Workarounds

My roommate made this piece of artwork in her ceramics class freshman year and so we decided to keep our keys and small valuables in it as a way to not lose them.
I used an old wine bottle and popped some baby’s breath flowers in it to make a nice, easy piece of decoration. The nightstand itself is actually just a large storage box with a sheet over it.

Gallery Day Reflection

Our team, the Hospital Helpers, updated Michelle Peters through a visual presentation of the information we gathered and analyzed thus far.

Main Takeaways

  • Allowed a chance for team members for update each other on the research and analysis they gathered in a cohesive manner
  • Michelle’s presence allowed for immediate comments and feedback
    • Suggested we speak with ER workers and patients
  • The process of creating our visual presentation was just as important as the finished product itself – pushed team to analyze our individual data and relate everything back to the core question
  • Unfortunately, we were short on time
  • After Gallery Day, our team members and I were able to begin pitching different realistic solutions to the problem at hand
    • Relations with Uber
    • Legal issues surrounding possible shuttles
    • Medicaid

Analogous Immersion- Public School Bus

Teammates Dan, Cole, and I were supposed to have a phone call with someone from the South Bend Public School Bus System to understand how the transportation areas and routes are determined. However, we did not hear back from our contact and did online research. We are hoping to be able to speak to someone about this soon, as we believe this is an analogous situation to SJHS’s transportation problem at hand.

Public school buses must determine which areas to serve, how many stops are made, and the location of the stops to help students safely and efficiently get from point A to point B.

Public School Bus:

  • Many students and children of the individuals I held interviews with had to walk to the bus stop alone and ride the bus to school. Routine of the bus lowers feelings of anxiety and disorganization because users know what to expect. The public school bus is a reliable mode of transportation.
  • Students and parents also do not have to worry about children coming home from school.
  • Schools and online platforms easily communicate and inform users which bus to ride and the area is covers.

Parallels for SJHS:

  • Hospital needs to know where and what kinds of neighborhoods their low-income patients are living in to know where to make safe stops
  • SJHS can set up a shuttle that makes stops within a 5 mile radius (approximately 20-25 minute drive max)
  • Patients should be able to look up bus stop times and locations online easily and hospitals should advertise their service much more

Interactive Immersion (Journey Mapping)

Date: 3/6/17

Location: SJHS Mishawaka Medical Center

Participants: Helen Sung

As Alex mentioned in her previous blog post, I visited the Medical Center and asked patients in the open to mark a red X on the problematic stages of getting from home to a medical appointment on time.

2 had said journey map didn’t apply to them, as they did not experience transportation issues. 1 woman said it was difficult to make it to appointments on time because she has to take her 2 young children with her. 2 said arranging transportation was difficult.

Possible bias: I asked patients who were out in the open in the lobby and café areas. More of these people may be waiting for a ride rather than have their own because a person who drove would be less likely to be just waiting in the lobby looking out at the parking lot.

I noticed that those who find transportation an issue have not chosen to explore public transportation, especially the Transpo bus running throughout South Bend. Near the elevators behind the lobby, there is a single Transpo bus stand giving directions to the Medical Center. Maybe if it was more noticeably placed towards the front desk, receptionists and nurses will remember and be more likely to inform their patients of the options they have.

Immersion: Borrow Car

As an immersion, I tried to role-play what many patients without a personal vehicle do- hitch a ride or borrow a car. This immersion took place on 3/6/17, anytime between Monday from 2:30-5:00PM. My classes ended at 2:30 and the doctor offices closed at 5:00, so this was the only available window I had on this day.

I had tried to arrange for a ride on the previous Friday, three days in advance of the given date I had expected to go to the hospital. I asked a couple close friends, who were more than willing to give me a ride, but there were either conflicting schedules with their classes or I did not have a guaranteed ride back.

I asked three other people who owned a car if I could borrow it and was finally able to secure a ride after asking a total of five people. As each person said their sincere apologies and explained their conflict schedule, I was able to empathize with those who face these challenges everyday. It felt very frustrating and confining. After I was told I could borrow my friend’s car that afternoon to go to the hospital, a great sense of relief came over me.

