Category: St. Joseph Health Systems

Our team met with Michelle Peters, the Community Benefit Ministry Officer and Director Community Health and Well-being for Saint Joseph Health System.  During gallery day we discussed the research we had conducted, future plans to conduct additional research and begin prototyping, and Michelle offered very insightful feedback for different parts of the project.  Her involvement with SJHS has proven a valuable resource as she is very knowledgable about past projects about the same issue.  She also is a great resource in terms of understanding the dynamics of funding, an issue we consider to be one of the main obstacles in securing transportation for SJHS’s clients living in poverty.  Below are listed a few takeaways from gallery day as well as future plans for our team which we discussed with Michelle.

Main Takeaways:

• In discussing our journey map which illustrates patients’ journey to their appointment, Michelle noted that the main obstacles are actually finding transportation and the timeliness of a patient who struggles to find transportation.  Miss appointments can potentially result in economic losses for SJHS.
• Our Users, Needs, and Insights board provided excellent insights from social and non-profit workers who deal with transportation issues with their clients.  Michelle noted we could certainly learn more from more encounters with actual patients.
• After we talked about our immersions which included a bus ride, an uber ride, and borrowing a friend’s car, Michelle noted that she believes if SJHS were to provide transportation it would likely be through a partnership.  She still believes outlets such as Uber should continue to be explored though.

Further Research/Plans

• Michelle provided us with the contact information of SJHS case managers so we may gain a better understanding into the struggles faced by SJHS clients who are living in poverty.
• We plan to spend more time analyzing the intricacies of funding for publicly funded, private, and other means of transportation.
• We plan to observe the current state of SJHS and see if there are any unused resources that could potentially be utilized in a transportation service.

*Pictures of our team’s gallery day will be provided by other team members.

The Gallery Day was very insightful because we were able to present all of our research to Michelle and then receive valuable feedback in moving forward with our project. We walked Michelle through the different aspects of our collected research starting with our Journey Map and finishing our Analogous Immersions. Michelle seemed to think that we were on the right track to solving the transportation problem and she was impressed to see that we collected research from so many outlooks.

Collectively, our team had three main walkaway points from our research pertaining to finding a solution:

1. Sustainable budgeting/ funding is needed
2. Awareness must be spread about current solutions because a lot of people are unaware of the current solutions
3. Organization must become more efficient and connected between different medical offices

It was very helpful having Michelle come to the Gallery because she was able to create links and provide ideas within our research. Moving forward, we will use all of our collective research to come up with a sustainable solution to the huge transportation problem that exists in South Bend.

Below is photo of the team presenting their research.

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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

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.

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.

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