Designing Better: Dignity by Default
A Service Standard for Adult Addictions and Mental Health Services in Waterloo Wellington
Designing Better is a project to re-design how intensive addictions and mental health services for adults are organized and delivered in the Waterloo Wellington Local Health Integration Network (WWLHIN).
Using Design Thinking we will explore what people actually need from intensive services and re-design intensive services to better meet those needs.
Why we did it
Despite our best efforts, we still have a system of siloed services. We know we are not keeping up with the demand for services and that people are waiting too long to get care. We hear that for people, their families and for people delivering care, the experience is often hard, frustrating and overwhelming. We know we can do better.
This project looks at a deeper level of detail than other projects. A significant focus of the engagement is learning about people’s lives outside of service.
We also want to test things at a small scale before making big changes. We want to quickly try something based on our engagement findings, and learn from that. Now that we’ve finished engagement, our goal is test some concepts that respond to what we learned, within the next two months.
Building off of previous pieces of work (e.g. Concurrent Disorders Experience Design Project) we went deeper with Designing Better.How we did it
We started with the needs of people and designed for that. Simple to say, hard to do.
Why do we need to go deep?
When we do an improvement project we typically focus on talking to as many people as possible to get a wide variety of perspectives. We ask about things directly related to the services we provide. This is important, as it is a good way to understand general, high-level problems, trends, and themes in the system.
Talking to fewer people allows us to spend more time engaging with them and really learn what life is like for them. This approach allows us to gather rich and meaningful insights that open up new possibilities for solutions.
How we did it
We used a Design Thinking approach that starts with empathy for the end user, in this case people using services.
We customized engagement for people and engaged deeply with them. We engaged with 12 people for over 100 hours to learn about who they are and what life is like inside and outside of services.
We identified what mattered to people.
We looked beyond ourselves to other industries that design services and experiences well.
We learned that one of the things that mattered most to people was dignity. People wanted dignity when engaging with services and supports.
We created Dignity By Default : An Addictions and Mental Health Service Standard. The Service Standard gives people and providers a way to design, deliver and measure services that offer dignity by default.
We created Experience Patterns: A collection of guidance and advice about how to build and deliver a dignified experience of addictions and mental health service. They are based on people’s needs.
We shared our work with the community and proposed improvement ideas we could prototype. The community selected: Act As One Service & Deal With Trauma
We built prototypes for each of the ideas and collected further feedback from the community. This allowed us to test whether or not the Service Standard and Experience Patterns were useful when trying to design and improve services.
We learned they are incredibly useful as they focus our efforts on both experience and quality. We now believe that Outcomes = Quality + Experience.
We proposed that over the next year we design and implement Act As One Service in each of the sub-LHINs. The Addictions and Mental Health Program Council agreed.
The Service Standard
What is a service standard?
A service standard is a set of criteria that enables providers to build and deliver high quality addictions and mental health services that promote dignity by default. We believe everyone deserves to be treated with dignity. Our goal is to create a service standard that:
balances evidence based practice with service experience
enables flexible and responsive service delivery based on the actual needs of people
makes services so good that people want to come back
Why is this different?
A service standard is an applied tool rather than a framework or strategy. It contains a set of commitments that an organization promises to honour when delivering a service.
These commitments support providers to design and consistently deliver quality services based on outcomes and experience.
Service Standards also give providers a way to share their commitment with the people they serve by describing what people can expect to receive from services and how services will be delivered.
How was it drafted?
We engaged with people to understand what they actually need, what they are trying to do and what matters to them.
We engaged with service providers to understand what matters most to them.
We reviewed other sectors’ wisdom on how to design services really well within a system and then applied that to our context. We also reviewed what we already know about designing service within our sector. This includes incorporating principles and frameworks such as Drs Minkoff and Cline’s Comprehensive, Continuous, Integrated System of Care, Recovery concepts and Service Design principles.
We identified dignity as a critical part of the service experience that needs our attention.
We compiled everything we learned into a list of commitments that now make up our draft service standard.
We will continue to revise the Service Standard as we try it out and learn from it.
Download the Service Standard
We have made Dignity By Default and Experience Patterns into a few different formats you may find useful. Feel free to take what works for you.
What is the Workbook?
The workbook is a way for providers to apply the Dignity By Default Service Standards and Experience Patterns to a new or existing service. The workbook prompts you to think about things differently and deliberately. It also documents your work as you go and shows evidence of how you are using Dignity By Default to build or improve services.
