Design Thinking in the Hospital

Get acquainted with design thinking as it applies to the hospital setting. You too can get in on the action! What is the orange vest and CareCube? Come up with some new ideas and products in your setting too! Nurses General Nursing Article

  1. Do nurses have the time to become design thinkers?

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Design Thinking in the Hospital

Sounds simple, but there comes a moment in the hospital when we all say, "I wish I had invented or thought of that. I could have retired by now." Looking at that concept, we find design thinking. This means that the person in the setting itself is responsible for creating the new product. In the hospital setting, this means that RNs and MDs are the ones coming up with innovative products1. Ideas for new products come from those in the thick of things or those working in the trenches instead of outside consultants.


Design thinking was invented in a non-hospital setting. It refers to the designer being a part of a setting and figuring out what is needed in that venue to improve services.2 A large part of this is also marketing the product to the core audience, in this case the hospital. The hospital team members then move the product to designers, who provide the product with input from the members.

A key concept to remember is that today's healthcare system is being stretched to full capacity. It is delivering products and services in a system that was never meant to take on such challenges when first invented.3 A Commonwealth Fund survey reveals that more than seven out of 10 adults are of the belief that this country's health system needs a complete overhaul.3 This just strengthens the need for design thinking.


To start from scratch, a definition of design thinking has three parts.3 They are as follows: it utilizes research and keeps the end users, in this case, the hospital staff in mind. It also uses a team approach to apply innovations from the team instead of obscure ideas. Keeping the end users in mind, refers to being empathetic to the players in the hospitals setting, that is, the doctors and nurses.3


One example is the orange trauma team leader identification vest. No one knew who was running a trauma code which was a chaotic scene and had many responders giving orders. This concept especially works in crowded code situations, which many times in acute care settings is the norm nowadays. This vest is easily transferable to all types of codes in the hospital setting. This vest idea was invented by a nurse. By the way, reports from the trauma team where it originated are that wearing the vest has helped the members during these critical events.1


Another idea generated by design thinking is the CareCube.1 At Thomas Jefferson University in Philadelphia, the Jefferson Health Design lab came up with the CareCube as a way for pediatric patients to score their pain level.1 It uses a cube, which has a drawing of a universally known expression such as a frown or grimace that the child can look at and identify with their hand. The nurse can then look at the pain scale that equals the expression and decide on the next course of action, which could mean administering pain medication or not.


A new concept introduced by the team at Thomas Jefferson Health Design is a digital mapping tool.1 Again, the emergency room, is the setting. This time, medical students and architecture students were placed in a course to figure out how three groups, patients, nurses and physicians occupy the same space. How they speak to each other was considered and how all these factors influence waiting times in an emergency room where time can mean the difference between life and death.


Finally, since pretty much of us are online, there is a group for design thinkers! This online group brings architecture to the medical mix. Called, Clinicians for Design4 it was started by Dr. Diana Anderson, and Dr. Eve Edelstein. Dr. Anderson is a doctor who started out as an architect. She calls herself a "dochitect" and Dr. Edelstein calls herself a neuro-architect. Her background is neurology. This web-based community offers online discussions about the health care environment and how to improve it from architectural and medical viewpoints.

In the hospital setting, there is always a need for new ideas and products. Just look around and see if you can become a design thinker!


1. Design Thinking for Doctors and Nurses Amitha Kalaichandran Aug. 3, 2017Design Thinking for Doctors and Nurses- The New York Times

Accessed July 20, 201

2.Roberts, P., Fisher, T., Trowbridge, M., Bent, C., A design thinking framework for healthcare management and innovation Healthcare 2016(4): 11-14

3. Design Thinking. Tim Brown June 2008

Design Thinking-Harvard Business Review June 2008 p. 85-92

4. Clinicians For Design

Accessed July 30, 2018

Debi Fischer RN, BA, BSN, MSW, LSCW is a nurse in a surgical oncology step down unit. Prior to that she worked in orthopedics and neurology. She has earned a master’s degree in social work and is also a Licensed Clinical Social Worker.

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Yes, we have time to think of the great ways to improve things! I think that some people have that type of personality/temperament. But most management and administrators are not open to new ideas for sure!!