to full term.
Key Challenge: Managing expectations and
emotions of self and others.
Needs
The risk of their pregnancy failing was so high
that they struggled to enjoy or celebrate it in
case their hopes were destroyed. They waited
until week 30 to inform their broader social
network.
Values
It’s important to protect yourself from
disappointment and sorrow.
Information and support
Her husband, an engineer, was presented by
work colleagues with a folder of leaflets and
printouts other fathers had collected during
their own pregnancies. It had become a ‘man’s
bible’ passed down over the years, with each
new father adding along the way.
Beliefs
You can not assume the future.
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1. Past & future drivers
2. Counterbalancing
3. Taking control
4. Transitions in identity
5. Points of reality
6. Information
7. The savvy consumer
8. Reaching out
9. Trust
INSIGHTS
Insights from families
3. Taking control
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“We don’t really know how it’s supposed to work”
Many families feel they lack
control, they need support
and information to help make
the right decisions now, to
better prepare them for later.
FROM FAMILIES
EXAMPLE INSIGHT
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7. Savvy consumer
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“If Amazon & O2 can do online chat, so should the NHS”
Today, a high precedent is
being set by other service
organisations we interact
with day-to-day. Families
expect a 24/7 on-demand
experience that allows them
to be high performing
individuals.
FROM FAMILIES
EXAMPLE INSIGHT
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Mapping information
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Mapping information
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Mapping information
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Health Visitor info packs
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Health Visitor info packs
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Research conclusions
TODAY
1. Trust
Trust is integral to the success of every interaction along the
lifecycle, the journey, of having a child. It is the foundation
upon which a smooth experience is based.
The opportunity
Make this a core mission of the service. Allow it to become the
driving force and principle for how decisions are made.
If trust can become a product of all activities in this transition, it
will provide a solid base from which everything else can grow.
CONCLUSIONS
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2. The lifecycle
There is a discrepancy between health professionals and
families view of what the lifecycle ‘is’ in terms having a
baby and in terms of the services provided.
The opportunity
Align these differing perspectives, so that there is a
shared view of the process, the timeliness, what and
how is provided.
CONCLUSIONS
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3. High-performing families The health service is based on a legacy of excellence, but which
now exists within a fast moving world where behaviours and
expectations of families have evolved hugely as they engage with
increasingly sophisticated service organisations, and come to
pregnancy with a wide range of personal histories and contexts.
The opportunity
To acknowledge and support the myriad of family values, needs
and behaviours to create both a better experience for them, and
in turn higher performing families for the health service.
CONCLUSIONS
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Concept generation
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Concept generation
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28 ideas
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Concept development
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7. HOLISTIC ACTIVITIES
10. BABY JAMBOREE
2. 1001 DAYS
9. CHARACTERISTICS CARDS
1. PREGNANCY OVERVIEW 3. ALL-IN-ONE PREGNANCY GUIDE 4. DIVIDE & CONQUER
11. MENTORS LIKE ME
8. DIGITAL MATERNITY RECORD / LIFE STORY
5. FINANCIAL DECISION-MAKING TOOL 6. NHS ENDORSEMENT
PROJECT PLAN 12 Concepts
The Baby Box is an idea borrowed directly from Finland, where it was established as a gift from the government for all expectatant mothers with the objective of reducing infant mortality.
The box is essentially a starter kit containing everything a mum needs for her newborn baby, and the box itself is used as a first crib.
Mothers have a choice between taking the box, or a cash grant, currently set at 140 euros, but 95% opt for the box as it’s worth much more.
In the UK, instead of giving this to all mums, no matter their situation, mums in particular need of support, or facing paticular circumstances, could be targeted first.
PREGNANCY TO EARLY YEARS CONCEPTS
12. Baby Box
Pregnancy journey
• The box is used as a crib
• Bedding
• Clothing
• Books and guides
• Nappies
• Socks
• Mittens, hat
• Bra pads and condoms
• Picture book and teething toy
• Cuddly toy
• Hooded bath towel
• Nail sciissors
• Hair brush, bath thermometer
• Nappy cream and washcloth
Key features
Challenge it addresses
The baby box gift signifies for many Finns that the government, the state, cares about giving all citizens an equal start in life.
At 75 years old, the box is now an established part of the Finnish rite of passage towards motherhood, uniting generations of women.
Knowledge that the state will look after them, also helps reduce mum’s stress towards the end of pregnancy.
