Women with a heightened risk of developing breast cancer waited up to three months before they were appointed a time at the Oslo University Hospital for examination and diagnosis. Unsurprisingly, the patients’ first impression of the hospital was nearly always negative. Inefficient, out-dated and suboptimal, the processes did not take into account the stress of having to wait for a life-changing verdict.
Backed by the Norwegian Design Council’s Design-driven Innovation Programme (DIP), Designit stepped in to optimise the patient’s journey for the better. The goal was to reduce waiting time and improve their entire experience.
Waiting for the verdict
The waiting period following a visit to the general physician and before visiting the hospital was identified as the most difficult part of the journey due to high levels of uncertainty, anxiety and pressure. Long waiting times of at least four to five weeks were often met with distressed patients taking matters into their hands by finding unofficial channels to obtaining an examination. They would call, email or personally visit the hospital in an attempt to speed up the process.
This resulted in an increased level of noise for the hospital staff, who instead of focusing on their tasks had to deal with distressed patients that were naturally unsure of what was happening next and whether someone was handling their case at all. The standard procedure previously included a visit to their general practitioner, who would subsequently refer the patient to the hospital if they thought the patient was at a risk for having breast cancer. Then the uncomfortable wait would begin, a previously overlooked yet crucial aspect of the entire process.
All the specialists including the radiologist, pathologist, surgeons and oncologists involved would meet twice or three times a week to discuss the cases, but if a patient was unlucky or there were too many patients, their case might get pushed back to the next week or the week after that.
The goal included improving cancer patients’ lives by rethinking behind the scenes processes from a service design standpoint. A vital step in reconsidering the hospital’s role in the patients’ lives included the hospital recognizing, accepting and working on improving their ‘customer service.’
Designit carried out in-depth user research to understand the pain points of the existing patient journey and what an ideal experience would look like. The research uncovered that the waiting was most unbearable due to the lack of information about the referral process. The alarm bells would start ringing at their doctor’s office and often the women would feel as if their life had stopped. One patient recounts, “I completely panicked, I was just so scared.” When at the hospital, they felt equally uniformed, anxious and alone in the waiting room. According to one of the patients, being there was like entering “death’s front yard.”
Conducting user research, however, was not enough. The Designit team immersed themselves in interviewing 40 hospital employees of all levels in order to find out about their daily schedules, processes and to draw up a plan of what needs to happen in hospital management in order to improve the patients’ experience.
The New Breast Diagnostics Centre (BDS)
The journey towards a diagnosis has been radically reduced down to the total of three days, a previously unthinkable goal. During the journey the patient is informed every step of the way and has the necessary support network to get through the process. The patient receives a brochure from their GP with information about what is going to happen next and they’re also given a direct phone number they can call in case they have any questions. The hospital then contacts the patient within 48 hours to schedule an examination for the following day.
On the day of the examination, the patient is greeted at the centre by a nurse and her mobile phone number is registered, so that she receives an SMS 10 minutes before every check-up. After all the necessary steps, she meets the radiologist and is given a preliminary diagnosis, which is then confirmed the day after at another meeting at the hospital, when she also receives a treatment plan.
Instead of meeting a few times a week, all the specialists involved meet every morning to discuss the patients from the day before. This ensures that all patient cases are discussed in a timely manner and the waiting time doesn’t accrue.
Less stress, more trust
The Oslo University Hospital has always prided itself on high levels of trust from their patients, who firmly believe in the medical expertise provided by the highly skilled and dedicated staff. Trust, nonetheless, goes beyond adequate medical attention. Treating cancer goes far beyond letting someone know they have cancer and providing chemotherapy.
The hospital’s processes were optimised to provide the information, support network and care needed to make patients feel secure at one of the most difficult crossroads of their life. Shortening the waiting period for one’s diagnosis by at least 90% dramatically improved the patients’ lives for the better by making them feel secure and cared for in the experts’ hands.
The new three-day process at BDS was officially inaugurated at Oslo hospital on the 4th November 2013 with the Norwegian minister of health and the Norwegian Design Council attending the event.