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

Author:

Wiegand Aaron A.12,Dukhanin Vadim3,Sheikh Taharat4,Zannath Fateha4,Jajodia Anushka5,Schrandt Suzanne6,Haskell Helen7,McDonald Kathryn M.18ORCID

Affiliation:

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

Abstract

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.

Funder

Coverys Community Healthcare Foundation

Publisher

Walter de Gruyter GmbH

Subject

Biochemistry (medical),Clinical Biochemistry,Public Health, Environmental and Occupational Health,Health Policy,Medicine (miscellaneous)

Reference61 articles.

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2. 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.

3. 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.

4. 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].

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

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