I was 19 the first time I visited Planned Parenthood. I had just started college, and like many girls my age, I had some questions. The experience was, as I recall, fine. The center I visited in Lincoln, Nebraska was unremarkable—a drab, beige building with a waiting room to match. There were no protesters outside (they were at the other Planned Parenthood in Lincoln), and the staff was nice enough that I wasn’t deterred from returning. On the whole it was largely unmemorable, which you might consider a good thing.

It isn’t.

Think about it. You probably remember more about the waiting room, the receptionist, the ease with which you filled out forms, and the feeling you had when you left the doctor’s office than you do about what actually happened in the examination room. This is about more than customer service. In 2013, a review of 55 studies, published in the British Medical Journal, showed that patient experience is positively correlated with clinical effectiveness and patient safety. As the authors of that review note, correlation does not entail causality, but “the weight of evidence across different areas of healthcare indicates that patient experience is clinically important.”

“Medical care is measured in medical outcomes,” says Becca Karpinski, vice president of strategy and organizational effectiveness for Planned Parenthood of the Southwest. “Most of us as patients have a really hard time judging the medical care we’re getting because we don’t know enough; so we judge the overall experience.”

Politics, funding, and other reasons loosely attached to people’s perceptions of reproductive health have long kept Planned Parenthood at a disadvantage when it comes to the patient experience. “We’ve always had high quality care,” Karpinski says. “But frankly, the rest of the experience wasn’t necessarily what we would want ourselves to go through.” And so Planned Parenthood is rolling out a comprehensive patient experience it developed with Ideo to change how patients interact with the organization.

In a healthcare landscape where patients have more choices than ever, Planned Parenthood has a lot at stake to prove it’s more than a walk-in clinic. With the redesign, the organization is attempting to streamline the quality of care across its centers and show it can be a longterm, primary-care option for both women and men. “It’s no longer just about a patient-provider relationship in the clinic at that moment,” says Grace Hwang, a design lead at Ideo. “It’s about a lifetime of engagement and how that relationship plays out even beyond that one visit.”

The five-year plan is based on more than a year of research Ideo conducted with hundreds of patients and employees nationwide. And it’s indicative of a bigger trend in healthcare, says Adam Baker, lead designer at Iodine, a digital health company that hosts a database of medication information. Baker believes that there’s a shift underway from informed consent to patients making decisions alongside their doctors. “Shared decision making—which often involves tools like the ones Ideo concepted out for Planned Parenthood—doesn’t necessarily improve health outcomes,
he says. “But it does tend to make people feel better about the decisions they’re making and the care they’re receiving.” Below, we look at some of the major takeaways from Ideo’s plan.

In This Together

Ideo realized that overhauling Planned Parenthood had to begin with uniting the organization’s culture. Planned Parenthood is comprised of 59 regional affiliates and more than 600 health care centers nationwide, most of which have their own set of values. Some centers, like those in Texas, are under assault, while others are celebrated for their work. This makes establishing a consistent set of service standards and values challenging. Ideo worked with Planned Parenthood to instill a set of guidelines, rules, and common vernacular that every employee will learn through a day-long training session. The overarching plan, called In This Together, is like an umbrella under which every affiliate will operate. Judy Tabar, the CEO and president of Planned Parenthood of Southern New England, says it’s about instilling a set of core values to remind employees about the organization’s commitment ideals like inclusivity and diversity. “The opportunity to have a seamless experience at any Planned Parenthood is just tremendous,” she says.

PP1.jpg IDEO

The Hub/Recovery
Ideo found through research that the layout and physical space of a health center can have a major impact on how patients feel about their experience. Before Ideo helped redesign the waiting room experience, most health centers had rows of chairs facing one another, which left patients looking at each other during what might be a vulnerable moment. That does nothing to promote a feeling of safety and well-being, so Ideo suggested dividing waiting rooms into zones that give the room a modular appearance. Seats can be arranged in multiple configurations to they face outward, allowing a measure of privacy. Others might be set apart, surrounded by a porous screen. Tables with chargers for gadgets and activities for kids are thoughtful touches. The redesign also calls for recovery rooms to have a separate space for each patient and a place for a loved one to sit next to her.

Some branches have implemented these ideas wholesale. Those on tighter budgets have adapted by positioning chairs back-to-back, ditching televisions in favor of peaceful music, and taking other steps. Ideo also suggested each center hang a poster outlining the services Planned Parenthood offers.

These may seem like simple changes, but Dawn Laguens, Planned Parenthood’s executive vice president and chief experience officer, says even the smallest changes were based on user research. “Usually it’s a lot of little improvements that make a big difference,” she says.

Visit Companion
The Visit Companion app, which is still in the conceptual phase, is intended to provide digital tools that will guide patients through their experience at Planned Parenthood. The app uses visuals to explain physiology (What does your uterus look like?), answer basic questions (How does an IUD actually work?) and explain medical procedures.

The idea is that patients and providers can use the app to address questions and concerns together, and Ideo says it’s designed to encourage that conversation, not detract or replace it. A patient receiving an abortion, for example, can read clearly-designed instructions for what to expect before, during, and after the appointment, with reminders for follow-ups. The app also will allow patients to compare different kinds of contraception and outline their effectiveness and side effects while explaining how they might fit into your lifestyle. “We heard from a lot of women that they are overwhelmed when they consider new birth control methods,” Hwang says. Yes, all of this information is readily available online, but Ideo points out that codifying it in a single app ensures every health center is using the same language.

Some of the apps will answer questions about contraceptives. Some of the apps will answer questions about contraceptives. Ideo

Friendly Forms
Not surprisingly, Ideo found paperwork was a big source of frustration for patients. To reduce the time spent filling in basic information, Ideo designed a system that reflects the conversational way a doctor might ask a patient questions. Ideo relied heavily on visuals to give patients a sense of how far along they were in the process. Graphical elements help clarify confusing clinical terms. The designers paginated pages and clustered questions into themes, which was an insight gained from watching nurses flip through forms to ask patients related questions instead of ticking them off chronologically.

The forms adapt as patients answer questions. For instance, if a patient doesn’t have medical history in a certain area, the form will skip any follow-up questions. Similarly, the forms will ask relevant questions about insurance and payment. If filling out multiple forms, reusable information will be pre-populated (names, dates, addresses, for example). Ideo says that in early testing, patients are filling out forms 50 percent faster and skipping fewer questions (on average they skip 0.8 questions, versus 1.5).

The concepts, some of which will have already begun to be implemented, will roll out over the course of five years. For a large, distributed organization like Planned Parenthood, it might take that long to gain full adoption. Though the changed might seem evolutionary, as Baker of Iodine describes them, they are in many ways Planned Parenthood’s longterm bet for future-proofing itself against a rapidly changing healthcare landscape. Because in five years time, good architecture, digital forms, and apps that guide you through your healthcare experience won’t seem radical at all—they’ll be expected.

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Planned Parenthood Redesigns What It’s Like to Visit Its Clinics