1 2 3 4 5 6 7 8 9Insights
Planning / conception Pregnancy Labour, birth, and
first days First weeks
12. BABY BOX
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A visual timeline that provides a simple overview of the entire pregnancy journey featuring what happens when, where and why (e.g. appointments, scans, tell your employer you’re pregnant), and with who.Takes both a physical and a digital form. The physical, e.g. a large
fridge magnet (or paper poster), gives you an overview of the 40 weeks and beyond, and serves as a visual reminder for the entire family of your pregnancy and what takes place when. The digital is more interactive, links to timely information, and syncs with your (and potentially also your MWs and HVs) calendar. Will also contain contact information for your MW/HV team, and a guide to who to contact when. Links with the NHS Alpha project.
Planning / conception Pregnancy
Labour, birth, and first days First weeks
PREGNANCY TO EARLY YEARS CONCEPTS1. Pregnancy overview
Challenge it addressesMany families, particularly early on in the pregnancy, struggle to gain an overview and keep track of what should/will happen when, where and with who.
Essential information and contact details are either often forgotten, lost or drowned in the plethora of information available.
Pregnancy journey
• Timeline overview ◦ Key appointments, scans etc. ◦ “When to prepare what”• Synchronisable calendar
• Reminders• Linking to time-based information
• “My MW/HV team” contact information• List of prioritised tasks
◦ Filterable by type ◦ Dividable between family members ◦ Pro-actively find calendar slots
• Add images• Shareable
Key features
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Insights
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Livework © 2015
A visual timeline that provides a simple overview of the entire pregnancy journey featuring what happens when, where and why (e.g. appointments, scans, tell your employer you’re pregnant), and with who.Takes both a physical and a digital form. The physical, e.g. a large
fridge magnet (or paper poster), gives you an overview of the 40 weeks and beyond, and serves as a visual reminder for the entire family of your pregnancy and what takes place when. The digital is more interactive, links to timely information, and syncs with your (and potentially also your MWs and HVs) calendar. Will also contain contact information for your MW/HV team, and a guide to who to contact when. Links with the NHS Alpha project.
Planning / conception Pregnancy
Labour, birth, and first days First weeks
PREGNANCY TO EARLY YEARS CONCEPTS1. Pregnancy overview
Challenge it addressesMany families, particularly early on in the pregnancy, struggle to gain an overview and keep track of what should/will happen when, where and with who.
Essential information and contact details are either often forgotten, lost or drowned in the plethora of information available.
Pregnancy journey
• Timeline overview ◦ Key appointments, scans etc. ◦ “When to prepare what”• Synchronisable calendar
• Reminders• Linking to time-based information
• “My MW/HV team” contact information• List of prioritised tasks
◦ Filterable by type ◦ Dividable between family members ◦ Pro-actively find calendar slots
• Add images• Shareable
Key features
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Insights
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TODAY
3. Stakeholder engagement
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CONCLUSIONS
How to…
Test your messages
Find an ally
Get everyone in a room together
Be open
Go to where the people are
Set some deadlines
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TODAY
4. Project story
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Pregnancy overview – timeline
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Digital maternity record
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Characteristic cards
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MythBuster Quiz
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FAMILY STORIES
Bekky
Kelly & Karl
Angela, MW, Leicestershire
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FAMILY STORIES
Bekky
Kelly & Karl
Angela, MW, Leicestershire
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Mums 1. Pregnancy overview
Overall Mums were very positive about the pregnancy overview, appreciating ‘everything in one place’, the variety of content and the ability to zoom in and out of the pregnancy timeline.
“All in one, useful for partners too. Don’t need to use google”
Positives “Everything in one place” was the main benefit mums saw in this prototype, plus the ability to see what was coming next using it as a diary so that they could plan and prepare.
It was seen as a practical replacement for printed material ‘Those leaflets, you’re guaranteed to lose them.”
Knowing WHO you’re going to see as well as WHEN is also very useful, plus tips on what to pack in your hospital bag, and the videos, which are especially attractive to younger people.
Mums see all sorts of possibilities for additions…
“I would find it useful to have a reminder 'pop up' to do pelvic floor exercises as kept forgetting and now have slight bladder control issues!”
Having up to date phone numbers for the midwife and maternity unit especially useful as these can change, plus all information contained is useful in an emergency or if mums go into labour early.
“I wouldn’t have to carry my notes everywhere I go and if an emergency occurred I could quickly show anyone around this page [personal preferences] on my phone as I always have that with me and not my maternity notes.”
