Kuanysh, Zhuldyz, Public relation specialist, PhD student, Karaganda Medical University, Kazakhstan

Omarkulov, Bauyrzhan, Director of the Institute of Public Health and Professional Health, Candidate of medical sciences, Professor, Karaganda Medical University, Kazakhstan

Heikkilä, Johanna, Senior Advisor, PhD, JAMK University of Applied Sciences, Finland

Johanna.heikkila@jamk.fi

Service design is a method for planning and implementing changes to improve the quality of service with a focus on holistic service experiences to fully understand the target group, users, and context. It is a user-centric approach that engages the service providers, end-users, and stakeholders in the design process. (1) It can be used for the development of person-centered care, identification of current problems for improved pathway design, and new service delivery (2).

In December 2021, a master class “Service design approach in the development of nursing services” was held in Karaganda. The master class provided the representatives from medical universities and practical healthcare with basic knowledge and skills on how to use service design approach in the development of nursing services. This new competence of “service design approach” is now further practiced through the implementation of nursing service development projects, which are guided by Jamk University of Applied Sciences (Jamk) and Karaganda Medical University (KMU). The projects support the medical and nursing practitioners and academics in listening to the wishes and voice of patients. In addition, they enhance the collaboration between medical universities and clinical practice on nursing issues.

Firstly, multiprofessional development groups were created in Kazakhstani medical universities. The groups include teachers from the nursing schools of medical universities, chief and senior nurses, nurses from departments of hospitals or polyclinics, as well as general practitioners and chief doctors, and directors of clinics. Next, two workshops were facilitated by the group leaders, during which the groups identified a nursing service topic as a problem that needs to be solved. The problem had to have a direct connection with the consumers of medical services, that is, with patients, meaning that the problem had to be experienced and expressed by patients. More than sixty persons are now involved in these projects.

The nursing service design projects aim at improving patient satisfaction, the quality of rehabilitation, and alleviating the problem of discomfort for nurses and patients during procedures. The team from Karaganda Medical University has chosen the topic “Long wait for medical documentation before and during hospitalization” for implementation based on the Occupational Health Clinic of the Institute of Public Health and Occupational Health. Astana Medical University has set up two teams who will be engaged in service design in “Improving the quality of rehabilitation for patients with atopic dermatitis” and “Satisfaction of patients with chronic diseases (arterial hypertension and bronchial asthma) with the quality of nursing care at the PHC stage.” Nazarbayev University School of Medicine plans to develop nursing care focusing on “Shaving and Preparing Adolescents for Surgery and Their Problems”. South Kazakhstan Medical Academy is working on a service design project “Patient satisfaction with the level of care provided in the cardiology department of the Shymkent Heart Center during diagnostic procedures”. Kazakh National Medical University named after S.D. Asfendiyarov has two projects: “Parent satisfaction with nursing services in the postoperative period at Aksai University Children’s Clinic” and “Rehabilitation of patients with cardiovascular diseases”. In addition, from outside the project consortium, Semey Medical University has launched a project on the topic “Nurse-led consultation via telemedicine for newly diagnosed diabetes patients”.

To understand the service through the eyes of the customer, the development groups are currently collecting data by observing and shadowing patients’ care pathway and interviewing both patients and nurses involved in the implementation of care. Based on the results, the groups will be able to identify needs and problems from the patients’ point of view. The data collection has been thoroughly planned. The multiprofessional group prepared questions for the interview and discussed how to appropriately conduct the observation and document everything coherently by each developer. Prior to the data collection, the participants were given information about the ongoing service design project and an informed consent was obtained.

Nurses note the uniqueness of the service design approach in their practice, as well as the unexpectedness of the results. During interviews with patients, some nurses described that the problems that were identified from their point of view to be issues needed development were not considered problems by patients. Meanwhile, moments of patient dissatisfaction were revealed that nurses had not noticed earlier.

After data collection, the development groups will continue their work according to the phases of service design. Each project will redefine the aims of their project based on the findings on the nursing service through the eyes of the client, and during the summertime, implement improved services, which will be later monitored and evaluated by interviewing the patients. The groups will report the results of their projects at the second master class “Applying service design in the development of nursing services in Kazakhstan”, which will be organized by Jamk and KMU in Nur-Sultan during September 26-30, 2022.

It is worth noting the importance of participation of practical healthcare representatives especially nurses is imperative for success of the development project and in the implementation of results. Since nurses, as providers of these services, know the problem areas of nursing care, and the chief physicians and directors of clinics will be able to provide a good impetus for the successful implementation of improved services.

References:

1. Fry KR. 2019. Why Hospitals Need Service Design: Challenges and methods for successful implementation of change in hospitals. DOI: 10.1007/978-3-030-00749-2_22  In book: Service Design and Service Thinking in Healthcare and Hospital Management. Theory, Concepts, Practice. Eds Pfannstiel MA Rasche C. Springer. Pp 377-399.

2. Simonse L, Albayrak A & Starre S. 2019 Patient journey method for integrated service design, Design for Health, 3:1, 82-97, DOI:10.1080/24735132.2019.1582741