| 1. |
- Holmqvist, Malin, et al.
(author)
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How older persons and health care professionals co-designed a medication plan prototype remotely to promote patient safety : Case study
- 2023
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In: JMIR Aging. - : JMIR Publications. - 2561-7605. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Harm from medications is a major patient safety challenge. Most adverse drug events arise when a medication is prescribed or reevaluated. Therefore, interventions in this area may improve patient safety. A medication plan, that is, a plan for continued treatment with medications, may support patient safety. Participation of patients in the design of health care products or services may improve patient safety. Co-design, as in the Double Diamond framework from the Design Council, England, can emphasize patient involvement. As the COVID-19 pandemic brought restrictions to face-to-face co-design approaches, interest in remote approaches increased. However, it is uncertain how best to perform remote co-design. Therefore, we explored a remote approach, which brought together older persons and health care professionals to co-design a medication plan prototype in the electronic health record, aiming to support patient safety.OBJECTIVE: This study aimed to describe how remote co-design was applied to create a medication plan prototype and to explore participants' experiences with this approach.METHODS: Within a case study design, we explored the experiences of a remote co-design initiative with 14 participants in a regional health care system in southern Sweden. Using descriptive statistics, quantitative data from questionnaires and web-based workshop timestamps were analyzed. A thematic analysis of the qualitative data gathered from workshops, interviews, and free-text responses to the survey questions was performed. Qualitative and quantitative data were compared side by side in the discussion.RESULTS: The analysis of the questionnaires revealed that the participants rated the experiences of the co-design initiative very high. In addition, the balance between how much involved persons expressed their wishes and were listened to was considered very good. Marked timestamps from audio recordings showed that the workshops proceeded according to the plan. The thematic analysis yielded the following main themes: Everyone's perspective matters, Learning by sharing, and Mastering a digital space. The themes encompassed what helped to establish a permissive environment that allowed the participants to be involved and share viewpoints. There was a dynamic process of learning and understanding, realizing that despite different backgrounds, there was consensus about the requirements for a medication plan. The remote co-design process seemed appealing, by balancing opportunities and challenges and building an inviting, creative, and tolerant environment.CONCLUSIONS: Participants experienced that the remote co-design initiative was inclusive of their perspectives and facilitated learning by sharing experiences. The Double Diamond framework was applicable in a digital context and supported the co-design process of the medication plan prototype. Remote co-design is still novel, but with attentiveness to power relations between all involved, this approach may increase opportunities for older persons and health care professionals to collaboratively design products or services that can improve patient safety.
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| 2. |
- Holmqvist, Malin, et al.
(author)
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Older persons' and health care professionals' design choices when co-designing a medication plan aiming to promote patient safety : Case study
- 2023
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In: JMIR Aging. - : JMIR Publications. - 2561-7605. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Harm from medications is a major patient safety challenge among older persons. Adverse drug events tend to arise when prescribing or evaluating medications; therefore, interventions targeting these may promote patient safety. Guidelines highlight the value of a joint plan for continued treatment. If such a plan includes medications, a medication plan promoting patient safety is advised. There is growing evidence for the benefits of including patients and health care professionals in initiatives for improving health care products and services through co-design.OBJECTIVE: This study aimed to identify participants' needs and requirements for a medication plan and explore their reasoning for different design choices.METHODS: Using a case study design, we collected and analyzed qualitative and quantitative data and compared them side by side. We explored the needs and requirements for a medication plan expressed by 14 participants (older persons, nurses, and physicians) during a co-design initiative in a regional health system in Sweden. We performed a directed content analysis of qualitative data gathered from co-design sessions and interviews. Descriptive statistics were used to analyze the quantitative data from survey answers.RESULTS: A medication plan must provide an added everyday value related to safety, effort, and engagement. The physicians addressed challenges in setting aside time to apply a medication plan, whereas the older persons raised the potential for increased patient involvement. According to the participants, a medication plan needs to support communication, continuity, and interaction. The nurses specifically addressed the need for a plan that was easy to gain an overview of. Important function requirements included providing instant access, automation, and attention. Content requirements included providing detailed information about the medication treatment. Having the plan linked to the medication list and instantly obtainable information was also requested.CONCLUSIONS: After discussing the needs and requirements for a medication plan, the participants agreed on an iteratively developed medication plan prototype linked to the medication list within the existing electronic health record. According to the participants, the medication plan prototype may promote patient safety and enable patient engagement, but concerns were raised about its use in daily clinical practice. The last step in the co-design framework is testing the intervention to explore how it works and connects with users. Therefore, testing the medication plan prototype in clinical practice would be a future step.
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| 3. |
- Holmqvist, Malin, et al.
(author)
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What can co-design teach us about involving patients in patient safety work?
- 2022
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Conference paper (peer-reviewed)abstract
- Medication Without Harm is according to WHO the third Global Patient Safety Challenge and affects everyone of us. But how can we make medication management safer and what is our role in this improvement process as a person using medications, next-of-kin, physician, nurse, quality improvement leader etc.? How do we all get involved and what are our input and responsibilities?
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| 4. |
- Hylving, Lena, 1974-, et al.
(author)
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Game design as a pedagogical tool for learning and reflection : The case of the ethics experience
- 2022
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In: Design, Learning, and Innovation. - Cham : Springer. - 9783031066757 - 9783031066740 ; , s. 86-96
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Conference paper (peer-reviewed)abstract
- This paper sets out to present an ongoing pedagogical project where game design is used to let students both learn and reflect upon different perspectives of ethics relevant to the master program they are enrolled in. The paper explains the underlying logic behind the pedagogical process where students develop their own game and at the same time learn about different perspectives of ethics in relation to courses that they are currently taking. With an open and iterative method, we let the students explore, discuss and design a game that can be used by future students. By letting the students decide and lead the development we democratize the learning-process and engage them in a learning experience. More so, this approach to game design as a pedagogical tool to engage and democratize the learning experience is new and increasingly relevant for both students that play games on an everyday basis, but also students that are new to games. Also, it is a constant and dynamic process for both students and teachers. © 2022, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.