At 2:00PM, I was sent out to search up and down the vast rows of D Bulla for a car I had never seen before. It took a good while before I found that faded blue Ford Focus. From Notre Dame to SJHS Mishawaka Medical Center, it took about 15 minutes and was a total of 3.3 miles. The patients I interviewed both had mentioned that they also live a 20 min driving distance away from the hospital. By the time I had parked and walked through the entrance, it was approaching 3:00PM.

From the worries of navigating the car in the parking lot to the frustration and pressure of the time limit I had, I felt disorganized upon entering the hospital. I conducted my interviews and quickly headed back, as I was under a time constraint to get the car back to my friend by 5:00PM sharp.

The purpose of this immersion was to put myself in the shoes of a patient who had no car and relied on those in her social sphere who would take her from point A to point B. This would be incredibly difficult and tiresome to do over a longer period of time and with children.

Ethnographic Expert Interview Summary- Family & Children’s Center (Roxanne)

Helen Sung interviewed Roxanne Ultz, Executive Director of the Family & Children’s Center of St. Joseph County, regarding the clients and services FCC offers.

Date: 3/6/17

Type: Expert Interview

Location: Hesburgh Library; phone call

Team participants: Led by Helen and observed with Cole

User Characteristics:

  • Bachelors and Masters of Social Work from Western Michigan University
  • Licensed Clinical Social Worker
  • Executive Director of FCC
  • Driven by public service and empathy for clients

 

Can you briefly tell me about what kind of services Healthy Families provides?

  • Healthy Families is a 100% home visitation program to new or expecting parents struggling with the demands and stresses of raising a child.
  • Parents learn about appropriate parent-child interactions, medical concerns, and important goals for themselves and the baby
  • All families remain linked to a clinic or physician

Who are the services targeted for?

  • At risk families, 2 out of 3 of these families live on $10,000 or less a year. “At risk” is a broad definition using a standard the national Healthy Families organization uses. It consists of households involving anything from substance abuse, domestic violence, adversity, and/or poverty.
  • Hear about us mainly through referrals from hospitals, OBGYNS, pediatricians, and other social workers.

Why did the program choose to provide at-home services?

  • Healthy Families is a national organizational design of the entire program. As a whole, the at home services are practiced as an accreditation to the organization.
  • Not aware of current hard facts, but would say majority of program clients do not have a personal vehicle or have convenient mobility.
  • Part of the program is the education clients about transportation resources available to them: Medicaid, Transpo bus routes, and eBus.

What is the transportation system of the program right now?

  • Our staff take their own vehicles are make trips to their clients’ homes and are reimbursed for gas for $0.50 a mile.
  • Each staff makes at least three trips a day

Insights

  • Many of SJHS’s patients who face transportation challenges may also fall under Healthy Families’ clients. There is an opportunity for patients to have more access to resources and education if SJHS made more referrals to the Family & Children’s Center.
  • FCC does not actively try to tackle the transportation conflicts its clients face, as it is not the aim of the program. But rather, it serves as an informative function to its clients.

Ethnographic Interview Summary-Patient in Lobby (Kate)

Helen Sung, accompanied by Cole Gillan, conducted an individual interview with patient Kate at about the transportation challenges she faces everyday.

Date: 3/3/17

Type: Individual Interview

Location: Mishawaka Medical Center; sofa in the main lobby

Team participants: Helen Sung, accompanied by Cole Gillan

User Characteristics: “Pregnant Patient”

  • Mother of three children with boyfriend
  • 9-months pregnant
  • Homemaker
  • Does not own personal vehicle

Quotes:

  • I face transportation challenges everyday. I usually walk, which is more difficult carrying 3 kids and I’m 9-months pregnant.”
  • Got to my appointment today using Medicaid. I just have to call 48 hours in advance to schedule a ride and they come pick me up at my home when I’m ready. The longest I’ve ever waited for the service to take back home is an hour.”
  • “I’ve missed a lot of my one year old’s appointments because I couldn’t get a ride so he’s behind on his shots. He’s 14-months, but he should have gotten his shot at 12-months old.”
  • “My boyfriend doesn’t have a car either. His friend gives him a ride to work. My mom borrows her sister’s car if I need to go somewhere.”
  • “I don’t have a credit card for Uber. And I just never tried the bus.”
  • “Spend about $100-200 on a monthly average paying people for gas.”
  • “Haven’t really tried to do much if I couldn’t find a ride. We’re from a bad neighborhood that I don’t even like to walk unless someone is with me.”

