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Redesigning care: adapting new improvement methods to achieve person-centred care
  1. Onil Bhattacharyya1,2,
  2. David Blumenthal3,
  3. Roger Stoddard4,
  4. Lynne Mansell5,
  5. Kathryn Mossman6,
  6. Eric C Schneider3
  1. 1 Frigon Blau Chair in Family Medicine Research, Women's College Hospital Research Institute, Toronto, Ontario, Canada
  2. 2 Family and Community Medicine, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  3. 3 The Commonwealth Fund, Policy and Research, New York City, New York, USA
  4. 4 National Leadership Council, Primary and Integrated Health Care Innovation Network, Quispamsis, New Brunswick, Canada
  5. 5 National Leadership Council, Primary and Integrated Health Care Innovation Network, Edmonton, Alberta, Canada
  6. 6 Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Onil Bhattacharyya, Family and Community Medicine, Women's College Hospital, Toronto, ON M5S 1B2, Canada; onil.bhattacharyya{at}

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In many industries, meeting the needs of customers can mean the difference between thriving and going out of business. In the last century, manufacturers started to use and refine methods to reliably make products that offered a better customer experience at lower cost, by reducing defects and waste.1 These methods, introduced to healthcare almost 30 years ago2, are now part of the routine operations of many hospitals and large physician organisations. They have contributed to improvements in patient experience, reductions in hospital acquired infections and fewer readmissions.3 Customer-focused companies have not stood still during this time, creating an abundance of new products and services.4 5Many of these were made by technology startups and firms adapting industrial design methods like ‘human-centred design’ to create better experiences by understanding and responding to unspoken or unmet needs of customers.6 Embracing methods to create new products and services can augment current efforts to improve existing products and services and has potential to make health systems more responsive to patient’s needs. While the financial pressure to improve the user experience is less in healthcare than other service industries, the rise of value-based financing in many health systems creates an incentive to explore new models of care that offer a better patient experience and better health outcomes at lower cost.

The broad goal of improving value and delivering a better experience can be pursued using established methods like Lean and Six-Sigma that are relatively well established in healthcare.7 However, these methods may not be as well suited to generating novel services. Methods less familiar to healthcare like design thinking (first introduced by some healthcare organisations in the last 15 years or so),8 9 and Lean Startup (introduced within the last 5 years)10 may confer advantages on …

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