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

  • Aaron A. Wiegand , Vadim Dukhanin , Taharat Sheikh , Fateha Zannath , Anushka Jajodia , Suzanne Schrandt , Helen Haskell and Kathryn M. McDonald ORCID logo EMAIL logo
Published/Copyright: August 29, 2022
Diagnosis
From the journal Diagnosis Volume 9 Issue 4

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
Corresponding author: Dr. Kathryn M. McDonald, Johns Hopkins University School of Nursing, Baltimore, MD, USA; and Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA, Phone: +1 410 502 4015, E-mail:

Funding source: Coverys Community Healthcare Foundation

Acknowledgments

We would like to thank everyone that contributed to this research, including the research team at Johns Hopkins and Stanford, as well as the members of the Society to Improve Diagnosis in Medicine. Additionally, we thank the patients, patient advocates, clinicians, and researchers that participated in the study. Johns Hopkins University research team: Leta Ashebo, Danielle Ellerbe, Owen McManus, Isabel Rubin, Robab Vaziri, Jill Williams, Zihui (Lily) Zhu. Stanford University research team: Andrea Banuet, Sheryl Davies. Society to Improve Diagnosis in Medicine: Dan Persky, Sue Sheridan. Clinicians and researchers: John Brush, Yvonne Covin, Carmel Crock, Traber Lee Giardina, Kelly Gleason, Robert El-Kareh, Prashant Mahajan, Daniel Motta, Andrew Olson, Art Papier, Gordy Schiff, Anjana Sharma, Dana Siegel, Kelly Smith, Janiece Taylor, Thilan Wijesekera. Patients and patient advocates: Jeanette Averett, Susie Becken, Lyn Behnke, Sarah Kiehl, Kimberly Rodgers, Shani Weber, Io Dolka.

  1. Research funding: This project was funded through a grant from the Coverys Community Healthcare Foundation. The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: The Johns Hopkins Medicine Institutional Review Board deemed the study exempt from review.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/dx-2022-0025).

Received: 2022-02-25
Accepted: 2022-07-19
Published Online: 2022-08-29

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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  4. Opinion Papers
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  6. Pursuit of “endpoint diagnoses” as a cognitive forcing strategy to avoid premature diagnostic closure
  7. Guidelines and Recommendations
  8. The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy
  9. Original Articles
  10. Exploring procedure-based management reasoning: a case of tension pneumothorax
  11. A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts
  12. Human centered design workshops as a meta-solution to diagnostic disparities
  13. Longitudinal clinical reasoning theme embedded across four years of a medical school curriculum
  14. Using the Assessment of Reasoning Tool to facilitate feedback about diagnostic reasoning
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  18. Letter to the Editors
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  20. OPeNet: an AI-based platform implemented to facilitate clinical reasoning by primary care practitioners, as well as the virtuous co-management of chronic patients during and after the COVID-19 pandemic in Italy
  21. Letter to the Editor in reply to Diamandis “COVID-19 and the Le Chatelier’s principle”
https://doi.org/10.1515/dx-2022-0025
Keywords for this article
co-production; diagnostic disparities; diagnostic error; human centered design; patient safety; patient-centered

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. Diagnostic and therapeutic approach to hypernatremia
  4. Opinion Papers
  5. The diagnostic potential and barriers of microbiome based therapeutics
  6. Pursuit of “endpoint diagnoses” as a cognitive forcing strategy to avoid premature diagnostic closure
  7. Guidelines and Recommendations
  8. The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy
  9. Original Articles
  10. Exploring procedure-based management reasoning: a case of tension pneumothorax
  11. A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts
  12. Human centered design workshops as a meta-solution to diagnostic disparities
  13. Longitudinal clinical reasoning theme embedded across four years of a medical school curriculum
  14. Using the Assessment of Reasoning Tool to facilitate feedback about diagnostic reasoning
  15. Evolution of throat symptoms during the COVID-19 pandemic in the US
  16. Evaluating the role of a fully automated SARS-CoV-2 antigen ECLIA immunoassay in the management of the SARS COV 2 pandemic on general population
  17. miR-21-3p and miR-192-5p in patients with type 2 diabetic nephropathy
  18. Letter to the Editors
  19. Convoluted molecular maze of neprilysin
  20. OPeNet: an AI-based platform implemented to facilitate clinical reasoning by primary care practitioners, as well as the virtuous co-management of chronic patients during and after the COVID-19 pandemic in Italy
  21. Letter to the Editor in reply to Diamandis “COVID-19 and the Le Chatelier’s principle”
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