Human centered design workshops as a meta-solution to diagnostic disparities

doi:10.1515/dx-2022-0025

. 2022 Aug 29;9(4):458-467.

doi: 10.1515/dx-2022-0025. eCollection 2022 Nov 1.

Human centered design workshops as a meta-solution to diagnostic disparities

Aaron A Wiegand^{1

2}, Vadim Dukhanin³, Taharat Sheikh⁴, Fateha Zannath⁴, Anushka Jajodia⁵, Suzanne Schrandt⁶, Helen Haskell⁷, Kathryn M McDonald^{1

8}

Affiliations

¹ Johns Hopkins University School of Nursing, Baltimore, MD, USA.
² Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Johns Hopkins University, Baltimore, MD, USA.
⁵ Center for Social Design, Maryland Institute College of Art, Baltimore, MD, USA.
⁶ Society to Improve Diagnosis in Medicine, Arlington, VA, USA.
⁷ Mothers Against Medical Error, Columbia, SC, USA.
⁸ Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

PMID: 36027891
DOI: 10.1515/dx-2022-0025

Human centered design workshops as a meta-solution to diagnostic disparities

Aaron A Wiegand et al. Diagnosis (Berl). 2022.

. 2022 Aug 29;9(4):458-467.

doi: 10.1515/dx-2022-0025. eCollection 2022 Nov 1.

Authors

Aaron A Wiegand^{1

2}, Vadim Dukhanin³, Taharat Sheikh⁴, Fateha Zannath⁴, Anushka Jajodia⁵, Suzanne Schrandt⁶, Helen Haskell⁷, Kathryn M McDonald^{1

8}

Affiliations

¹ Johns Hopkins University School of Nursing, Baltimore, MD, USA.
² Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁴ Johns Hopkins University, Baltimore, MD, USA.
⁵ Center for Social Design, Maryland Institute College of Art, Baltimore, MD, USA.
⁶ Society to Improve Diagnosis in Medicine, Arlington, VA, USA.
⁷ Mothers Against Medical Error, Columbia, SC, USA.
⁸ Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

PMID: 36027891
DOI: 10.1515/dx-2022-0025

Abstract

Objectives: Diagnostic errors - inaccurate or untimely diagnoses or failures to communicate diagnoses - are harmful and costly for patients and health systems. Diagnostic disparities occur when diagnostic errors are experienced at disproportionate rates by certain patient subgroups based, for example, on patients' age, sex/gender, or race/ethnicity. We aimed to develop and test the feasibility of a human centered design workshop series that engages diverse stakeholders to develop solutions for mitigating diagnostic disparities.

Methods: We employed a series of human centered design workshops supplemented by semi-structured interviews and literature evidence scans. Co-creation sessions and rapid prototyping by patient, clinician, and researcher stakeholders were used to generate design challenges, solution concepts, and prototypes.

Results: A series of four workshops attended by 25 unique participants was convened in 2019-2021. Workshops generated eight design challenges, envisioned 29 solutions, and formulated principles for developing solutions in an equitable, patient-centered manner. Workshops further resulted in the conceptualization of 37 solutions for addressing diagnostic disparities and prototypes for two of the solutions. Participants agreed that the workshop processes were replicable and could be implemented in other settings to allow stakeholders to generate context-specific solutions.

Conclusions: The incorporation of human centered design through a series of workshops promises to be a productive way of engaging patient-researcher stakeholders to mitigate and prevent further exacerbation of diagnostic disparities. Healthcare stakeholders can apply human centered design principles to guide thinking about improving diagnostic performance and to center diverse patients' needs and experiences when implementing quality and safety improvements.

Keywords: co-production; diagnostic disparities; diagnostic error; human centered design; patient safety; patient-centered.

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References

1. Institute of Medicine . Overview of diagnostic error in health care. In: Balogh, EP, Miller, BT, Ball, JR, editors. Improving diagnosis in health care . Washington (DC): National Academies Press (US); 2015.
1. Singh, H, Meyer, AN, Thomas, EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf 2014;23:727–31. https://doi.org/10.1136/bmjqs-2013-002627 . - DOI
1. Institute of Medicine Committee on Quality of Health Care in America . To err is human: building a safer health system , Kohn, LT, Corrigan, JM, Donaldson, MS, editors. Washington (DC): National Academies Press (US); 2000.
1. Leonhardt, D. Medical malpractice system breeds more waste. The New York Times ; 2009. Available from: https://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=0 [Accessed 21 Feb 2022].
1. McQuillan, LJ, Abramyan, HUS. Tort liability index: 2010 report . San Francisco, California: Pacific Research Institute; 2010:108 p.

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[1] Institute of Medicine . Overview of diagnostic error in health care. In: Balogh, EP, Miller, BT, Ball, JR, editors. Improving diagnosis in health care . Washington (DC): National Academies Press (US); 2015.

[2] Institute of Medicine . Overview of diagnostic error in health care. In: Balogh, EP, Miller, BT, Ball, JR, editors. Improving diagnosis in health care . Washington (DC): National Academies Press (US); 2015.

[3] Singh, H, Meyer, AN, Thomas, EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf 2014;23:727–31. https://doi.org/10.1136/bmjqs-2013-002627 . - DOI

[4] Singh, H, Meyer, AN, Thomas, EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf 2014;23:727–31. https://doi.org/10.1136/bmjqs-2013-002627 . - DOI

[5] Institute of Medicine Committee on Quality of Health Care in America . To err is human: building a safer health system , Kohn, LT, Corrigan, JM, Donaldson, MS, editors. Washington (DC): National Academies Press (US); 2000.

[6] Institute of Medicine Committee on Quality of Health Care in America . To err is human: building a safer health system , Kohn, LT, Corrigan, JM, Donaldson, MS, editors. Washington (DC): National Academies Press (US); 2000.

[7] Leonhardt, D. Medical malpractice system breeds more waste. The New York Times ; 2009. Available from: https://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=0 [Accessed 21 Feb 2022].

[8] Leonhardt, D. Medical malpractice system breeds more waste. The New York Times ; 2009. Available from: https://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=0 [Accessed 21 Feb 2022].

[9] McQuillan, LJ, Abramyan, HUS. Tort liability index: 2010 report . San Francisco, California: Pacific Research Institute; 2010:108 p.

[10] McQuillan, LJ, Abramyan, HUS. Tort liability index: 2010 report . San Francisco, California: Pacific Research Institute; 2010:108 p.

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Human centered design workshops as a meta-solution to diagnostic disparities

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Human centered design workshops as a meta-solution to diagnostic disparities

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