Background The COVID-19 pandemic limited access to primary care and in-person assessments requiring healthcare providers to re-envision care delivery for acutely unwell outpatients. Design thinking methodology has the potential to support the robust evolution of a new clinical model. Aim To demonstrate how design thinking methodology can rapidly and rigorously create and evolve a safe, timely, equitable and patient-centred programme of care, and to share valuable lessons for effective implementation of design thinking solutions to address complex problems. Method We describe how design thinking methodology was employed to create a new clinical model of care. Using the example of a novel telemedicine programme to support acutely unwell, community-dwelling COVID-19-positive patients called the London Urgent COVID-19 Care Clinic (LUC3), we show how continuous quality outcomes (safety, timeliness, equity and patient-centredness), as well as patient experience survey responses, can drive iterative changes in programme delivery. Results The inspiration phase identified four key needs for this patient population: monitoring COVID-19 signs and symptoms; self-managing COVID-19 symptoms; managing other comorbidities in the setting of COVID-19; and escalating care as needed. Guided by these needs, a cross-disciplinary stakeholder group was engaged in the ideation and implementation phases to create a unique and comprehensive telemedicine programme (LUC3). During the implementation phase, LUC3 assessed 2202 community-based patients diagnosed with acute COVID-19; the collected quality outcomes and end-user feedback led to evolution of programme delivery. Conclusion Design thinking methodology provided an essential framework and valuable lessons for the development of a safe, equitable, timely and patient-centred telemedicine care programme. The lessons learnt here—the importance of inclusive collaboration, using empathy to guide equity-focused interventions, leveraging continuous metrics to drive iteration and aiming for good-if-not-perfect plans—can serve as a road map for using design thinking for targeted healthcare problems. All data relevant to the study are included in the article or uploaded as supplemental information. N/A.

中文翻译：

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应用设计思维的经验教训：为社区居住的严重不适的 COVID-19 患者提供独特的护理计划

背景 COVID-19 大流行限制了初级保健和现场评估的机会，要求医疗保健提供者重新设想为病情严重的门诊患者提供护理服务。设计思维方法有潜力支持新临床模型的稳健发展。目标 展示设计思维方法如何快速、严格地创建和发展安全、及时、公平和以患者为中心的护理计划，并分享有效实施设计思维解决方案以解决复杂问题的宝贵经验教训。方法 我们描述了如何采用设计思维方法来创建新的临床护理模型。以伦敦紧急 COVID-19 护理诊所 (LUC3) 的新型远程医疗项目为例，该项目旨在支持严重不适、居住在社区的 COVID-19 阳性患者，我们展示了如何实现持续的质量结果（安全性、及时性、公平性和患者利益）。中心性）以及患者体验调查的反应，可以推动项目交付的迭代变化。结果 吸气阶段确定了该患者群体的四个关键需求：监测 COVID-19 体征和症状；自我管理 COVID-19 症状；管理 COVID-19 背景下的其他合并症；并根据需要升级护理。在这些需求的指导下，一个跨学科的利益相关者小组参与了构思和实施阶段，以创建一个独特且全面的远程医疗计划（LUC3）。在实施阶段，LUC3 评估了 2202 名诊断为急性 COVID-19 的社区患者；收集到的质量成果和最终用户反馈导致了项目交付的演变。结论 设计思维方法为制定安全、公平、及时和以患者为中心的远程医疗护理计划提供了必要的框架和宝贵的经验教训。这里学到的经验教训——包容性协作的重要性、利用同理心来指导以公平为中心的干预措施、利用连续指标来推动迭代以及制定即使不完美也很好的计划——可以作为使用设计思维实现目标的路线图。医疗保健问题。与研究相关的所有数据都包含在文章中或作为补充信息上传。不适用。