Abstract
This document explains the rules for writing your C&C paper. It presents tips on how to structure it, and is itself formatted along the required formatting style. (note: the abstract should be about 150 words long, and written in boldface)
Keywords
Evidence-based design, experience-based design, healthcare, design approaches
Introduction
Design plays a significant part in the innovation of healthcare. Healthcare is a complex system that consists of multiple sectors, stakeholders and systems. It is crucial to have regard for these interrelations when solving problems. Current design approaches are mainly focused on improving the efficiency of care, reducing costs and innovating technology of medical appliances. However, there seems to be a lack of focus on designing for people, practitioners and societies (Jones, 2013).
Over the last decades, several design approaches have been gaining popularity in the healthcare design industry. This paper will describe two of the biggest shifts. The first approach that has significant impact on the healthcare industry is evidence-based design (Rashid, 2013). McKibbon (p. 393) describes evidence-based design as “a method that uses clinical research in order to make the most reliable decisions for individual patients”. Another approach gaining attention is experience-based design. In this approach, users become stakeholders instead of just passive recipients of the care (Jones, 2013).
Current literature describes either a shift to evidence-based design or a shift to experience-based design. This paper however, describes how strengths of both approaches can be used simultaneously in order to create a balanced design involving all stakeholders.
EVIDENCE-BASED DESIGN
Background theory
Evidence-based design is a quite common design approach within the healthcare industry. It is a method based on reliable research (Rashid, 2013). It makes use of empirical knowledge, which is knowledge retrieved from credible research based on experience of health professionals and clinical experiments. It is a method based on hard scientific evidence (McKibbon, 1998). The approach helps people to gather scientific intelligence in order to validate hypotheses. This intelligence is obtained trough scientific literature and experimental experience from colleagues in the design field. It does not provide a solution, but rather factual information from which conclusions can be derived according to the experience of the health professional (Cama, 2009). This way of working stimulates people to share knowledge and experience.
Limitations
Designs made using this approach are based on credible research, but seem to be failing in achieving good design. One limitation of evidence-based design is that it encourages quantitive knowledge more than qualitative knowledge even though the latter has been an important source of information over the last decades (Rashid, 2013). It seems to be forgotten that human issues are essential to consider while designing, no matter how complex the design challenge is. Evidence-based design is based on the assumption that human traits are the same for everyone. In his paper ‘The Question of Knowledge in Evidence-Based Design for Healthcare Facilities: Limitations and Suggestions’, Rashid (p. 112) says that “we do not need to design for every individual need. Rather, we design for humans in their context, with the hope that if all fundamental human issues involving design are taken into account with reasonable care then it is possible to satisfy individual needs sufficiently”. Secondly, even though the knowledge of evidence-based healthcare design has grown rapidly in recent years (Ulrich, 2008), there has been minimal effort to collect knowledge from design field such as industrial design (Rashid, 2013).
WHAT Makes a good design
To determine what is missing in the evidence-based design approach, it is important to determine what makes a good design and thus what knowledge is needed to come to a good design. Berkun came up with the following principles (figure 1), as published in ‘Toward more user-centric OD: lessons from the field of experience-based design and a case study’ by Bate and Robert (2007).
Figure 9: Design principles to come to a good design (Berkun)
Evidence-based design only covers the first two principles, so it can be argued that designs that come out of this are not considered good designs. As Bate and Robert (2006) state: “One wonders what is the point of a great, safe process and a terrible experience, which is why we believe the balance needs to be restored to take account of the latter.” While it may be true that research studies provide reliable empirical knowledge, qualitative studies providing semantic knowledge can be at least as valuable, if not more.
Experience-based design
Next to evidence-based design, there has been an shift towards making design methods more patient centred. This comes with a focus on qualitative research aspects as well as taking the societal context into account. There are several different approaches that can be categorised within this so called experience-based design, but what they have in common is that they have the aim on making the interaction with the product or service a better experience for the user (Bate and Robert, 2007). This can be considered one of the main elements of experience-based design. The second element is making the user an integral part of the design process (Jones, 2013). To get more understanding of this design approach, it is important to know what is meant by experience, as multiple definitions are surfacing around. ISO 9241-210 describes experience as “A person’s perceptions and responses that result from the use or anticipated use of a product, system or service”. As opposed to evidence-based design, which is based on empirical knowledge, experience-based design is based on the acquisition of semantical knowledge. This refers to knowledge related to the meaning and understanding people relate to a certain concept (Rashid, 2013). Semantical knowledge has the benefit that it can provide qualitative data.
This is done primarily through the use of narratives to provide a way for care providers (e.g. nurses, doctors, commissioners) to emotionally connect with patients’ experiences and reflect upon potential service improvements (Locock, 2014).
Discussion
This paper explores both approaches and discusses how they can strengthen each-other. There has been research done on how to create a framework for either one of the approaches. However, more research has to be done in how to create a framework when combining both approaches. This framework can than be used by health professionals and clinicians in order to improve current design methods.
Conclusion
Must a balance between both. Using evidence in order to retrieve empirical knowledge, whereas experience of people gives insight into semantic knowledge. This can fill all gaps and thus lead to designs considered ‘good’. One thing to remember here is that for design we need qualitative knowledge that tells the story of how messy individuals, groups, and organisations are in any given environmental setting, so that we can try to make things better by design. For this, an empirical study using qualitative research methods may be more appropriate than an experimental research study. Our figural and semantic knowledge, as opposed to procedural knowledge, of design depend more on redundant, information-based, “thick and rich” first-hand descriptions of a design setting that no amount of empirical knowledge gained by experimental research may provide. (QUOTE) People like to be involved because they want to see change as it is something that directly involves them and seeing these actual changes can motivate patients and staff to want to continue to improve healthcare (SOURCE). A design project builds on existing knowledge, but must also consider unique aspects of that specific context (Cama, 2009) especially with the different contexts within healthcare changing so rapidly (Jones, 2013).