SHM Converge Scientific Abstract ePoster Gallery-Designing for Equity: Using Systems Design in Improvement Work

Pdf Summary

This document describes an effort to improve hospital care for patients with limited English proficiency (LEP) by using systems design as a complement to traditional quality improvement. The team observed that standard improvement methods had only mixed success in addressing disparities, so they developed a collaborative, transdisciplinary model informed by design thinking and systems design principles.<br /><br />Working with partners from RISD, the team used systems design methods to better understand the complex and interconnected factors contributing to poor outcomes for LEP patients. This approach helped them step back from narrow problem-solving and instead identify multiple lines of inquiry, reveal system-wide issues, and generate ideas for improvement across the patient experience.<br /><br />The document highlights several example interventions and design explorations, including:<br />- quiet observation of the patient environment,<br />- before-and-after photos of patient food trays,<br />- patient letters explaining expectations,<br />- integrating interpreter services into the care team,<br />- simple control questions to confirm clinician understanding,<br />- near-immediate translation of discharge instructions,<br />- culturally specific words for pain,<br />- equity-focused health outcome goals,<br />- an LEP health equity dashboard,<br />- improved equity in patient handoffs,<br />- studio-based collaborative inquiry for culture change,<br />- and improvements in emergency department equity.<br /><br />The central conclusion is that systems design-informed improvement work is a novel and promising strategy for advancing health equity. By combining creative, patient-centered, and interdisciplinary approaches, teams can better identify, understand, and address the structural and cultural factors that perpetuate disparities in care.

Asset Subtitle

Archna Eniasivam

Meta Tag

Author List Alyes Wong, Anand Habib, Archna Eniasivam, Catherine Lau, James D. Harrison, Jenica Cimino, Julie Woods, Kasia Kadela, Lev Malevanchik, Manuel Arteaga, Martha Ockenfels-Martinez, Mateo Rutherford, Monisha Bhatia, Nishita Nigam, Rachel Luke, Ritu Bans

Category Innovations

Concept Systems Design

Concept Health Disparities

Concept Limited English Proficiency

Concept Health Equity

Concept Patient-Centered Communication

Distinguished Non-Finalist

Presenter Organization Ucsf

Presenting Author Archna Eniasivam

Track Quality Improvement

Keywords

hospital care

limited English proficiency

health equity

systems design

quality improvement

design thinking

interpreter services

patient experience

disparities

discharge instructions

Systems Design

Health Disparities

Limited English Proficiency

Health Equity

Patient-Centered Communication