Archive by Author | marikajarvinen

Service design meets RAI –evaluation system

Be open-minded

Yes, I have heard it, and I think I have even preached about it. Be open-minded. First and for most. That is how service designer should think, no doubt about it. Still, I have found myself being by and by too blindsighted. Last time this happened to me was few weeks ago. I waited my turn to give a presentation about service design in health care in a seminar which was concerning work with geriatric people (Kehittyvä vanhustyö 13-14.2.2017). Funny thing when going back in my mind to that situation, is that in my own presentation, I had quotation from Dalai Lama: “When you talk, you are only repeating what you already know. When you listen, you may learn something new.”

What is RAI-evaluation system…actually?

Just before my presentation there was Development Manager Rauha Heikkilä from Finnish National Institute for Health and Welfare given her presentation about RAI-evaluation system and its benefits while evaluating service needs of geriatric people. Abbreviation RAI has come to my knowledge when I have been doing service design with geriatric patients, nurses and doctors. But I haven’t really understood what it is. My preconception about RAI –evaluation system was that it is something that consumes a lot of face to face time from patients, nobody actually uses the results and something that is already out of date. So I was little bit suspicious about the subject, I have to admit.

Rauha Heikkilä started her presentation by talking about customer focus in different levels of producing services: strategic, tactic and operative. She pointed out that Primeminister Sipilä’s government programme for advancing Health and Welfare is executed by top projects. One main objective is to take customer oriented approach to development of health and welfare services. Then she started to talk about RAI (Resident Assessment Instrument) and how it can help to achieve this objective. RAI is a tool for decision-making and to support management. It helps to

  • predict the population service needs
  • develop services that are based on actual needs of customers
  • target customer services according to their needs
  • monitor the quality and the performance of services

 When Rauha Heikkilä moved on with her presentation my ears grew bigger. These were the words that talked my language. I started to pay more attention. I started to actually listen. I could have said same sentences in my presentation about service design and how it can support management. What I learned was that RAI- evaluation system is a comprehensive system for evaluating, monitoring and improving the quality of care and service. It is standardized system to information gathering and an instrument for observation of service needs of a customer. RAI –evaluation is examining customer’s ability to cope in everyday life, mental and cognitive condition, social performance and wellbeing, health condition, nutrition and feeling of pain. RAI –evaluation is examining patient as a holistic person. It is carried out with a customer. Yes, in co-creation with customer. Evaluation process starts with interview and observation of a person himself and his peers. Again sounds something that could have come out of my mouth while giving my service design presentation.

What I also learned was that RAI -evaluation system is a support system for different service providers to give more personalized service and service that answers better to customer’s actual needs. Geriatric patients with chronic illness and disability use variety of clinical and support services. With RAI-system there is always background knowledge about customers overall situation and thus it is possible to do better decisions for taking care of the geriatric patient. RAI-evaluation system enables planning standardized services for typical customer needs. Also service profiles can be planned with RAI-evaluation system.

Same goals. What can we do together?

While listening the presentation I didn’t find any conflicts between service design and RAI –evaluation goals. The goals are actually the same. I started to think what could be accomplish by combining these two methods. I brought up this idea to Professor of Geriatrics Jaakko Valvanne in a lunch discussion. He is acquainted with both methods and specialist with RAI- system. He clarified me that RAI – system is well deployed in Finland. However, he has seen that even in the best organizations, it really takes years to be able to use the results so that they actually help in developing services.

From the user’s (nurses and doctors) point of view, RAI system is difficult, complicated and troublesome in many ways. Professor Valvanne pointed out also that the results of the RAI –system should be first the results for the patient and his peers. Secondly results of organization. But are they easy to understand for ordinary people? Are they presented in a way that awakes interest? Could assets of service design help to make RAI –system more approachable, make the system more usable by understanding user needs better, simplify the process and the results by visualization and maybe make less serious by adding some fun and humor to it?

When thinking other way around, people who work in the field of geriatric patients, are acquainted with RAI –system. Could it be easier to accept service design as a serious development method, if these two are methods are offered hand in hand? There are similarities but also differences between these two methods. RAI –system is a data bank for designing services. Service design is more of qualitative and emphatic method.  If using these methods simultaneously, could it raise the benefits of the results in a different level?

Blending methods and thoughts

While finishing our lunch discussion with professor Valvanne we were both excited about this idea of service design meeting RAI –evaluation system. This seminar and enriching discussion after that cleared out to me that something unexpected may happen when you let yourself to be open. There is no only one right way of doing things. There are many. And if you are clever, you make these many ways overlap each other and you might find results that lead you to something totally new.

We might have another lunch and discussion around this subject with professor Valvanne and start something new by blending our thoughts more.