In previous discussions about use of endoscopies to diagnose dyspepsia in health adults, gastroenterologists (GIs) identified a few barriers to ordering endoscopies in line with Choosing Wisely Canada recommendations.
One barrier was that they don't feel like they can refuse patients who expect to receive an endoscopy when they get referred for their symptoms of dyspepsia.
This project aims to develop an educational resource to show patients why an endoscopy is not needed to diagnose dyspepsia. A secondary output of the project is to be a patient-friendly version of the province's clinical pathway to treat dyspepsia.
The core project team is comprised of two gastroenterology specialists, a project manager, a junior information designer and myself. My role in this project has been to plan and oversee the design process to create the educational resource, as well as design the patient-friendly clinical pathway document.
The patient's journey spans across primary care, gastroenterology clinics and into the patient's life outside the clinic. To understand the problem beyond what was identified by GIs - and why the GIs felt pressure to order endoscopies - we needed to engage primary care physicians, gastroenterologists, and people with lived experience of dyspepsia or the GI referral process.
Through semi-structured interviews conducted through video calls, our three stakeholder groups were asked questions to understand what their experience has been with diagnosing and having dyspepsia. Due to issues with scheduling and coordination, interviews were conducted with individuals and in small groups, when possible.
Data collected from the interviews was independently reviewed by myself and the jr. designer for themes and insights. Together, we discussed our findings and came up with a draft list of criteria - which we then discussed in a multi-disicplinary discussion to get a clear idea of what each criteria would look like to the group.
After a the design criteria were finalized, the criteria were presented to our project sponsors for feedback and to get information about implementation capabilities. This informed the design of the education resource, which is currently being completed by the jr. designer.
A mid-project deliverable of this project was a synthesis map, depciting the dyspepsia referral process and influencing factors for each stakeholder group. Since the document is not publically available yet, I am unable to post it here. Please contact me if you would like to see the document.
The educational resource is currently being designed in a feedback loop between the jr. designer and myself, with periodic check-ins with project stakeholders to seek feedback on elements of the resource. Focus groups are being planned for early 2020 to seek feedback from multi-disciplinary working groups and patient advocates.
The patient-friendly pathway is being designed in a shortened process, guided data from interviews and information design principles. It will enter a similar feedback loop of internal reviews and multi-disciplinary focus groups.