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设计思维在改善重症监护病房医疗服务中的应用:承诺、陷阱和经验教训。

Design thinking to improve healthcare delivery in the intensive care unit: Promise, pitfalls, and lessons learned.

机构信息

Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, 633 N. St. Clair St. Suite 2000, Chicago, IL 60611, United States of America; Northwestern University Feinberg School of Medicine, Arthur J. Rubloff Building, 420 E. Superior St., Chicago, IL 60611, United States of America.

Northwestern University McCormick School of Engineering, Technological Institute, 2145 Sheridan Road, Evanston, IL 60208, United States of America.

出版信息

J Crit Care. 2022 Jun;69:153999. doi: 10.1016/j.jcrc.2022.153999. Epub 2022 Feb 2.

Abstract

Design thinking is a problem-solving approach characterized by the empathetic lens through which designers integrate perspectives of end-users and key stakeholders throughout the entire process of developing solutions. This approach is rooted in diverse fields including engineering, computer science, psychology, and business and is increasingly widespread in healthcare. Herein, we describe the promise of design thinking to help solve intractable problems in healthcare delivery, including those within the complex social and technical intensive care unit system. We highlight our team's experience using design thinking to address the complex problem of aligning the delivery of life-sustaining treatments with patients' individual goals, values, and preferences. However, given the high stakes of design failure in healthcare, we also discuss the limitations of this approach and the potential consequences of inadequate application. Finally, we suggest a pathway forward that combines the philosophy and tools of design thinking with existing methods within healthcare delivery science, such as qualitative research, quality improvement methods, and implementation science. Ultimately, we argue that design thinking is a valuable approach to guide designers, clinicians, researchers, and administrators towards a more genuine understanding of the healthcare experience, through the lens of patients, their families, and frontline clinicians.

摘要

设计思维是一种解决问题的方法,其特点是设计师通过同理心的视角,将最终用户和关键利益相关者的观点融入到解决方案开发的整个过程中。这种方法源于工程学、计算机科学、心理学、商业等多个领域,在医疗保健领域的应用越来越广泛。本文介绍了设计思维在解决医疗保健服务中棘手问题方面的应用前景,包括在复杂的社会和技术密集型重症监护病房系统中存在的问题。我们强调了我们团队使用设计思维解决与维持生命治疗的提供与患者个人目标、价值观和偏好相匹配的这一复杂问题的经验。然而,鉴于医疗保健设计失败的高风险,我们也讨论了这种方法的局限性和应用不足的潜在后果。最后,我们提出了一条前进的道路,将设计思维的理念和工具与医疗保健服务提供领域内现有的方法(如定性研究、质量改进方法和实施科学)相结合。最终,我们认为设计思维是一种有价值的方法,可以通过患者、患者家属和一线临床医生的视角,引导设计师、临床医生、研究人员和管理人员更深入地了解医疗保健体验。

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