Insights:

  • Opportunity for less missed appointments through knowledge of South Bend’s Transpo bus routes and eligibility for Medicaid’s transportation services.
  • Rides need to be scheduled in advance because patients ask car-owners within their social sphere for rides. Schedule conflicts are bound to arise.
  • Ride sharing services and taxis may be out of budget for many living as low-income
  • There are opportunities to spread awareness of the transportation services Medicaid offers

 

Activities

  • Had oldest child (19 years old) stay at home to watch over younger kids
  • Rode in car using Medicaid transportation service
  • Was waiting in the lobby for almost forty minutes waiting for Medicaid ride back home
  • Sitting quietly by herself on coach in the waiting area of the main lobby

 Environment

  • Main lobby of Mishawaka Medical Center near entrance
  • Later in the evening reaching to around 5:00PM on a Friday afternoon
  • Fairly empty lobby with sparse patients and staff working at the nearby Starbucks or other boutique gift shop
  • Several waiting areas with varying chairs, sofas, and tables. Interview conducted in two armchairs facing each other
  • Ride came in drop-off/ pick-up zone in front of main doors

 Interactions

  • Approached Kate as she was quietly sitting alone in lobby
  • Brief greeting exchanges with others in lobby; pleasant and polite staff

 Objects

  • Kate’s medium-sized bag was held in her lap

 Users

  • Other patients and staff in the lobby and shops/ café

 

 

Ethnographic Interview Summary- Specialty Pediatrics (Laura)

Team member Helen Sung, accompanied by Cole Gillan, interviewed Laura, mother of a patient, about her experiences regarding transportation to and from the hospital.

Date: 3/3/17

Type: Individual Interview

Location: Specialty Pediatrics at SJHS Mishawaka Medical Center; waiting room

Team Members: Helen Sung accompanied by Cole Gillan

User Characteristics: “Mother of Patient”

  • Female, late 20s
  • Mother of three children, guardian for foster daughter
  • Wife
  • Photographer
  • Driven to be a good mother and guardian to her children
  • Optimistic and persistent in two of her autistic children

Quotes:

  • “We’re off to doctor’s appointments because there’s usually an appointment everyday.”
  • “Just gas maybe $300-400. With insurance around $550-600 a month.”
  • “My kids are autistic so they have Medicaid and are eligible to do that. So kids with     Medicaid, you can either drive yourself and ask for reimbursement through the insurance to cover gas, or you can say you need a ride to get you somewhere.”
  • “I come to all the doctor’s appointments with these three kids four times a week.”
  • “All my kids go to different schools. My foster daughter and other son ride the bus. My youngest son, Nick, always has to ride the car. Sometimes I’m back and forth a lot. Every other day is different.”

Key Insights:

  • Patients not only have to go to one hospital location, but often need additional healthcare services in other areas that would not be possible without transportation means.
  • Disabled children are eligible for Medicaid transportation services.
  • Owning a personal vehicle is costly.
  • Families, especially those with disabled or sick children with frequent appointments, really need full mobility and financial stability in order to healthily raise their children.
  • Children and parents each have different schedules that often result in time and ride conflicts.

 

Activities

  • Picked up son, Nick, from school
  • Took Nick and other two kids to hospital
  • Sat in waiting room with baby in her lap
  • Talking with foster daughter

 Environment

  • Waiting room of Specialty Pediatrics at Mishawaka Medical Center
  • Around 4:00pm on a Friday afternoon
  • Many chairs along the walls and children’s toys sprawled in the room
  • User sat close towards the receptionist window
  • Kid-friendly atmosphere

Interactions

  • One other mother and son sat diagonally across User
  • Other mother politely declined to partake in interview because she and her son were tight on time
  • User was carrying her baby on her lap

Objects

  • Baby seat with thick, soft blankets
  • Large tote with baby supplies and personal belongings
  • Child’s toy that the baby played with during interview

 Users

  • Other visiting patients
  • Receptionists
  • Other patients’ guardian