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| 5. |
- Hylving, Lena, 1974-, et al.
(author)
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Turtles and Ethics : Experiential Learning through Game-making
- 2023
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In: Proceedings of the Annual Hawaii International Conference on System Sciences. - : IEEE Computer Society. - 9780998133164 ; , s. 4671-4680
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Conference paper (peer-reviewed)abstract
- Teaching and exploring the ethical issues brought about by digitalization is an important challenge in current higher education programs. Experiential learning through games is becoming increasingly relevant as games exert an enormous influence on the imaginarium of newer generations. This paper details how a class of international graduate students engaged in a year-long exploration of ethics, gender, and sustainability issues by playing, remixing, and designing games using an original Design Games Framework. Using a qualitative approach based on participatory observations that followed the student's entire game-making process and a series of final semi-structured interviews, the paper illustrates how game-making can enable higher education students to better understand the complex interplay of ethical issues and digitalization processes, as well as confirming that the Design Games Framework is a valid instrument for the exploration of ethics through the design of tabletop games in a higher education setting.
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| 6. |
- Lind, Jonas, et al.
(author)
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Contact patterns and costs of multiple sclerosis in the Swedish healthcare system : A population-based quantitative study
- 2022
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In: Brain and Behavior. - : John Wiley & Sons. - 2162-3279. ; 12:6
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Journal article (peer-reviewed)abstract
- BACKGROUND: The burden of disease for persons with multiple sclerosis (MS) and society is changing due to new treatments. Knowledge about the total need for care is necessary in relation to changing needs and new service models.OBJECTIVE: The aim of this study was to describe the contact patterns for MS patients, calculate costs in health care, and create meaningful subgroups to analyze contact patterns.METHODS: All patients diagnosed with MS at Ryhov Hospital were included. All contacts in the region from January 1, 2018, until September 30, 2019, were retrieved from the hospital administrative system. Data about age, sex, contacts, and diagnosis were registered. The cost was calculated using case costing, and costs for prescriptions were calculated from medical files.RESULTS: During the 21-month period, patients (n = 305) had 9628 contacts and 7471 physical visits, with a total cost of $7,766,109. Seventeen percent of the patients accounted for 48% of the visits. The median annual cost was $7386 in the group with 10 or fewer visits, compared to $22,491 in patients with more than 50 visits.CONCLUSION: There are considerable differences in the utilization of care and cost between patients with MS in an unselected population, meaning that the care needs to be better customized to each patient's demands.
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| 7. |
- Lindenfalk, Bertil, et al.
(author)
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Big design – designing at scale
- 2019
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In: Conference Proceedings of the Academy for Design Innovation Management. - London : Design Research Society. - 9781912769025 ; , s. 1772-1774
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Conference paper (other academic/artistic)abstract
- Large-scale transformation projects have so far rather consistently embraced a dirigist, technicistic perspective. Their outcomes are on the other hand meant to be experienced by communities in a direct, engaged manner that is embodied, spatial and temporal. For processes meant to radically transform the lived experience of people, they have so far been strategically unconcerned with any human-centric view.
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| 8. |
- Lindenfalk, Bertil, et al.
(author)
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Digitally mediated schizophrenia care – A Swedish case of translating, designing and expert evaluation of Dialog
- 2022
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In: MEDINFO 2021. - Amsterdam : IOS Press. - 9781643682648 - 9781643682655 ; , s. 882-886
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Conference paper (peer-reviewed)abstract
- This work presents initial results of translation, design, development and expert testing of a digitally mediated dialogue based tool for schizophrenia care in Sweden. Dialog+ is a conversational methodology that has been shown to empower patients, promote co-produced and more cost-effective care. Dialog+ was translated and the digital application was redesigned to fit with the local context using human-centered design principles. Initial results of expert user testing, using heuristic evaluations and cognitive walkthroughs, shows promise for the method to work well also in Swedish settings. Initial testing with patients shows promising results. This work exemplifies how care patterns can be improved by considering the information layer of the interaction and creating shared and collaborative working spaces during treatment sessions can help to both empower patients and facilitate a more co-produced treatment plan.
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| 9. |
- Lindenfalk, Bertil, et al.
(author)
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Guidance Through Use : Value as a Pathfinder in e-Health Services Implementation
- 2017
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In: MEDINFO 2017: PRECISION HEALTHCARE THROUGH INFORMATICS. - : IOS Press. - 9781614998303 - 9781614998297 ; , s. 151-155
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Conference paper (peer-reviewed)abstract
- The lack of awareness and confidence in eHealth solutions among certain stakeholders creates a barrier for the implementation of e-Health services. The aim of this paper is to explore issues that promote the development and implementation of patient-centered care services for the elderly. An exploratory case study approach is applied to a e-Health monitoring service that was developed and piloted in 38 homes for the elderly in Sweden and the Netherlands. The unit of analysis, concept of 'value-in-use', was used in order to determine how pilot participants felt about a service of this kind benefiting them the most. The findings were then translated into actionable considerations for implementing organizations. The results indicate a need for active participation, technical support infrastructure, mobility demands, and an extension of the concept of trust in e-Health services. The knowledge presented in the study is important for decisions makers, public organization strategists, and policy writers.
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| 10. |
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