[MUSIC]

Our middle child, Rebecca, who had recently turned five, became ill.

And we took her to our local urgent care center

where she was diagnosed with strep throat.

So they gave us antibiotics and sent us on our way.

And we gave her the antibiotics over the next couple of days but

her symptoms actually gradually got worse instead of better.

Until that Thursday evening just before dinnertime she was waiting with my wife

in the emergency room of a local medical

center when she had a sudden grand mal seizure.

She came out of it within a minute and

was rushed for a CT scan and actually seemed better than she had in days.

But within less than half an hour she had a second far more severe seizure.

Her heart rate and

respiration plummeting to the point that the code blue alarms went off.

Within seconds, the ER staff broke into a crash cart, intubated her, and

stabilized her by using paralytic drugs to induce a coma.

So in less than three days, our little girl had gone from playing on the beach,

to the literal brink of death and we had no idea how it had happened.

The CT scan showed that there was a large mass on the center of her brain and

at that point the medical center staff informed that she would be life flighted

to the Children's Hospital of Philadelphia about 150 kilometers away.

When the helicopter arrived it had the pilot and the co-pilot, and

four emergency medical technicians on board.

They were there because their condition was so

severe that it even with them present,

no one could assure that she would even survive the flight to Philadelphia.

There was no room for me or my wife aboard even if we've been allowed, and so

the helicopter took off for Philadelphia with our medically comatose daughter

aboard leaving us behind not knowing if we would ever see her alive again.

Someone we barely knew volunteered to drive us to Philadelphia.

And so we found ourselves sitting in the back seat of a stranger's car,

barreling up the Garden State Parkway at 11:00 at night,

barely able to comprehend what was happening.

And in moment like that, there are surprisingly small number of thoughts that

go through your head and the thought that kept returning to us over and

over was how do we get to our daughter?

Not is she all right or even will she be all right,

but how do we get to her as quickly as possible?

And it took a little bit of time, probably longer than you might believe, but

eventually I realized that I could try to find out the answer to this question.

I thought, I have a pocket Internet terminal.

I could use it to find out what to do.

So I pulled out my iPhone, and I Googled children's hospital Philadelphia,

tapped the top result, and this is what I saw.

I needed to know how to get to my critically, possibly fatally ill child and

this is what I saw.

Although, that's not quite accurate to be more precise, this is what I saw.

I saw a brochure, out of focus not because of tears in my eyes,

I was too far in shock for that.

But because I lack the mental capacity to understand what I was seeing.

Steve Krug famously said, Don't Make Me Think.

This is a situation where I almost literally could not think.

But I still had instinct and so after a few moments,

20 years of web experience started to assert themselves I started pinching and

zooming around, trying to figure out where the information was to tell us what to do,

and how to find her.

So I zoomed into the center column, because that's where the content goes.

But there was nothing there for me.

My child has, I didn't know, I had no way of answering that question.

Find a specialty or service by first letter.

There was nothing there for me.

So I pan to the left where I found press releases.

Which, if anything, was even more useless.

Also the welcome kit section, which at first I remember thinking,

oh, okay well we're going to the hospital, welcome kit would be useful.

This actually turned out to be where you could get a video guide for

parents and families and also how to send an eCard.

So I panned upward and that's when I saw it, the navigation which I had missed

initially, the very tastefully designed and integrated navigation

that I had skipped in my distraction.

For patients and visitors, seem like it might apply, so I tap that and

I got a drop down on my smartphone.

Now I wanna reiterate that all of the texts basically look like this.

Blurry and out of focus and I remember squinting at is as though that would

somehow make it come into focus or maybe grant me some sort of mental power up.

Unfortunately neither occurred but I looked at this and eventually I decided

type visit probably applied because this was, afterall, a type of visit.

So I tapped that, and I got this.

I know you can't read that.

There are four options here.

Outpatient visit, inpatient visit, surgical visit and emergency room visit.

Even now, looking back at this with relative dispassion and

all of the insider knowledge I've built up in the meantime.

I still cannot tell you which of these is actually relevant to the situation

that we were in.

