Stroke Pathways is an two-phased research project to improve stroke outcomes by taking a system design approach to health care delivery. The project was conducted at the Harvard Design School during 2005-2008, under the leadership of Professor Marco Steinberg. The Strategic Design phase produced three distinct bodies of knowledge:
1. A methodology for looking at complex systems
2. A comprehensive & strategic roadmap to better outcomes at lower costs
3. Identify and defining the "top 10" opportunities for improvement
In the process we've developed: a "zero footprint" organizational model to collaborate across institutions and specialties a "strategic design" framework to create change opportunities a "system change" innovation model (outlined in our activity map below)
Activity map- our system innovation model
A Design perspective to "big picture" problems
A NEED FORSYSTEM DESIGN
Our society has been served well by deep and narrow specialties, but the nature of today’s “big picture” challenges fall at the intersection of what we know. Not unlike cooking, the solution today is not in any one ingredient, but in the mix.
Because key decision makers cannot always see a complete synthetic whole, they are often blind-sided by the unintended consequences of their action. As an integrative discipline, design is uniquely position to fill this strategic need.
Our work leveraged our unique skill-set to: Ask questions at different scales, because different scales provide unique insights; Examine problems in different contexts and from different perspectives, to understand their relative value; Involve stake holders and make our project their project; Create frameworks to integrate complex, and frequently contradictory, problems; Visually represent complex, multidimensional issues to enable a productive problem-framing; Bring to bear our ability to work with indeterminacy and relative precision.
Rather than provide good solutions to the wrong problems, our strength lies in asking the right questions.
Monday, May 26, 2008
Our "TOP 10" System improvement opportunities
Our system design approach looked at stroke from a full care cycle perspective. We defined this into three distinct but interrelated phases:
1. Before a stroke (includes prevention) 2. Acute 3. After a stroke (includes rehabilitation and long term needs)
The diagram shows our framework overlaid with the opportunities.
Research Team Laura Crescimano (GSD ’06) Justin Cook (GSD ’08) Cathy Braasch (GSD ’06) Sarah Holton (GSD ’06) Phoebe Schenker (GSD ’06) Behrang Behin (GSD ’08) Bryan Boyer (GSD ’08) Catherine Fowlkes (MIT ’07) Sarah Jacoby (GSD ’07) Marisa Kolodny (GSD ’07)
Primary Collaborators Collaborative Initiatives at MIT (link coming soon) Dr. Gil Gonzalez, Director of Neuroradiology, Massachusetts General Hospital Elizabeth Teisberg, Associate Professor, Darden Business School, UVA Dan Schodek, Professor, Harvard Design School
Stroke Care Pilot Dr. Sen Souvik, Director of UNC Stroke Team, University of North Carolina, Neuroscience Hospital, Chapel Hill, NC Dr. Michael Lee, Professor and Chairman, Department of Physical Medicine and Rehabilitation at UNC Dr. Bruce Whitman, Medical Director, Emergency Services, Southeastern RegionalMedicalCenter, Lumberton, NC
Diagnostic Tool Andrew J. M. Kiruluta, Assistant Professor of Radiology, Physics Department, HarvardUniversity Research Assistant Adam Yock (HarvardCollege ’08)
Advisory Group
Esko Aho President, Finnish Innovation Fund; Former Prime Minister of Finland
Emilio Bizzi Institute Professor, Brain Sciences, MIT
David Cutler Professor, Economics, Harvard Univeristy