Negatives None to speak of, except for reassurance needed over privacy and security of information.
Note. There’s something about the interactivity making it more appealing than books and websites, which surely much include all this info already.
4.4
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1. Pregnancy overview
Overall Health Professionals thought the pregnancy overview timeline best for first time mums, with lots of information about the whole pregnancy all in one place. They also saw it as an effective tool for sharing and involving their partner.
“A really good start point.”
Positives Being able to zoom in and out, seeing the detail through rich media, and the full and future picture of the pregnancy.
Using preferences to personalise the tool to enable mum’s key dates and information to be accessible and control notifications.
“It will make women and their families more aware and keen to be proactive about their care and wellbeing.”
“Accurate, succinct information with pictoral representation, so visually appealing and if personalised, a relationship is already developing prior to birth, especially for 1st child.”
“It has all contacts in one place and can be updated by the health professionals as teams change.”
“…would cut down on DNAs and save MW time and NHS money.”
“ Health professionals can make their services more accessible to parents and parents may be prompted to engage with professionals more.”
Negatives Some professionals noted that not all mums have smartphones and /or good access to the internet, so this mobile service would not have universal access.
There were also concerns over privacy, security and data protection (in line with all digital services but especially where personal health information is concerned).
4.4
Professionals
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Professionals
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Overall ranking scores
4.4
5.0
4.9
4.8
4.7
4.6
4.5
4.4
4.3
4.2
4.1
4.0
3.9
3.8
3.7
3.6
3.5
3.4
3.3
3.2
3.1
3.0
3.1
4.1
3.6
Mums
4.2
3.7
4.1
4.5
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4.4 4.3
4.1
2.6
4.4
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5. Project conclusions
TODAY
Three final conclusions: 1. Choice and decision-making 2. Health promotion and safety 3. Freeing-up time to care.
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2. More empowered choice and decision-making Through our prototyping of concepts, it’s been clear that there are
opportunities to support families to make better decisions - whether
by simply giving them the right information at the right time, or by
setting out the options and alternatives for maternity and beyond birth.
For example:
The characteristic cards provide accessible, even basic information,
through pull, not push.
The pregnancy overview sets out what will happen when, where, why
and with who – so helping them be better prepared – and to make
the right decisions.
CONCLUSIONS
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3. A platform for health promotion & safety Many concepts are focused on providing targeted information through
channels and in formats which users are currently familiar with (eg,
interactive timelines, video, user-friendly language, characteristic cards).
This will help cut through the ‘information overload’ and support the
promotion of health and safety.
For example, we heard of timely notifications for pelvic floor exercises.
This personal approach can also help service users perform at a higher
level, for instance by staying safe and healthy, reducing DNAs, or being
able to differentiate fact from fiction.
Finally, better informed and higher performing families also help reduce
the strain on resources.
CONCLUSIONS
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4. Freeing-up time to care This project explored needs among ‘low’ and ‘high’ risk families and
provoked debate about access to digital services which support safer
pregnancies leading to better outcomes for mother and child.
We think there is an opportunity to explicitly satisfy the ‘worried well’,
especially through encouraging higher levels of online ‘self service’.
By doing so we could potentially save time and resources which we
are then able to direct to the more ‘at risk’ or disengaged mums and
address more serious health risks.
This hypothesis deserves further investigation and validation.
CONCLUSIONS
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TODAY
5. Next steps
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Sustained impact…
Influencing policy via the NHS maternity review
Informing the design of national services e.g.
NHS.UK
The lasting impact of bringing teams together
(Public Health England, NHS Business Services
Authority) informing Healthy Start and maternity
exemptions.
A model for a new way of working.
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NEXT STEPS
TODAY
6. Do it again?
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If DH did the project again…
Warm stakeholders up early
Decisions don’t get made in the summer
Plan for research days throughout
Keep it simple
One point of contact
Be even more open.
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LEARNINGS
If Livework did the project again…
Get the right people in the room for early decision-making
Lead with our experience and expertise (Ethics)
Pragmatic but flexible around scope and decision points
Share more tasks with the client
Visualise even more (Gov - “we operate in publications”)
Finally, never forget why you’re doing it.
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LEARNINGS
Helsinki Livework © 2015 9 March 2016
Thank you March 2016
SD IN GOV
CASE STUDY
Alice Ainsworth
Head of Digital Services
Department of Health
@aliceainsworth
Alex Nisbett
Senior dervice designer
Livework
@alexnisbett