being a patient

I am obsessed with service, to borrow a phrase from Richard I think I am as close as it gets to being a service junkie. This means that  I spend my days devouring every tweet, article and policy about the health service, patient experience and the role design can play in that. In the early hours of Thursday morning I woke up with unbearable pains in my stomach. To cut a long story short, I phoned the NHS 24 hour help line twice, on the second phone call they referred me to the out of hours GP, who then referred me to casualty who then took me to a ward.  They kept me in for two nights and I had an ultra sound scan, blood tests, all kinds of other bodily tests ( ! ) and the conclusion is they think I had an infection in my appendix that has sorted itself out.

I have never been a patient before so there were many things that I noticed, appreciated, felt could be better, even when poorly those " design lenses " picked up detail and feeling.

It was the absence of communication that increased my anxiety. The taxi driver drove us to the hospital in silence - which made me think of Barry Schwartz's talk on our loss of wisdom and the way he describes the role of a hospital janitor. I've just moved into a new flat and had no idea where we were, if he had let me know we were only five minutes away it would have made the journey a little easier.

When I arrived I was asked to put a gown on, and my first instinct was why? Then being moved to the surgical ward, my first thought was does this mean I am going to have surgery.

And at shower time... where was I meant to go? are there towels and shampoo in there? well I didn't want to ask, what if they thought I was treating the place like a hotel! Alice, in the bed next to me filled me in , there is only hair mousse ( or moss as she called it ) so I asked another long haired lady for some shampoo ... the nurse gave me a towel.

Walking in to all these things for the first time, in pain, in a strange place, was the time I needed that extra bit of reassurance. I'm sure when you work in this environment all of the time you can take for granted the normality of it, and also the pressures of being emotionally attentive to people must be tough. But an explanation of the simple things between each new experience would have made a difference.

After those first few hours though, and into the rest of Thursday, Friday and Saturday, I was able to immerse myself more in to the ward. My bed was straight across from the desk so I could eavesdrop and watch all the goings on.

The staff seem like best friends, constant winks and giggles brought sunshine into the ward and I knew they were happy to be there. They come to work every day and genuinely laugh out loud, I don't think there are many people who are lucky enough to feel that way at their work.

The last experience I had with the NHS in Stoke Mandeville Hospital was horrific and inspired me to write an article on why the NHS needs service design. This experience was totally different and has inspired me to make a thank you card for all the staff in ward 16!

The NHS help line was particularly good and they helped me so much. Simple things like reassuring me they would call me back if our line got cut off and telling me they would make sure I got the attention I needed.

It's all about people, from how we communicate to how we smile. The staff in ward 16 are faced with people who are bored, stubborn, tired and anxious. Yet they see past that and go out their way to make sure you are comfortable and as at ease as you can be. The doctors really explained what was happening to my body and why and the nurses really cared. You can't buy that, or teach it. That's what I call true service.

We are not electronic beings

A new service called Usocial charges you about $200 (£125) to “buy” 1,000 new friends on Facebook and Twitter. Although the people who are being 'sold' don't realise it! Who is using this service?

“A woman in Detroit said she travels for business a lot,” said Leon Hill, uSocial’s chief executive. “She said she’ll be stuck in a hotel room without anyone close to her [this month]. She just wanted more people to keep in touch with during the holiday season.”

A man moved to Taiwan six months ago, although he intends to return home next year. “Living out here, in the area I live in, there’s very little interaction. Very few people speak much English.I want to know what’s going on. You can read news on the internet, but you get a better gist of what’s going on through people’s opinions and chatting.”

We are more connected than ever before yet young people are lonely and facebook only adds to the problem.

“Social networking has not helped because it is a remote contact. Some young people don’t have any real friends.“They are completely surrounded by people, but they can still be lonely because they are not able to make lasting bonds.”

Sue Palmer, author of a book, Detoxing Childhood, said: “It is reckoned that 10 per cent of communication is through language. The rest is reading faces, expressions, body language, establishing tone of voice.If children are not developing those skills, then that is worrying. We’re not electronic beings.”

I reluctantly joined facebook about a year ago. I set up an account as 'Redjotter' as I wanted to use it to connect to people for 'work, inspiration, networking et al'.  None of my family or 'real friends' who I see most days are my friends on  facebook. People laugh at me because of this but it just didn't feel right. Of course there is an overlap as many people I  'work' with have become very good friends.

This article makes me think of that scene from the movies when a lonely someone is standing outside in the cold peeking through the windows of a family home wishing they were part of it. It seems when some young people look at their 'facebook friends' it makes them feel the 'friends' are having more fun, visiting more exciting places and generally leading more exciting lives than they are and this can only lead to feelings of vulnerability.It is sad but seems to be as true as always.

Instead of focusing energy, talent on skills on ventures such as uSocial we should be thinking about how to make real conversation happen.

Service signage failure

I walked into my local GP surgery to find this:

3794789721_3a14717f53I don't understand ... so where am I supposed to go? Call for advice from the front door? Why can't a person come and speak to me?

This is an example of why people don't like going to the doctors and why people don't seek help when they are ill.

A conversation has to be happen between:

  • the person who made this sign
  • the person who decided to place it at the front door
  • the doctors who walk past it every morning approvingly
  • the reception who witnesses the reactions
  • most importantly - the patients

...fling a service designer into that mix and you are onto a solution!

'People' or 'service users'

Encouraging officers to use plain language and communicate effectively with their residents, the Local Government Asssociation (LGA) has produced a list of 200 words and phrases currently used by councils, that make very little sense to most people. The LGA recognises that words sometimes used by public sector bodies make their services inaccessible, as people fail to understand their relevance. In turn, this reduces their chances of getting the right assistance at the earliest opportunity.


It is therefore essential that all matters are explained to people in plain, simple and clear English. This is even more important today, given that Britain is so multicultural, with many people accessing public body services without English as their first language.

For example, you should avoid using:

  • best practice
  • service users
  • outsourced
  • multi-agency

And in their place, encourage the use of:

  • best way
  • people
  • privatised
  • many groups

Whilst this observation has been made by the LGA, it is of course just as applicable to Registered Providers. The use of plain language benefits all those concerned, as it:

  • breaks barriers between professionals in the public sector and local people
  • eliminates meaningless language
  • is far more effective, and can result in fewer calls and/or letters from people due to misunderstanding or confusion, resulting in less pressure being put on the professionals
  • can help reduce the drain on finances for queries that could otherwise have been resolved through using plain, simple language in the first place

Communicating with your customers should be easy: it is about having a common understanding of what is being communicated.  If the message is not getting across, then what is the point?  Use plain language!"

Full list of 200 words which the local government association says should not be used by councils.

This list is long overdue. I wonder what the same list would look like for designers? What word would be at the top of the list?

(Via. 'Try using plain english')