Addressing Racial Disparities in Cancer Readmissions
How might we understand and respond to persistent disparities in 30-day unplanned readmissions for Black cancer patients?
Client: UChicago Medicine
Design Capabilities: User Research, Service Design
My Role: Lead Researcher
Topics: Healthcare, Senior Citizens
THE PROJECT
UChicago Medicine's research arm partners with the Equitable Healthcare Lab at the Institute of Design, which works with industry partners to tackle the root causes of healthcare inequity.
The project employed a 14-week, 4-phase design approach to systematically evaluate and implement system changes addressing disparities in 30-day readmissions at the UCM Cancer Center. Beginning with baseline data exploration and collaboration with staff, the process included mapping current care, engaging representative Black cancer patients, and finally, prototyping interventions with stakeholders. This structured design approach aims to enhance equity and contribute to improved healthcare outcomes.
THE OUTCOME
Collaborating with Cancer Center patients, the team established priorities and crafted culturally-responsive solutions. The outcomes include four solution prototypes accompanied by respective design requirements to guide the implementation of targeted interventions, aiming to address the identified challenges and enhance the overall healthcare experience for minority cancer patients.
PROJECT TIMELINE
As per 1 year hospital data..
Black patients were 1.5 times more likely to readmit than White patients.
APPROACH
Phase 1: Scoping existing best practices
A comprehensive literature review identified established best practices in the field. This served to leverage existing knowledge and inform the selection of recommendations to be tested with stakeholders.
Phase 2: Understanding stakeholder needs and gaps
Stakeholder feedback was then solicited through individual interviews with ED providers, charge nurses, cancer-focused community health workers (CHWs), physicians, care coordinators, population health nurses, and post-acute staff.
Phase 3: Interviews & Card Sorts with 20+ patients
To ensure the solutions were culturally relevant and met the specific needs of the target population, engaged a representative group of Black cancer patients (and, in some cases, their caregivers) residing in the UCM service area to better understand preferred solutions that respond to their needs, priorities, beliefs and community norms related to cancer care and ED utilization.
INTERCEPTS
2 care givers
2 inpatient nurses
OBSERVATIONS + TOURS
MDR + Cancer Center
Oncology Rapid Assessment Center
INTERVIEWS
20 patients
1 hospitalist
3 ONNs
3 floor nurses
CARD SORTS
17 patients
1 hospitalist
3 nurses
ANALYSIS
The project employed a 14-week, 4-phase design approach to systematically evaluate and implement system changes addressing disparities in 30-day readmissions at the UCM Cancer Center. Beginning with baseline data exploration and collaboration with staff, the process included mapping current care, engaging representative Black cancer patients, and finally, prototyping interventions with stakeholders. This structured design approach aims to enhance equity and contribute to improved healthcare outcomes.
WHAT WE HEARD...
"
Patient's eagerness to go home can turn their focus away from necessary preparation.
"
"
Patient openness to more intensive follow-up services may be informed by their attitude towards having cancer.
SYNTHESIS
OUTCOME
An equity-enhanced framework for care delivery
Collaborating with Cancer Center patients, the team established priorities and crafted culturally-responsive solutions. The outcomes include four solution prototypes accompanied by respective design requirements to guide the implementation of targeted interventions, aiming to address the identified challenges and enhance the overall healthcare experience for minority cancer patients.
4 Key Findings
4 Strategies for Equity Enhanced Toolkit
RECOMMENDATIONS
Timeline
14 weeks
Region
Southside Chicago
My Role
Lead Researcher
Tools & Methods
Service Mapping
Stakeholder Analysis
Rapid Prototyping
Team
Emery Donovan
Mary Morgan
Smrti Ganesan