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LRI Project 1 Project Goal The goal was to research the nursing facility transition process and design a prototype to make this process easier for the user.

Key Terms Advocate - A volunteer who works directly with individuals moving from a nursing facility. Consumer - The individual moving from the nursing home.

Our challenges were... • • • •

Designing with accessibility in mind Building trust with client and users Using clear non-designer language Finishing the project within the time constraints of a semester


Designing for the Nursing Home Transition Process

Designing for the Nursing Home Transition Process Design Tools Used: Sd

SHADOWING

Cc

CO-CREATION

Ci

CONTEXTUAL INQUIRY

Ry

ROLE PLAYING

En

ETHNOGRAPHY

Rp

RAPID PROTOTYPING

Pe

PERSONAS

Ia

INFORMATION ARCHITECTURE

Cj

CUSTOMER JOURNEY MAP

Ut

USABILITY TESTING

Fd

FLOW DIAGRAMMING

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We observed an interesting dynamic between Nancy and Norma. Nancy is very talkative and often leads the conversation. Norma often NANCY SALANDRA Director of Independent Living

follows and tends to be quiet during the group discussion. This meant that we had to facilitate our meetings well and make sure Norma had a voice.

NORMA ROBERTSON-DABROWSKI Director, Specialized Transition Services


Designing for the Nursing Home Transition Process

The Client Contacts We observed very early that the culture at Liberty Resources is open and organic. Our initial goal was to build trust and rapport with both Nancy and Norma. This was easy because everyone is friendly and open to newcomers. In their eyes, by us being there, that was enough to trust us. This meant it was easy to make decisions and move in the direction we felt was necessary.

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1

2 $

$

4 Public Housing Authority

5 $ Eligibility paperwork

Maximus

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Find housing

Find housing

Find housing


Designing for the Nursing Home Transition Process

Cj

CUSTOMER JOURNEY MAP

3 Nursing Homes

Maximus Nursing Home Transition Process

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1. The National Gov. gives the money to the State. 2. The State consolidates the process to save money. Shareholders

3. The nursing home sends in a request to transition. 4. PHA is notified and begins looking for housing. 5. Eligibility paperwork is sent through Maximus. 6. Maximus works for its shareholders and not the consumers. 7. The individual waits at least a year to move from the nursing home.

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Internal Observations: The Advocate Meeting The Advocate system at Liberty Resources was implemented to help Consumers move out of nursing facilities. The Advocate meeting allowed us to do initial networking and research. It gave us a chance to meet individuals who have already moved from nursing facilities. The Advocates are given four Consumers, a month, to help transition and can only work a maximum of eight hours in that month. The Advocate meetings are very loose and unstructured. Which makes it very confusing. We observed that the Advocates lack structure. Several individuals forgot what they needed to do and much information had to be retained from their visits to the nursing facilities.


Designing for the Nursing Home Transition Process

En

ETHNOGRAPHY

Nancy had to stop the meeting several times to answer questions and help certain advocates catch up.

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User Stories

Michael:

Sue:

Volunteer

Advocate

Insight: “It costs three times as

Insight: “To be reunited with

much for tax payers to support

her children she lost when she

people with disabilities living in

first acquired her disability, Sue

nursing homes as opposed to

has re-entered a nursing facility

supporting them to live in the

across the country to be closer to

community.”

them. It is the only way to receive the services she needs without being placed on a two year wait list for what she needs to live independently.”


Designing for the Nursing Home Transition Process

Vincent:

Glenda:

Volunteer

Advocate

Insight: “I believe that the

Insight: “Nursing facilities unjustly

mayor and general public do not

take a resident’s money. I know

understand what it is like to live

a couple who was ‘tricked’ into

in a nursing facility. It is easier to

moving in to the nursing facility.

support nursing homes versus

When the wife got sick, the

supporting living independently.”

husband missed her so much that the facility convinced him that he should move in as well.”

