Abstract

Background
How come, waiting times in the emergency department has been a subject to debate for more than 20 years? And how come, a national investigation of patients perceptions on the Danish EDs, danske akutmodtagelser, shows, that questions concerning waiting time information, over a period of three years, constantly have been among the lowest rated?
Is it possible, that a lack of understanding the problem, makes it hard to find good solutions?
And is it possible, that some of the reasons are, that the problem is a wicked one, and therefore hard, or almost impossible, to handle?

Goals
This paper aims to investigate and describe, how you can design good solutions to improve the patient’s experience of waiting in a Danish ED, dansk fælles akutmodtagelse.

Methods
The project uses a triangulated combination of methods for data gathering, and conducts a synthesesis, developing a framework of the problem, using affinity diagramming, concept mapping and abductive reasoning. Design ideas can be produced by insight combination.
Its approach is similar to Design Thinking, deliberately shifting between divergent and convergent phases, dragging on Herbert Simon’s definition of design: Everyone designs who devises courses of action aimed at changing existing situations into preferred ones.
The users have been involved as co-designers in meetings taking place in The Third Space.
Among the tools and techniques, being used, are Journey Mapping, Situation Cards, Follow The Actor and 3rd Space - and so, the use, of traditional tools for design, has been multidisciplinary.
Tangible objects and spatialization have been central in facilitating the processes.
In the closing act, towards selection of relevant solutions, a model of Technology has been imposed, in order to evaluate feasability of the ideas for solutions.

Conclusion
Finding good solutions and designing are intertwined concepts.
The project suggests mitigating the problem by a combination of solutions, that meets the design princples derived from emphasizing with the users and feeling their needs.
The feasability of the solutions depends on the context imposed upon them, and the organization’s willingness towards a changed technology. But when it all comes down, the final judgement is up to the user.
Wicked problems are never solved - designers can meerely mitigate their consequences by suggesting good solutions.
Implementation of these solutions will inevitably change the problem and so the designer must start all over again.