Family-centered empowerment for perioperative stress and pain management – using novel design thinking approaches

Spine fusion (scoliosis) and Nuss procedure (pectus) are among the most painful surgeries healthy adolescents undergo. Pain experience depends on family interactions and preexisting psychosocial factors. Thus, focusing on perioperative pain protocols is not sufficient to optimize pain experience. We applied design thinking approaches in conjunction with Livewell Collaborative to design family-centered empowerment tools focused on personalized, interactive pain management solutions. The design thinking modality employed was based on Vogel and Cagan's 4-phase integrated new product development process. The project was conducted in 2 stages each over 24 weeks. Both stages consisted of design research (focus groups with all key stakeholders to define the problem and processes from a patient perspective and identify opportunities), concept ideation (benchmarking and co-creation of new solutions) and concept refinement phases. During 1st stage, we identified 5 opportunities (key drivers), positive and negative influencers of pain experiences and visual tools used to map anxiety peaks. Using a non-weighting matrix, current tools were evaluated, 4 parent-child engagement dynamic spectrums and solution themes identified – empowering, road map, clear/consistent communications, technology based AIM system and vision of Hero's journey. During the second stage, patient and parent personas were identified via thematic analyses. Existing stress management tools (sensorial, thinking, relaxation, activity) were evaluated, and an interactive tool kit was built (including binder, booklet, card set and interactive site) to empower patients and caregivers with the flexibility to find the right tools suiting their needs. Interactive tools/video were co-created with Generation Z's perspectives. Our findings are driving the implementation of solutions tailored to family units to address key periods of increased stress. Changes implemented/ready to test include preoperative psychologic screening within surgical workflows and addressing anxiety, an app for medication management, empowerment binder, booklet, card set and Hero's journey storyboarding using videos.