Greetings! Our Department of Family Practice is currently exploring the clinical placement model and environment. Given this, our Abbotsford-Mission site took the opportunity to use the design thinking process to consider how the clinical learning setting would look if it were to:

1. Support the inclusion and practice of medical students, residents, clinical educators, and their staff, and;
2. Offer patients interdisciplinary, team-based care.

During our Academic Half Day, we assembled in teams of 2-3 and went through a series of steps including:

1. Create a Blueprint: Plan and draw out the space. Describe the objectives of each area and services provided.

2. Design a Narrative: Describe the experience and transition of patients, learners, and educators within the environment.

3. Illustrate the Accommodation: Describe the activities, resources, and number of users that may be accommodated.

Here are the results of our three teams:

TEAM ONE: Patient-Centred Sanctuary: Music School Model

Patient Centred Sanctuary
Patient-Centred Sanctuary: Music School Model

A music school is the inspiration behind the physical design and layout of the space. The clinic’s objectives include offering patients a sanctuary that is safe and comforting in addition to providing learners an environment that is centred on education and patient inclusion. The patient enters the space on the right side and is greeted by the medical office assistant (yellow rectangle).

The patient area is  surrounded by “empathy” and “healing” walls. The “Empathy Wall” contains patient stories and art. In this room they are offered services such as coffee, water, massage, and aromatherapy. In the middle of the space is the “Recording Room” (brown rectangle) where the student and/or resident, preceptor, and patient explore learning. Patients invited into the Recording Room are intimately involved in the learning process and assist both preceptor and learner in delivering care. There is an “Observation Room” directly attached to the right of the Recording Room for learners, educators, and patients to observe, provide constructive feedback, and debrief.

Above the Observation Room is a small private “Resident/Student Space” designated for computer work, note taking, etc. To the right is a large “Procedure Room” (pink rectangle) that allows for the team to watch and engage with both spaces. To the left of the Recording Room is the “Doctor Workspace” (blue rectangle) that offers an open concept setting allowing for physicians to converse on patient, teaching, and learning matters. Surrounding the Recording Room are a series of “Practice Rooms” designed for R2s who require less observation in their work with patients and more hands-on experience.

TEAM TWO: Patient Education & Empowerment Model

Patient Education and Empowerment
Patient Education & Empowerment Model

The objectives of this clinic include empowering and educating patients as well as supporting physician wellness and learning. Patients arrive at the top centre of the layout where they are greeted by the medical office assistant (represented by orange polka-dot square). As the patient enters the space, they experience aromatherapy and light music.

To the right of the room, there are a series of “Patient Workstations” (heart-shaped cushions) and wifi that offer access to patient-centred educational websites and resources. Once greeted and checked in, the patients are then asked to head into the room on the right that educates them on taking their own vitals including blood pressure, heart rate, weight, and height. Next to the “Vitals Room” (blue pipe cleaner) there is a “Patient-Dedicated Bathroom” (yellow pipe cleaner) to the right of this space.

In the centre of the office is the ”Learning/Command Centre Pod” (yellow, white, purple polkadot squares) that has a series of “Patient Exam Rooms” (white squares) where students, residents, and preceptors meet with clients. As patients enter the room, they come upon an iPad located at the door that registers their mood and responds by adjusting the exam room’s lighting, scent, and music to provide greater patient comfort. Each room is outfitted with one door for staff and one door for patients as well as a skylight for natural light.

The “Staff Workroom” (yellow square) is where physicians and learners can convene to discuss their experiences. There are one-way mirrors that connect the Staff Workroom to the surrounding patient rooms allowing for observation. To the right of the Learning Pod, is the dedicated “Staff Bathroom” (pink pipe cleaner) and “Meeting Room” (blue square) serving treats and craft coffee. To the left of the Learning Pod is the “Procedure Room” (cork square) again offering two separate doors for staff and patients. In the top left-hand corner, there is the “Staff Gym” and “Change/Shower Room” that encourage employee health and wellness.

TEAM THREE: Patient-Family Oriented Model

family
Patient-Family Oriented Model

The main objectives of this clinic include creating an inviting and inclusive environment for the patient and the patient’s family members. The residents working on this space discussed the increasing presence of family members at their clinics and felt the need to accommodate them.

The patient enters the setting from the top left-hand corner (blue rectangle) and is greeted by a medical office assistant at the front. On the right side, they have access to comfortable seating (heart-shaped cushions), a library, snacks, coffee, and toys for the kids. To the right of the “Patient Learning” area is the “Patient Bathroom” (black square). On the far left, the patient enters the exam room, now identified as the ”Family Room” (pink rectangle) where patients and their family are encouraged to make themselves at home. These rooms are fairly large in that they can accommodate for up to 4-6 people.

In the centre of the space is the “Learning Office” (aquamarine square) outfitted with a series of “Workstations“. To the right of that room is the “Procedure/Supplies Room” (light blue polkadot rectangle) empowering and educating both learners and the patients on the procedures being performed. Surrounding the space are varied “Exam Rooms” for learners and educators to see patients and debrief their experiences.

In summary, this exercise emphasized that there are several ways to think about a clinical learning space that is designed to address a variety of patients’ needs while also accommodating for one’s learning and development. All the models illuminate the creativity and genius of our Residents as they take their experiences and ideas and articulate them on paper. I hope this provides others the inspiration to tinker with their clinical space and consider other alternatives and perspectives as to how people experience their environment.

A big thank you to our Residents for participating and providing your insights and thoughts on how we can design a clinical learning environment for the present and future of healthcare.

Warm regards and have a great weekend,

Jacqueline

P.S. Visit our other brainstorming and prototyping sessions on Design Thinking & Healthcare and Residents’ Transition to Practice. Since we’ve embarked on the Design Thinking method, we’ve also taken field trips to Holmberg House and Maplewood Long-Term Residential Care as well as invited special guests (Celebrity Chef Michael Smith, CEO Ikona Health Tim Fitzpatrick, and our Elder Roberta Price) to share their experience. This month we have Patient Advocate and Champion Carolyn Canfield joining us!

#EcologyOfCare #DesignThinking #Ideate #Prototype #ClinicalPlacementModel #ClinicalLearningEnvironment #HumanCentredDesign

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