Evidence map›Paper›PMID 38413092›Full record

ArticleBMJ open quality2024

Applying the lessons of design thinking: a unique programme of care for acutely unwell, community-dwelling COVID-19 patients.

Megan K Devlin, Natasha J McIntyre, Matthew D Ramer, Young Han Kwon, J Michael Nicholson, Marko Mrkobrada, Jami Kronick, James E Calvin, Erin Spicer

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open quality, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Megan K DevlinDivision of Infectious Diseases, Department of Medicine, Western University, London, Ontario, Canada megan.devlin@sjhc.london.on.ca.ORCID 0000-0002-0026-5194
Natasha J McIntyreCentre for Quality, Innovation and Safety, Western University, London, Ontario, Canada.
Matthew D RamerFaculty of Health Sciences and Wellness, Humber College Institute of Technology and Advanced Learning, Toronto, Ontario, Canada.ORCID 0000-0001-9478-4907
Young Han KwonCentre for Quality, Innovation and Safety, Western University, London, Ontario, Canada.
J Michael NicholsonDivision of Respirology, Department of Medicine, Western University, London, Ontario, Canada.
Marko MrkobradaDivision of General Internal Medicine, Department of Medicine, Western University, London, Ontario, Canada.
Jami KronickWestern University Schulich School of Medicine & Dentistry, London, Ontario, Canada.
James E CalvinCentre for Quality, Innovation and Safety, Western University, London, Ontario, Canada.ORCID 0009-0003-7620-3330
Erin SpicerCentre for Quality, Innovation and Safety, Western University, London, Ontario, Canada.ORCID 0000-0001-9857-4069
Western University · CAHumber Polytechnic · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic limited access to primary care and in-person assessments requiring healthcare providers to re-envision care delivery for acutely unwell outpatients. Design thinking methodology has the potential to support the robust evolution of a new clinical model.

aimTo demonstrate how design thinking methodology can rapidly and rigorously create and evolve a safe, timely, equitable and patient-centred programme of care, and to share valuable lessons for effective implementation of design thinking solutions to address complex problems.

methodWe describe how design thinking methodology was employed to create a new clinical model of care. Using the example of a novel telemedicine programme to support acutely unwell, community-dwelling COVID-19-positive patients called the London Urgent COVID-19 Care Clinic (LUC3), we show how continuous quality outcomes (safety, timeliness, equity and patient-centredness), as well as patient experience survey responses, can drive iterative changes in programme delivery.

resultsThe inspiration phase identified four key needs for this patient population: monitoring COVID-19 signs and symptoms; self-managing COVID-19 symptoms; managing other comorbidities in the setting of COVID-19; and escalating care as needed. Guided by these needs, a cross-disciplinary stakeholder group was engaged in the ideation and implementation phases to create a unique and comprehensive telemedicine programme (LUC3). During the implementation phase, LUC3 assessed 2202 community-based patients diagnosed with acute COVID-19; the collected quality outcomes and end-user feedback led to evolution of programme delivery.

conclusionDesign thinking methodology provided an essential framework and valuable lessons for the development of a safe, equitable, timely and patient-centred telemedicine care programme. The lessons learnt here-the importance of inclusive collaboration, using empathy to guide equity-focused interventions, leveraging continuous metrics to drive iteration and aiming for good-if-not-perfect plans-can serve as a road map for using design thinking for targeted healthcare problems.

Indexed as

COVID-19Independent LivingAmbulatory Care FacilitiesHumansOutpatientsPandemicsAmbulatory careCOVID-19Healthcare quality improvementPatient-centred careTelemedicine

Identifiers

PMID38413092
PMCPMC10900416
OpenAlexW4392202419

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.