Transition of Care from Hospital to Home

Discharge planning care-coordination and its implications on a patient's health and the healthcare system. My thesis research opens up a conversation on logistics, healthcare infrastructure, cultural backgrounds, and other system-level issues on the coordination of care. It also focuses on illustrating the journey of patients and healthcare professionals to understand the experiences of moving within care units and showcasing the importance of design as a mindset to create stable transitions for everyone involved in moving from hospital to home.

Duration: 6 months

Industry: Healthcare

Mentor: James Read, Ben Little

Thesis Research Project

EVERYONE IS A PATIENT..

We are all different things in life. Some of us are parents, teachers, construction workers, designers, and even physicians. However, every one of us has one thing in common, and that's having a healthcare experience. This means that you will be a patient. Your parents will be patients. Your friends will be patients. Even your doctors will be patients. Everyone, at some point, will be a patient.

DOES A PERSON DESERVE TO LIVE IN A CONSTANT STATE OF INFLUX? CERTAINLY NOT.

Having seen my family members being readmitted to the hospital and struggling to manage their medical conditions. I wanted to work in the healthcare system that affects all of us. 

A person that was close to me was my aunt. Over the last few years, she was hospitalized for the same reason on multiple occasions for the last few years. Why was this a problem? Why were they ending up in an emergency department or primary care clinic more often than necessary? These were the big questions in front of me. Like any other person in the family, we all expected my aunt to get treated by the best physicians and return home happy and healthy. Still, regardless of anything, she was stuck in a perpetual loop of readmissions. She dealt with rehospitalizations with emotional and mental turmoil because of cancer and other chronic health complications, and sickness was her constant companion.

But this was in India...

LET'S COME BACK TO READMISSIONS IN THE US HEALTHCARE SYSTEM!

Readmissions may progress due to natural medical history of the patient's underlying disease, development of a separate issue or complication that is unrelated to the initial admission, or a consequence of patient's inability to follow through with a discharge plan (e.g., the patient is unable to fill prescriptions) some of these readmissions can be prevented.

Still, each year almost 2 million people are readmitted to the hospital within 30 days of their discharge.

 Although some of the readmissions are unavoidable, many are preventable through interventions and hospital readmission reduction programs. Readmissions are not only expensive for the healthcare system but also financially draining, physically, and emotionally challenging for patients and their family caregivers.

Avoidable Hospital readmissions that occur within 30 days of discharge cost Medicare approximately $17 billion per year. 66.5 percent of all bankruptcies were tied to medical issues because of high costs for care or time out of work.

CLEARLY, READMISSIONS IN HOSPITAL IS A CRUCIAL PROBLEM IN THE US HEALTHCARE SYSTEM.

One aspect leading to readmissions is care coordination while transitioning from care units and others, such as lack of health literacy and lack of right resources for healthcare infrastructure and logistics. Care coordination, while moving from one care unit to the other, is a sophisticated space. In the current U.S. healthcare system, many external factors are working against patients during these transitions from hospital to home.

Being a designer and listening to readmission stories and experiences in the healthcare system in India and the U.S. 

I focussed on...

(IBJ illustration/Brad Turner)

SO, WHAT IS MY THESIS?

Every patient deserves a smooth transition from hospital to home. Even though this experience has been improved over the years, readmissions after discharge remain a significant healthcare challenge. The transition from one unit to another involves many factors and points of view from multiple systems that include patients, hospital infrastructure, insurance companies, and federal programs such as Medicare. Designing for healthcare can be complicated. While designing for transition within healthcare, a designer needs to tackle complex problems from all vantage points, especially for patients and healthcare practitioners.

Taking a strategic design approach can render the healthcare system transparent, providing the tools to co-create with healthcare practitioners and patients to improve care transition.

QUESTIONS THAT PROVED TO BE THE BACKBONE OF MY THESIS BOOK: 

  • What is the journey of a healthcare practitioner and patients while moving from hospital to home?

  • In what ways do significant collaborators such as family, healthcare practitioners, and insurance company providers move from one care unit to the others interact?

  • What are the obstacles that are experienced by healthcare professionals and patients during this transition?

  • How can a design mindset impact healthcare?

  • What are the significant challenges faced by designers in the healthcare system?

MY METHODOLOGY

LEARNING ABOUT EXPERIENCES IN THE HOSPITAL AND HOME. PRIMARY RESEARCH

I conducted over twenty interview sessions with healthcare professionals, patients, and designers, which became my research's backbone. These interviews were explicitly focused on the transition of care from the different perspectives of these three groups to better understand their experiences with the system, their opinions, and to explore their hopes, fears, and doubts. My interviews proved to help map out these different experiences within specific healthcare departments that allowed me to recognize common problems faced by patients and healthcare providers while transitioning from hospital to home.

Patients • • • • • • • | Healthcare practitioners • • • • • • • • • | Designers • • • • • • •

DIGITALLY EXPLORING THE HEALTHCARE SYSTEM. SECONDARY RESEARCH 

Secondary research was a meaningful way to clearly understand the healthcare system's basics in support of the data collected from my primary research. Data was collected through articles, books, case studies, and blog posts using various web databases, including Jstor, Gale One, Update, Center for Disease Control and Prevention (CDC), Research Gate, and Pubmed.
Main Themes explored -

The transition of Care and Readmissions | Insurance companies and Policies Design | Healthcare system

LEARNING ABOUT SOME NEW INNOVATIVE SOLUTIONS FOR HEALTHCARE. EVENTS 

I attended professional events organized in the healthcare industry to interact with experts in the field, such as medical and design researchers. This research method provided me with vital data that is integral to my thesis.


Discover Brigham
"Discover Brigham" is a day at Brigham and Women's Hospital, where medical and design researchers and healthcare practitioners showcase their work.

17th Annual HBS Student Healthcare Conference
The theme of this year's conference was 'patient to whole-person care.' The conference focused on the critical ways that a person's health should be understood from intersecting vantage points.

HXD Healthcare Conference - Mad Pow
The HXD Healthcare conference was dedicated to the "transformation of the healthcare system." 

Hack ED - Hackathon by BMC
Boston Medical College conducts a 'Hackathon,' an annual student-organized nonprofit initiative, to foster students' collaboration from diverse backgrounds to create impactful solutions for the Emergency department ED.

That's how I created my thesis that talks about…

WHAT TO EXPECT IN MY THESIS?

My thesis is just the tip of an iceberg but it focuses on…
My thesis research opens up a conversation on logistics, healthcare infrastructure, cultural backgrounds, and other system-level issues on care coordination. It focuses on illustrating patients' and healthcare professionals' journey to understand the experiences of moving within care units and showcasing the importance of design as a mindset to create stable transitions for everyone involved in moving from one care unit to another.

Interested to know more about it, let's get in touch, and talk more about my book...