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The Challenge

Help a hospital differentiate itself and improve outcomes through deep culture change.

The Outcome

The implementation of groundbreaking care initiatives by a hospital team dedicated to continual and creative change.

Healthcare is notoriously difficult to change. Rules and regulations present complex barriers; health practitioners and organizations often have entrenched ways of working; and lives are literally on the line. Despite these significant barriers, the leaders at Newton-Wellesley Hospital (NWH) boldly committed to improving patient care through a new approach.

I came to IDEO looking to transform not only our patient experience, but our employee experience—realizing that if caregivers feel empowered, they can provide the best care to their patients every day.

Dr. Michael R. Jaff, NWH President, 2016-2019

NWH is a community teaching medical center in Newton, Massachusetts. Because of its proximity to Boston—a city known for world-class healthcare institutions—NWH needed to differentiate itself. The hospital's new president, Dr. Michael R. Jaff, reached out to IDEO for help: "I knew that providing an unparalleled patient experience would set us apart from our competitors." But, Dr. Jaff’s particular approach was unique. He and Dr. Jodi Larson, Chief Quality and Experience Offer (CQXO), saw an opportunity to drive better patient outcomes through cultural and organizational change.

"You cannot learn any more than when you get to listen to your potential patients say why they would never walk into your place." —Dr. Michael R. Jaff

IDEO partnered with NWH for a year of work together, kicked off by defining the vision for NWH and ramping up to in-hospital prototyping and the launch of several new initiatives. A pilot project with the Women's Imaging Center (WIC) focused on solving departmental and employee challenges to provide a better experience for women getting mammograms.

To start, the Women’s Imaging Center employees participated in IDEO’s Creative Difference, an online assessment that measures the creative capabilities and behaviors of a team. The assessment revealed opportunity areas that would help the team realize its goals, including comfort with experimentation and empowerment to contribute to positive change.

The pop-up design studio, dubbed Project Phoenix, was centrally located on the main thoroughfare of the hospital.

Fueled by this potential, the WIC team redesigned key work processes and created a set of experience principles that inspired new service prototypes. Guided by principles like "Express mutual gratitude" and "Honor every voice," the WIC team tested ways for patients to acknowledge outstanding caregivers and created tools to gather better feedback from patients and adjust quickly. The experience of designing better services inspired the WIC staff to become ambassadors for the power of design thinking across other departments inside NWH and they continue to build on the work through new prototypes and experiments. At the end of the partnership, the team repeated the Creative Difference assessment and noticed improvement over time in their creative competencies.

Next, IDEO partnered with NWH’s ambulatory surgery group. They took an analogous research trip to Boston’s Logan airport to see with fresh eyes how other high-touch customer service organizations provide customer value in a complex setting. Insights from the trip were applied through live prototyping of several new experiences inside the hospital, including a pre-surgery visit summary and pre-operation care carts.

Analogous research helped us realize that we can learn from other industries and incorporate some (cool) best practices if we allow ourselves to get over the ‘that would never work in the hospital’ mentality.

Dr. Jodi Larson

A team of surgeons, anesthesiologists, nurses, and hospital executives headed to JetBlue seek out inspiration around analogous themes of teamwork, coordination under pressure, and customized pathways for patients.

One of the most impactful prototypes was Care Modes, a tool to empower the NWH care teams to tailor their approach and interaction with patients based on the patients’ unique needs, beyond simply their clinical requirements. Four distinct approaches were identified for engaging a patient before surgery—Explain, Partner, Embrace, and Encourage. The Care Mode is determined based on the provider's understanding of a patient's degree of self-advocacy and their confidence that surgery is the best solution to their issue.

The team produced several live prototypes in the hospital, gathering feedback and learnings directly from patients and staff. The first prototype launched was a series of experience kits selected by patients at check-in. Each kit represented a different mindset for patients—productive, serene, or enlightened—and a visual cue to signal different scripting and pathways from care providers.

Historically, care providers have been trained to deliver consistent care above all else. However, Care Modes powerfully acknowledge that patients respond differently to different types of care. The Care Modes empower the team—from surgeon to nurse to anesthesiologist—with a clear framework for how to interact with and provide care for patients so they feel most comfortable. Based on the prototype's success with patients and impact on the staff culture, NWH has incorporated Care Modes into EPIC, the hospital's electronic medical record.

What stands out to me is the empowerment that design thinking can provide to people across the organization. Certainly, it's true that new opportunities emerge from embracing the approach, but what's thrilling is seeing employees motivated to make change themselves.

Dr. Michael R. Jaff

With new insights and proven approaches, NWH was ready to build the internal infrastructure to continue their own human-centered practices and scale cultural change moving forward. Working with IDEO, Drs. Jaff and Larson established the Department of Tomorrow, a new instantiation of the hospital’s process improvement group. With new design thinking capabilities added to their toolkit, this group is now dedicated to launching and scaling new patient and provider experiences.

The importance of being patient-centered has been central to the healthcare conversation over the past thirty years; but new explorations reveal that there’s far more potential for innovation and improvement when the provider experience is considered in tandem with the patient’s. Each enables the other, and design for both together yields stronger solutions and better outcomes. IDEO's work with NWH demonstrates this vital shift in user-centered healthcare—one can't design services and experiences for patients without designing for their providers’ culture as well. When these go hand-in-hand, meaningful institutional change in healthcare is more than possible.

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