Designing For Women Vets: Reimagining the Service Experience at the Veterans Administration Hospital
Experience Design / Design Research
MFA Products of Design, School of Visual Arts / Guidance from Lawrence Abrahamson / Team Project with Smruti Adya, Bernice Wong, Lassor Feasley, Christopher Rand, and Kuan Xu / Fall 2016
Designing For Women Vets
As part of SVA Products of Design’s partnership with Veterans Affairs (and held through the Design Research and Integration class taught by IDEO’s Lawrence Abrahamson), our team designed a number of solutions to improve women veterans’ experience in three different areas specific to visiting the VA Hospital: transportation to the hospital, wayfinding once in the building, and pre-appointment communications.
We were given the prompt of understanding why there was a higher rate of missed appointments within the women’s clinic of the hospital as compared to the other departments. We conducted extensive interviews with veterans—those who do and do not use Veterans Health Administration (VHA) services—VHA doctors and staff, as well as other professionals who provide services to veterans.
Bringing together what they heard from the interviews, we were able to map the journey of a woman veteran as she navigates the various touch points of obtaining and attending appointments at the hospital. So, we decided to design for the three areas which we felt were key pain points described by interviewees across the board.
Addressing Transportation to the Hospital
We found that women veterans face challenges travelling to the hospital for several reasons. They may need to make numerous arrangements including taking time off work, scheduling childcare, juggling school demands, and more. Oftentimes, we found, this means that their personal health falls to the bottom of their list of priorities. “Women veterans always put their family first,” said one VHA administrator, “they prioritise their children or grandchildren over their doctor’s appointment.” We also learned that many women veterans experience difficulties with mobility or mental health as resulting from their time in service.
"Currently, up to 20% of women veterans have PTSD, and 55% of women veterans have experienced Military Sexual Trauma (MST)"
We were shocked to learn that currently, up to 20% of women veterans have PTSD, and that 55% of women veterans have experienced Military Sexual Trauma (MST)—a higher rate than ever before. Alarmed by the statistics, the team looked to existing alternatives for private or semi-private transportation, finding the options to be either too expensive or overtly taxing upon anyone with mental or physical trauma.
Determined to seek out an alternative, we reached out to representatives from the four rideshare companies with a presence in New York: Uber, Lyft, Juno, and Via. We designed branded interfaces to propose different, viable methods by which the organization could support veterans.
The first option was a feature on veterans’ apps in which they could access discounted rides originating from and arriving at the VA hospital. The team imagined that the company would absorb this cost, contingent upon on the number of veterans making use of the feature. The second, more sustainable alternative, was a feature that gave civilians the option of gifting rides to veterans, being prompted to donate a few dollars at the end of their own trips.
Wayfinding within the Hospital
The women's clinic in the VHA has strived to create a safe and comfortable environment for women veterans. Unfortunately, this environment does not often extend past the clinic's walls. Women, especially those who have experienced MST, can be made to feel uncomfortable by some of their male peers.
“I get screamed at every day walking in the building from the [male] vet who sells stuff outside. So there is this male culture that makes it really hard for female vets to come.”
We felt strongly that this was an issue they wanted to tackle. However the deeper they looked, the more they realized that it was beyond that of the in-hospital environment, and even beyond systemic military culture. From there, we arrived at a subtle system of strategically placed ‘breadcrumbs’ leading to the 9th floor women’s clinic.
While marking this route, we wanted to remain unobtrusive to the greater hospital landscape. We did this by making use of colors and symbols without the visual clutter of traditional signage. We made use of strategic areas such as hallway corners and door handles, which are often left unused. The final design included a series of acrylic corner guards and door knob hangers, easily installed, adjusted, and moved.
Another critical realization for us was that the patient journey starts at home, once the woman veteran receives her appointment confirmation and details in the mail. As such, we also redesigned the brochure that comes with her appointment package, to both introduce the symbology of the breadcrumbs and extend the personal, comfortable environment of the women’s clinic to the home.
Humanizing the Language of Pre-Appointment Communications
Lastly, the team looked to opportunities where they could humanize the language of pre-appointment communications with women veterans. Given the complex and highly regulated environment of the veteran health care system, much of the print information available to patients was impersonal and difficult to parse. As such, the team hoped to re-evaluate these touch points, including the appointment reminder letters and the doctor profiles section of the VHA website, seeking opportunities to integrate more precise and comprehensible language.
“I don’t really care if you have a professional profile for every one of these doctors. I just want some stories about who these people are! ...We need to inspire some confidence. There are great practitioners here.”
We began by our researching existing examples of methods used by private clinics to correspond with their patients. Over and over again in our interviews, we had heard great stories about a specific doctor or staff member that turned a regular hospital experience into a something memorable. However, we came to a breakthrough moment after speaking to a woman veteran with several positive experiences at the VHA. She said, “I don’t really care if you have a professional profile for every one of these doctors. I just want some stories about who these people are! We need to inspire some confidence. There are great practitioners here.” From this, we realized that we needed to emphasize the strengths and stories of the VHA’s dedicated doctors, administrators, and staff.
We were able to create several prototypes, illustrating the direction towards which the VHA could improve their methods of communication with patients. Despite an abundance of pre-appointment interactions the VHA had with patients; a reminder letter, an email, and a reminder phone call, as well as other online resources, there were few resources for patients to learn about their providers prior to an appointment. Even in situations where patients were able to learn more about their providers, we heard that patients were often disappointed by the resources available to them.
It was important for us that their final designs be implementable at little disruption and cost to the VHA. For this reason, we integrated patient and physician stories into pre-appointment correspondences that were already being sent to women veterans.
In the end, we wanted to acknowledge that our interventions were small steps in the larger picture of women veterans’ health care experience. Throughout the fifteen-week project, we were exposed to an array of incredibly dedicated stakeholders, committed to giving back to the veteran community. We came to a number of insights around staff turnover and the appointment notification system that were beyond the scope of our project, but are aware of existing initiatives to improve upon them. We’re excited to see what’s to come!