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External Observations: Nursing Facility Visits We set up visits to shadow Advocates at the nursing facilities. We had a chance to observe the interaction between the consumer, advocate, and nursing facility staff. By concentrating more on the process we were able to observe the steps taken by the advocate and consumer. I found that staff of the nursing facility are busy and do not have time to manage all consumer needs. Meaning, the consumer is left to manage their own needs. Social workers are required by the facility to work with the advocate and consumer and act as a middleman by facilitating the transition. However, the social worker is often vacant from the process due to high demand. The consumer often feels lost in the process. Also they have no way of tracking what they need to do. Many Advocates are sloppy and untrained. We feel Advocates should inform the Consumer about what steps are left and must do better at tracking progress.


Designing for the Nursing Home Transition Process

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Upon my arrival to the Inglis House I observed that it was gated in, almost like prison. We heard from several advocates that they felt like they were in prison while in a nursing facility. While inside I was asked to put my camera away. Much like a hospital, photography is prohibited. However, relying on observation was good practice.

Sd

SHADOWING

En

ETHNOGRAPHY


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Designing for the Nursing Home Transition Process

Prototype: Liberty Cards This simple booklet shares the step-by-step process and assists the Consumer to transition out of a nursing facility and live independently in the community.

ADVOCATE

CONSUMER

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Liberty Card Content Co-creation with the Client We quickly realized the complexity and extent of the steps needed to complete the transition. To create a better understanding and test some of the assumptions we had been making, we decided to co-create with our clients, Norma and Nancy. To make sense of this complex process, we used card sorting to show chronology and connections. Making this process visual and external encouraged us to zoom in and out to see the big picture as well as distinguish smaller steps and phases.


Designing for the Nursing Home Transition Process Cc

CO-CREATION

Ia

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INFORMATION ARCHITECTURE

We collaborated with Norma and Nancy to more deeply understand the steps of the transition process.

Once we understood the process in their eyes, we mapped it ourselves to better understand how

Fd

FLOW DIAGRAMMING

to make it easy to follow.


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Liberty Cards: Iteration In order to meet the immediate needs of speeding up the transition process at Liberty Resources, we designed the Liberty Cards as a tangible tool. It can provide the Consumers in nursing facilities with the first six steps of the transition process.

Fd

FLOW DIAGRAMMING


Designing for the Nursing Home Transition Process

Liberty Cards: Concept We felt it would be important to understand how the process would be packaged. Thinking of format, style,and material we collaborated, discussed, and visualized.

We gave ourselves time constraints by coming up with as many ideas as we could in five minutes. Then we iterated on these ideas and discussed their feasibility.

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Liberty Cards: Development Considering the physical limitations of the user, we tried out different structures of our prototypes, for instance:

• • • Rp

RAPID PROTOTYPING

Lamination – Protected and spill proof Binding Ring - Maybe more feasible to the user with hand disabilities Accordion Binding - Easily remove steps of the process to feel accomplishment


Designing for the Nursing Home Transition Process

Liberty Cards: Production + Distribution After we identified the budget issue at Liberty Resources, the Liberty Cards were designed half the size of normal print paper, allowing the staff at Liberty Resources to easily print and cut.

We planned how the prototypes would be distributed. We needed to figure out a cheap and easy way to make the cards for the volunteers to replicate.

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Liberty Cards: User Feedback and Usability Testing From our observation in the advocacy meeting, we found and concluded the pros and cons of the different construction forms of the Liberty Cards. For instance, in some versions, cards easily fell to the floor. In others, it was difficult to turn the pages or bound pages were too loose to control.

Ut

USABILITY TESTING

Ci

CONTEXTUAL INQUIRY

By putting the prototypes in the hands of the advocate, we were able to compare and contrast the usability of each.


Designing for the Nursing Home Transition Process

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Possible Future Iteration - iPad Application


Designing for the Nursing Home Transition Process

The Prototype Today As our semester came to a close, we presented to our client recommendations about how to make the packet. Currently, the Liberty Cards are being used by consumers and advocates. In the first round, volunteers of Liberty Resources created 40 booklets for consumers to be used and tested. The current iterations are in the hands of our client and can easily be adjusted or refined.

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LRI Project 1: Nursing Home Transition Process