Alleviating patient anxiety through improved communication.
A guide that uses graphic narrative and easy-to-digest information to facilitate conversations between patients (or their caregivers) and their medical care providers.
*Note : This case study discusses topics related to cancer recovery, trauma, and radiation therapy. Some readers may find the content sensitive or distressing*
Overview
This four month project was a part of the CEBRE series which were initially developed by Prof. Tomoko Ichikawa at IIT Institute of Design with the support ROI’s, Dr. Golden’s team.
The previous guides developed were about radiotherapy which covered breast, lung, and prostate cancers. The following guides cover central nervous system, digestive system, head and neck.
Tools
Miro
Zoom
Microsoft Excel
Adobe InDesign
Adobe Illustrator
Team
2 UX Design Researcher
1 Project Lead
My responsibility was to recruit and conduct interviews, generate research insights, synthesize, storyboard and design the layout for the guides.
Timeline
Overall : 3 Months
Onboarding : 2 weeks
Recruitment : 2 weeks
Conducting Research : 3 weeks (Simultaneous)
Interviews : 6 weeks
Analysis and Synthesis : 2 weeks (Simultaneous)
Deliverables : 2 weeks
The Challenge
39.5 percent of people in the US will be diagnosed with cancer at some point during their lifetimes (Cancer.gov, May 2018), and nearly 66 percent of US cancer patients will receive radiation therapy (American Society for Radiation Oncology, 2015 Legislative Priorities Brief).
And treatment decisions are complex for those fortunate patients and families who have access to care, have health care coverage, and possess adequate knowledge and skill in navigating the health care delivery system.
External beam radiotherapy is the most common treatment for cancer, yet the process is intimidating and unfamiliar to most patients.
Providing understandable educational material to help anxious patients and caregivers navigate the process is vital—current patient education material is voluminous and overwhelming.
Our Approach
Improve patient experience, enabling doctors to effectively set expectations while empowering patients to seek the care they deserve.
The world-wide published guides, are designed to be used during doctor-patient discussions during the initial consultation, before starting the external beam radiation therapy treatment for malignant and benign cancers.
The Impact
“It helps patients to have a more concrete idea in their heads of what we’re talking about,” adds Dr.Golden. “I can show these graphic narrative images that are designed intentionally to have the right amount of detail. This helps the patient to have just the right amount of granularity to understand what’s going on, without being intimidated by it.”
We also received positive feedback from clinicians. Licensed with Creative Commons, anybody can download, print, and use the materials.
Research
Understanding the Context - Assessed the existing portfolio of guides and gained context on the physical constraints of designing the guide.
Expert presentations by Dr.Daniel Golden and a resident student at the University of Chicago Medicine also gave us in-depth information about the treatment flow. We also got familiar with the medical terminologies and jargon to dive deep into the primary research.
Attended the Graphic Medicine Exhibit and attend the Virtual Graphic Medicine Chicago Conference 2022 to observe and learn about the role of comics in healthcare and evolution over time.
We learned that graphic storytelling is its own visual language that can be leveraged to display concepts such as time passage, simultaneity, and projection.
On-site visit - What proved to be really beneficial in understanding a patient's perspective was walking through the various hospital rooms and absorbing the context, tools, surroundings, sights, and sounds.
We had the opportunity to conduct intercepts with both medical and non-medical staff, during which we gained insight into how they interact with patients and guide them through the treatment process
Hover for more insights 👇🏼
Some of the few main insights through the visits were,
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How the materials used felt on the patients' skin, whether they felt cold or warm.
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Whether the materials and immobilization allowed for easy breathing and didn't cause feelings of claustrophobia.
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How much time certain processes took, such as the hardening of the mask and the wait time for scans.
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How to position patients on the table for certain cancer sites and whether it was a comfortable position or not.
Remote and in-person Interviews - It was now time to understand patients’ and caregivers’ experiences. Based on what we learned about the context and the journeys, we made interview discussion guides and set out to conduct stakeholder interviews.
Over 6 weeks we conducted 25 interviews across 4 stakeholder groups. They were :
Insights
Synthesis Lens - Applying the synthesis lens, we began to find interesting overlaps, contradictions, and miscommunications between the stakeholder experiences.
Our debriefing sessions yielded most of our 'aha' moments, some of them were
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Playing music during radiation treatment helps patients feel more comfortable and relaxed while lying on the treatment table. Allowing patients to choose their preferred music can make the experience even smoother.
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Patients often have misconceptions about the effects of radiation treatment on their skin, particularly concerning skin burns. Educating patients about the actual risks and side effects of radiation treatment can alleviate their worries.
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Delays that occur during radiation treatment could be due to normal machine delays, which can be explained to patients to help them understand and prepare for the treatment process.
Synthesis
We used the ‘Quad A’ and MLRF frameworks for extracting actionable insights.
Mapped insights into patients' and staff’s Activities, Attitudes, Ambitions, and Anxieties.
Then apply it through the Multi-level Requirement Framework which focused on these insights through the Content level, User Needs level, and Contextual level.
Reframing Design Principles
Simultaneous synthesis helped us gain a better understanding and re-frame the guiding design principles.
Better prepare the patients
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Avoid any unpleasant surprises
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Help dispel common misconceptions
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Help them prepare for expected changes
Alleviate the overall anxiety
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Each experience can vary greatly between individuals.
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Build trust by providing a behind-the-scenes look and people involved.
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Identify common sources of anxiety or uncertainty about the process.
Help patients seek care
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Help patients communicate and prompt them to seek care.
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Reduce communication barriers.
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Help raise awareness about the resources available.
Key Concepts and Storyboard
We organized site-specific insights into clusters that helped us create a refined procedural map & a 'key concepts' document
This document was our primary reference point when it came to designing the guides. It was an iterative process as we asked for feedback from radiation oncologists while developing them.
Iterations and Design
Multiple iterations through reaching out to site-specific radiation oncologists and medical staff for feedback, our guides scored at a 5.4 Flesch-Kincaid grade level. The final deliverables were an 11' x 17' (tabloid) sized three-fold discussion guide. Tested and printed on various ink printers to check for colors and tones.
Hover for more insights 👇🏼
Refelctions and Learnings
Collaboration with Multiple stakeholders
This project was a multi-level collaborative experience that involved multiple stakeholders, including patients, families, and healthcare providers. Collaborating with these stakeholders allowed me to gain a deeper understanding of the healthcare system and its complexities, and ensured that our solution addressed the needs and concerns of all parties involved. This collaborative approach ultimately led to a more comprehensive solution that better met the needs of patients and providers alike.
For more information feel free to contact me 💬