In collaboration with Adanna Onuekwusi, Hongji Zhang, Cole Rennie and Andy Wang
CLASS RESEARCH QUESTION
HOW CAN DESIGN help medical practitioners to provide a visual understanding of congenital heart defects (CHD) for the Stollery Children’s Hospital Cardiology Clinic patients and families?
HOW CAN DESIGN help medical practitioners to provide a visual understanding of congenital heart defects (CHD) for the Stollery Children’s Hospital Cardiology Clinic patients and families?
CONGENITAL HEART DEFECTS (CHD)
The Heart and Stroke Foundation of Canada defines congenital heart disease as,
“A heart condition someone is born with. A congenital heart defect happens when the heart or the blood vessels near the heart don’t develop normally before birth."
Depending on how the defect manifests, people with CHD will experience a variety of symptoms such as fatigue, and live with this for much of their lives.
COLLECTING STORIES
We built on our understanding of CHD through the stories of content experts, Jennifer and Jody.
We built on our understanding of CHD through the stories of content experts, Jennifer and Jody.
JENNIFER DANKO - MOTHER
Provided a mother’s perspective as her son lives with CHD. Jenn shared the complexity, abruptness, and longevity of living with CHD. As a parent it was her desire to establish control, consent, comfort and calmness.
JODY GINGRICH - TRANSITION NURSE
Works with 16 and 17 years olds to aid them in their upcoming transfer of healthcare management from the Stollery Children’s Hospital Care to Adult Care. Building understanding in teens about their CHD’s will help set up their expectations for the future.
FOCUSING THE TASK
There are a lot of issues within the healthcare system regarding how people understand their hearts, and these issues became even more complex when we thought about the various people that are involved in managing a person’s care. Seeing as Jody was our main point of contact for this project, we decided to focus on teens during their transition from child to adult care. After making this decision, we developed a more focused research question...
NEW RESEARCH QUESTION
How might we encourage interaction between teenagers and medical practitioners through the use of CHD visuals?
How might we encourage interaction between teenagers and medical practitioners through the use of CHD visuals?
TEENS AND CHD
High quality healthcare can be defined as integrating the patient within the system of care (Webb, 2004). Likewise, psychological studies of medical relationships revealed that developing adolescents seek genuine relationships with adults (Campbell, 2007). However, younger adolescents with less education on their personal condition often refer to their parents or guardians to provide information about their health (Burström et al., 2017).
“ ... it was important that the meeting with the physician was a dialogue and not just a monologue with questions directed to the adolescent.”
— from BURSTRÖM ET AL., 2017
CURRENT STOLLERY VISUALS
Now that we defined a more focused task, and had a better idea of what makes quality healthcare we returned to the current Stollery visuals. With Jody’s help, we examined the current visual tools used in the Stollery Children’s Hospital and identified the pros and cons...
One example of the current CHD sheets handed out to patients and families of the Stollery Children’s Hospital.
GUIDELINES FROM JODY
Jody also provided us with general guidelines of what she wanted to see in our designs. These included...
• Coloured drawings
• Mixing of blood
• Labeling of anatomy
• Space for notes / drawing
• Directions of blood flow
IMAGE AUDIT
As we worked to understand the CHD defects ourselves we found our own experience helpful in realizing how some images were better at communicating a defect than others. We made notes of this through an image audit. Combining our observations with Jody’s criteria set up for the next phase of ideating.
Images we didn't like
WHAT WE DIDN'T LIKE
REALISM Images that contained all the details of the heart were convoluted and busy.
SCIENTIFIC/MEDICAL AESTHETIC Although these drawing styles may feel familiar to medical practitioners we found them unrelatable and inaccessible.
Images we did like
WHAT WE DID LIKE
FLAT DRAWINGS Easier to understand as they were less clustered with shading and highlights.
LARGER CIRCULATORY SYSTEM Helpful in identifying the hearts main purpose, the transfer of nutrients and waste through our bodies.
