In September, as Sharon and I began the Health for America (HFA) at MedStar Health fellowship, we quickly dove into one of the most important aspects of design thinking - empathy. According to IDEO, a leader in design thinking, “Design thinking utilizes elements from the designer's toolkit like empathy and experimentation to arrive at innovative solutions.” To build empathy, and understand the experiences of the patients in each of our segments of health care, integrative medicine for myself, and telehealth for Sharon, we put ourselves in the shoes of our patients through a key aspect of the HFA experience: simulation.
There were two aspects of my simulation: a more intensive hour in the MedStar Simulation Training & Education Lab (SiTEL) and 72 hours of changes to my day-to-day activities.
Chronic Back Pain
Integrative medicine has clinically proven benefit for chronic pain patients. Therefore, my simulation challenge was to partially experience what a patient with chronic back pain might face.
During my time at SiTEL, I spent an hour in a Kendrick Extrication Device (shown in the photo on the right) and a neck brace to restrict the movement of my upper body. Although I was not in physical pain, the purpose of these braces was to give me the experience of limited movement, much like that of a person with chronic back pain.
Throughout the experience, I was extremely careful and strategic with every move that I made. Getting into and out of the hospital bed was difficult. During one of my first tasks, putting on my shoes, I strategized how to get my shoes from the ground. I used my toes to grab onto the shoes and bring them closer to reaching distance without bending.
Walking around the room, I moved extremely slowly, paying close attention to the way I walked, trying not to turn left or right or look around. I felt the need to keep my gaze forward and pay attention to what was in front of me.
I used my SiTEL experience to inform how I would go about the following 72 hours. Changes made to my day-to-day activities focused on habit changes I might make if I were actually experiencing chronic pain. Prior to this, I did some research on the recommendations for chronic low back pain relief. The first aspect was to change my desk setup to be more ergonomic. I obtained a foot stool to keep my knees bent, a lumbar support to give myself proper posture, and I used a monitor stand to keep my laptop screen at eye level.
Next was changing my activity level. Working at a desk the majority of the week, I’m sitting for close to a full 8 hours. From sitting, my low back gets extra pressure and my muscles are constantly stretched in one direction without a reciprocal stretch in the opposite direction. To help change this, I used an app called “Stand Up!” to remind me to get up and move every 30 minutes. When I stood up, I did some stretches that counteracted my constant seated position: quad stretches, arm stretches, and neck stretches. I even did some stretches on the floor such as a glute bridge.
What I learned
Through the day-to-day part of my simulation, I discovered that I liked the changes I made during my work day, but they’re exceptionally hard when you’re in meetings often or don’t have your own office. I felt awkward with two other people in our office when I was stretching on the floor. In a meeting, in deep conversation, I was reluctant to get up and start stretching. My team knew about the simulation, but it may not feel appropriate or realistic for others with less understanding teams. All of these new habits were extremely difficult to consistently do to make the change.
Habits do not change overnight
Through many of the projects I have worked on thus far, I have learned that many of our poor health habits are rooted in constant habit. After performing the same motion over and over in a poor manner, pain starts to creep up without notice until eventually, the pain is as significant as the amount of time necessary to reverse the habits that caused it.
How empathy is reflected in my work
Throughout my HFA experience, I have remained conscientious about habit change. In the current culinary medicine cohort, habit change has been a key focus to measure the impact of our program over the short- and long-term. We are all accountable for our health and must be persistent about implementing new habits, making small changes, positively changing our frame of mind, and recognizing each aspect of our capacity for healthy living.
“We become what we repeatedly do.”
― Sean Covey
Teaching and sustaining holistic wellness is not an instant cure. As part of a team designing healthcare products and initiatives, we must consider the patients, what they are accountable for outside of clinician care and the lifestyle changes needed for support. In health care, we must regularly consider―How might we facilitate sustainable habit changes?