To improve quality, leverage design

The year was 1987, and a bold experiment was under way—the US-based National Demonstration Project in Quality Improvement in Health Care (NDP). This effort brought together 21 companies recognised for excellence in quality manufacturing with 21 healthcare organisations to test whether revolutionary practices from quality improvement (QI) could be applied to healthcare. The partnership succeeded and NDP was extended for another 3 years, eventually becoming the Institute for Healthcare Improvement.1 Since then, QI principles and methods have spread broadly across healthcare. Around the same time the NDP was under way, another quiet revolution in systems thinking was taking shape in the emerging field of human-centred design. In 1988, Norman authored the landmark book ‘The Design of Everyday Things’, an explanation of how human-centred design—‘an approach that puts human needs, capabilities, and behavior first, then designs to accommodate those needs, capabilities, and ways of behaving2’—could dramatically improve products and services. Human-centred design methods, broadly referred to as design thinking (DT), are now widely used across diverse industries.3 Companies that have implemented design practices outperform their peers,4 and leading organisations like Google, Apple and General Electric use DT to create world-class products and services.5 Although healthcare has invested heavily in systems improvement using QI, far fewer in healthcare are familiar with the improvement methodology of DT. A tremendous opportunity exists to further enhance contemporary healthcare improvement efforts by integrating the human-centred methods of DT that have revolutionised other industries. However, a knowledge gap remains on how to practically implement core methods from DT into QI practice. Here we explain fundamental DT methods and how they can integrate into existing improvement efforts, providing a starting point for organisations and leaders to leverage this human-centred approach and harness the powerful emotional perspectives of ‘users’, the patients, families, caregivers and …