I would argue that none of them are.

Now, my wife Kat is an advanced practice nurse.

She actually has several advanced practice degrees, including a doctorate in nursing.

So over the years, in helping her study for her boards, and also

just hearing her talk with her nursing friends, I've absorbed some of the lingo.

I happen to know that out patient visit did not apply to us at that moment.

Out patient visit is when you go in and you have an appointment and

then you go home.

That's what we hoped would happen, but that was not our situation.

Maybe in-patient but we weren't impatient yet.

Surgical visit, I assumed that there might be surgery in the future at least

I hope so at that point because the alternatives were worse.

But no one had said

that she was going to the surgical unit because at that moment she wasn't.

Emergency room visit might have seemed like it applied except

the late flight helicopters does not land at the emergency room.

And so, skipping out patient because again,

with that insight or knowledge, I knew not to do that.

I tried them in order.

Here's in-patient and surgical was no better than this.

This massive walls of text that are all about what to do for

your planned visit, your planned in-patient visit.

What documents to bring, and what to pack.

And remember, we had already left, and I was not gonna turn around if they said,

please make sure to bring your driver's licence.

We were not turning around at that moment.

Eventually I caught onto the fact that there's a for patients and

visitors hub page.

This is it, or

at least was the Children's Hospital of Philadelphia has redesigned since I

took these screen capture, but pretty much everything I'm telling you still applies.

It looks different but there's really been no change.

You got to this, they way to get this, was to tap on for patients and visitors, and

then ignore the drop down, and tap on for patients and visitors again,

and then you get this page.

Sometime later, I went through every single one of these links.

There was nothing here to help us with what we needed to know right then.

How do we get to our daughter in the shortest possible time?

There isn't even anything here for, what do we do when we get to the hospital?

Now, some of you may have spotted what looks like a solution to our problem.

There is a phone number on every page of this design.

I don't think I ever saw it.

You might have noticed it's in the sidebar.

Jen Simmons has observed, and not the only one, but

Jen Simmons was recently observed.

The sidebar is where we put things that we don't want anyone to see.

But the thing is, even if I had seen it, I'm not sure that it would have helped.

Because I was holding and iPhone in my hand and it never once occurred to me that

it was a phone which is the standard joke, right?

That night, sitting in the back of that car, we literally forgot that.

There were a total of four people in that car.

Every single one of us had a smart phone.

And not one of us thought to say hey you know what let's try calling the hospital

and see what they tell us to do.

And if you wanna know the weirdly surreally almost hilarious part?

I was using my phone to try to look up this information

because my wife was staying off her phone.

Because the hospital was going to call us when the Life Flight helicopter arrived.

We were waiting for a phone call,

and it never occurred to us that we could do the same thing in reverse.

Which might seem completely ridiculous, but

it's actually consistent with findings in cognitive research.

It's been shown that every single one of us has a limited

amount of cognitive resources, and it's a single pool.

If you drain cognitive resources in doing one thing,

you have less cognitive resources to do something else.

So as an example, there's been research done where there are two groups

of people in the research, one set is given a very easy memorization task.

Something like memorize two numbers.

And the other group is given a very hard memorization task.

Something like memorizing nine numbers in a row.

Then when they're done with that task,

they're taken to a break room where they have a choice of snack.

Either healthy fruit plate or chocolate cake at 10:00 in the morning.

The ones who have done the difficult memorization task are twice as likely to

pick the cake because they don't have the cognitive resources left to exercise

willpower.

So Karen McGrane has said, that you don't get to decide what your users want to do

on mobile, which is absolutely true.

But my point is we didn't even make a choice,

we did not decide what to do on mobile.

We simply acted on bare instinct.

We became mobile first users.

Sort of by force of the context.

And the fact that we didn't have the brain power left over to think about

ways to get out of this, ways to figure out this situation,

because all of our cognitive resources were being consumed by the circumstance.

So to come back to the CHOP website,

Children's Hospital of Philadelphia abbreviates to CHOP.

And they call it that which I find really weird, but okay.

We come back here.

This was not doing anything to help us.