RED, BLUE, PURPLE Keep conventional colours that represent oxygen transfer in the bloodstream.
DIRECTED ATTENTION Guided eyes to locate the defect.
MAGGIE MEETS HER HEART
(click story to enlarge)
MEET YOUR HEART
We imagined this folder will be handed out to teen patients during their first transition meetings with Jody. She mentioned her transition meetings last about 45 minutes to an hour, and that a teen will see her 3 to 4 times before transitioning to Adult Care.
*(graphic and information design by myself, illustrations teammate Adanna with assistant from Hongji, presentation mock-ups by Adanna)
INTERACTION Included personalization with having a place for the patient’s name, giving space for both doctors and patients to write and draw notes, and encouraging questions through prompts.
SYSTEM Visual system kept blues to the left and reds to the right, mirroring the way blood flow is conventionally represented.
HOW THE HEART WORKS
Having a solid understanding of a typical heart makes it much easier to understand the problems, symptoms, and consequences of a heart that is not working normally. In our own efforts to understand the heart we felt one visual was not enough to communicate the basics. We also felt it was important to break down the learning into steps as not to overwhelm a patient with a busy page of information. We developed a static booklet called “How the Heart Works.”
LEARNING IN STEPS It was important break down the learning into steps as not to overwhelm a patient with a busy page of information.
LANGUAGE Using a phase such as “How the Normal Heart Works,” carries and emotional weight, perhaps making them feel abnormal.
LARGER CIRCULATORY SYSTEM We broke down the process into digestible and progressive steps, with the starting point where blood enters the heart. Numbers and arrows help to guide the patient through the visual.
CHD PAGES
DYNAMIC Our prototype is dynamic since we gave each CHD it’s own page. Depending on the patient they may receive only one or multiple defect sheets.
PERSONALIZATION Each of these pages also provide a spot for the patient to put their name, and includes an illustration of a typical heart that is the same size as the defect heart, making it easy for the patient to reference back and forth.
DIRECTED FOCUS We highlighted the area(s) of compilation so that patients weren’t left searching the page for the defect.
LIMITATIONS
To test our prototype, we presented it to other healthcare professionals. While the overall tone was positive, moving forward it would be important to work closely with cardiologists to refine our illustrations to be concurrent with the information they relay to teens and other patients.
One of the biggest limitations during this project was that we never had the opportunity to talk with teens living with CHD. Due to time constraints, we were unable to pursue this feedback. We only consulted people that worked closely with teens and relied on information gathered through secondary research.
MOVING FORWARD
What we really created was a conversation piece. The intention behind this design was to create visuals that help teens take ownership over their own healthcare. We presented in front of an audience of stakeholders including patients, families, nurses, cardiologists, and designers. We received positive feedback on storytelling and the thoughtfulness of our prototype. Our project was chosen to become a resource in the Stollery Children’s Hospital Cardiology Clinic. Adanna and I were chosen to continue our visual work with Adanna working on illustrations and myself coninuing the graphic and information design. We are currently in the process of developing the updated CHD materials.
REFERENCES
Burström, A., et al. 2017. “Adolescents with congenital heart disease: their opinions about the preparation for transfer to adult care.” Eur J Pediatr. (176) 881–889.
Campbell M. 2007. “Communicating with Adolescents.” CME. (25)5, 224-227.
Gibson, R., Reiss, J., and Walker, L. 2005. “Health Care Transition: Youth, Family, and Provider Perspectives” Pediatrics. (115)1, 112-120
Heart and Stroke Foundation of Canada. 2018. https://www.heartandstroke.ca/heart/conditions congenitalheart-disease, Accessed June 11, 2019.
Webb, G. 2004. “Improving the care of patients with congenital heart disease: an adult focus.” Greenwich Medical Media Ltd. (14) 6-14.
STORYBOARD ILLUSTRATIONS
Derived from www.humaaans.com illustrations.
Derived from www.humaaans.com illustrations.