I bet this site works for a lot of people.

Or worked for a lot of people.

Most of them in marketing and upper management at CHOP.

And it probably even works for a decent percentage of their regular users.

Because a decent percentage of their regular users

will resemble the ideal user.

This is who we design for.

This is who we're trying to not make think.

This cheerful, with it, savvy, focused user, all comfortable and

secure in her spotlessly gleaming home of the future.

Whatever site's she's on is making her really happy.

She is so happy to be there, someone who knows what she wants, has a time and

mental capacity to figure out what she's being presented with and

fulfill her goal, whatever that goal is.

We try not to make these people think but they can think and we rely on that.

Of course if we're honest with ourselves,

most of our users probably aren't like this, they're probably more like this.

Still savvy and with it, but maybe not so cheerful or focused.

Because clearly the kids are having a bad day, they've got bills to pay,

they've got stuff to look up, dinner has to get started.

There's a million things going on and coming to your site is just one of them.

So they're one, we maybe add a search box.

Give them fallbacks in case they don't spot that clever bit of content that

directly relates to what it is they're trying to do.

So we do that.

We handle this kind of persona, I think, fairly well.

And it's good but it is not enough.

You need to add another persona to your list, which is the user in crisis.

Someone who is unable to think.

Someone who has been pushed beyond that capacity, and

can barely focus on your awesome design and soothing copy.

Bobby, who just found out that his automated mortgage payment has failed for

the last few months and now he's not sure if he's going to be foreclosed on.

Or Sarah, who is traveling abroad and has a flight tomorrow and

just had her purse stolen along with her passport and needs to figure out

how to get travel documents as soon as possible so she can get back home.

Or Jennifer, who just got email from a stalker who's made a credible threat

against her safety and

now she needs to lock down every bit of her online presence as fast as possible.

These are personas who are,

that are every bit as developed as others that you might have.

They have a background.

They have stated goals.

They have a, you might have to search a little harder for

stock photos that relate but it's worth it.

And obviously those personas that I gave only work for specific types of sites and

you might think to yourself, well, I don't have one of those sites.

But with some creativity you can and you should come up with crisis driven personas

that relate to what it is that you do.

Because when you approach your design,

your site with that sort of persona in mind, it looks different.

It presents a different aspect.

It does require some empathy, that's not bad.

It's just difficult.

It can be very hard to put ourselves in that place.

But it's worth it because when you look at your work through other eyes,

eyes have been clouded by fear or

stress, you can find the weak points in the design very quickly.

Now, I am not saying that you should only design for such personas, but so

much of the time we talk about people who are in the midst of crisis as edge cases.

Edge case is another way of saying, I don't care about that.

Instead, these are stress cases.

And my contention is that stress cases should come closer to the center.

They should be considered as part of this process.

So I am not saying that the CHOP homepage should have simply been nothing but

a big link that said my child is ill, help.

Although, admittedly at the moment that would have been really useful for us.

But imagine that it had this up in the center.

Unexpected visit?

Here's what you need to know.

That right there,

in my idealized world, would have taken us to exactly the information we needed.

And adding that to the For Patients and Visitors drop down, and

weening it in throughout the site, maybe putting it in the sidebar,

just in case someone happens to glance over there, would have made that

information available and still let the CEO feel totally awesome about their U.S.

News and World Report banner on the homepage.

And this is something that using a crisis persona would have uncovered.

And you might wonder, you might think to yourself,

what is wrong with CHOP that they did not think about a crisis persona.

They are a hospital.

I have been on many,

many hospital websites in the last two years, none of them do this.

It's not just CHOP.

And none of us are doing it either, or very few of us.

The exceptions would be people who are doing design, designing things for

people who are likely to be in a crisis situation.

The example I always think of is the automated external defibrillator devices

that are hanging on walls, at least all around America.

I'm not sure about here.

They're incredibly simple.

They're incredibly easy to use because they were designed from the outset to be

used by people who have no medical training,

who maybe need to save somebody's life in a shopping mall.

But if that's not the brief, we don't think about these things.

And, since John mentioned Ted Nelson this morning,

I couldn't resist putting a quote in from Ted.

So, it's one thing to use persona's, but

I have another recommendation which is to also create contexts

into what you can set your persona's included your crisis persona.

So I'm gonna come up with a hypothetical example of a shopping website.

Granted, a shopping website has more than three personas and three context.

But I only have so much room on a slide, so work with me.

So there might be three context of someone who's doing online shopping.

People are doing online of shopping.

They could do it in the middle of the week, during their lunch break, you know,

at the office.

Also, after the kid's bedtime,

in that short window after the kids go to sleep, but before they go to sleep.

For some people that window is very narrow.

And then also on a mobile device in a waiting room, maybe waiting for

a tire to get fixed, or waiting for an annual check up.

Setting personas into contexts actually multiplies, in some sense, the number of

personas you're working with because context affects how people do things.

That seems obvious to say, but you might actually discover that

some personas don't actually even appear in some contexts.

And I have a physical world example of this.

So back in shop, the main elevators have this really, cute touch to them.

Where after you've gotten in and pressed the button for

your floor, this cheerful kids voice announces, door's closing,

going up, and then the doors close and you go up to your floor and

another different cheerful kids voice says something like, Floor five, Nephrology.

I guess assuming that people know what nephrology means.

Study of the kidney, by the way.

So, that's great.

Cat and I got to the Children's Hospital of Philadelphia

literally at the stroke of midnight.

And a pro tip in case you ever also find yourself going to the Children's Hospital

of Philadelphia at midnight, the front doors are locked.

Incidentally the website did not warn us about that.

Also the emergency room, closed.

Yeah.

So, the hospital's basically deserted at that hour.

Most of the lights have been turned off, and walking into a dimly lit

hospital at midnight is a little bit creepy under any circumstance.

So we got there, we found the security guards behind their

incredibly thick bullet-proof glass, because America.

And they told us, gave us our badges and told us where to go, so

we walk across the main atrium of the hospital which is this nine story tall,

cavernous space, with our foot steps echoing back at every step.

They're literally no other humans besides the security guards,

we don't even see staff.

It's dark.

We go to the elevators not knowing what's gonna happen next really.

I mean, we don't even know that we're gonna see our daughter.

We get in the elevator and push the button for seven.

Doors closing, going up.

And I thought, oh my god, we're in The Shining.

[LAUGH] >> And literally, that's what went through

my head, it was totally jarring and it added to that overwhelming sense

of disorientation and shock that we were experiencing at that moment.

I mean I think of it now as almost the definition of user hostile.

But if someone had done this.

If they had said, hey, let's take some personas, include some crisis personas and

put them in context like the middle of the morning and lunch time and

then also midnight.

They might have realized, you know what, the platonic ideal of user and

even the harried outpatient user?

They are not in the hospital at midnight.

There are no outpatient appointments at midnight.

The only people, the only users in this case

who are gonna be in a hospital at midnight are people in crisis.

The only other humans that would be there are staff.

And I can guarantee you that the staff would be really grateful if those kids

would just shut it for a while.

So this is the situation again,

where Persona's Plus contacts would have helped with that situation.

And they might have said to themselves, hey,

maybe we could not have the kids' voices during a hospital quiet hours, let's say.

We'll just go with the standard soft door chimes.

So, put those two things together and hopefully,

you find out things about your design that weren't obvious at first.

Where you find out, oh, this thing that I've done totally works here but

is actually the totally wrong thing to do over here.

Okay, so that's one example of how designing for

crisis actually gonna help in just about any field.

I have another one which is the airline industry, and

no I'm not gonna talk about airline accidents here.

I'm actually thinking about things more like delayed flights

when you have a connection.

So, maybe you've built in two hours to your connection, that's what I did coming

over here but, hey maybe your first flight is delayed by an hour and a half.

And so you land, and

you've only got 15 minutes to try to make your next connection.

Even if you're one of the first people off the plane,

if you're lucky enough for that.

You go sprinting across some sprawling dystopian maze of an airport

trying to find this gate and make it onto your flight just in time.

How great would it be, if airlines smartphone apps, or even websites, gave

you a map from the gate you're arriving at to the gate that you're departing from.

Because if you're on the smart phone app, most likely

you're already signed in, it knows what flight you're on.

It knows that that flight is late, and it knows where that's coming in, and

where the next one is.

So boom, turn by turn directions right there.

So that it's not gonna get you there any faster necessarily although it might help

you not go the wrong way, in this airport you're not familiar with.

But it could let you pre plan and therefore reduce some of that stress.

Another way that could help is the smartphone app could generate

a little card that you could show to the people around you that says

I have a tight connection, please let me out first.

Sometimes airline attendants do that.

They say, some people have tight connections,

could you please let them off first, but how do you know who that is?

Okay, so

that's one area where the airline industry could maybe do things a little better.

Another place where they could use help with this is in booking a ticket.

In many cases, booking a ticket, again we're back to this platonic ideal of user

who's looking up flight times for his two-week trip to Jamaica in nine months or

whatever is he's doing, I don't know.

But even in that situation,

most of our ideal users probably end up more like this by the time they're done.

Because Holy St. Francis, how bad are airline booking sites?

This massive wall of stuff, and I don't even like dealing with this in general.

Now imagine dealing with this in a crisis.

And a crisis is not necessarily always dire and bad, it could be that your sister

who was moved to another country just gave birth early to her first child.

The baby is fine, the mother is fine but you'd still like to be there

as quickly as possible to meet your brand new baby niece.

Right now in that situation you do not care about what kind of plane you will be

on or what kind of meal service you will get if we can even call it that, right?

You just need to know two things, how fast can I get there and

what will it cost me because we live in that world.

And in these situations when you don't have many cognitive resources.

You're more likely to overlook important details,

like accidentally reverse sorting by arrival time.

So you're actually booking a flight that will get you there in two days,

after a 27 hour layover in John F Kennedy.

And most unified booking sites, not much better.

In fact I would argue in some ways worse, but

I have an exception at least in the US I don't know if you have one similar here,

but Hipmunk, Hipmunk is great.

It shows you how long your trip is very clearly so that you don't do something

like I did once which is try to book a trip between February 1st and

February 4th and misclick and book a trip between February 1st and March 4th.

Yeah, that was embarrassing when I showed up at the airport.

You're not on this flight.

But I, oh, okay. >> [LAUGH]

>> What will it cost me?

Okay, and then once you've input that, you have these amazingly clear search results.

All right, you wanna get there right now?

Search by landing time, boom.

This is how soon you can get there.

Do you want the cheapest option?

Sort by price.

Turns out it's cheaper to get from Cleveland to Washington DC by Amtrak than

anything else.

It just takes an incredibly long time and I can see that, you can see that.

You can see those bars at the top.

So we can look at this price, and I might discover that an extra $20 gets me on

a direct flight instead of a connecting flight.

And then there's the agony sort,

which I think is one of the greatest labelling choices of all time.

And sorts flights from least agonizing to most agonizing.

They don't tell you the exact process they come to that by.

It's some combination of connections and price and so on.

But anyway, the point being, this is a design that works for

anybody, including people in crisis.

It's really easy to understand.

And if you're acting in leisure instead of in crisis,

this thing's a total joy to use.

And that's one of the points I'm making here, if you consider stress cases,

crisis cases and make it so that they can use your service or understand your site.

Then people who are not in that situation are gonna have no trouble at all.

It actually becomes a joy to use.

I love this site even if and this is often the case,

I don't have much flexibility in terms of date or air carrier.

I still come here to find out what my best options are and

I actually feel kinda good about it, I feel like I understand what's going on.

Even though all this does is it tells me, it lets me figure out what my flights are,

and then when I say, these are the flights that I want,

it literally sends me to the airline website to complete my purchase.

It's not even a middle man, they're just providing information.

So I'm hoping one of these days I actually get to meet some of the people from

Hipmunks, so I can do a little we're not worthy thing to them.

Anyway, so speaking of travel, I wanna go back to the road.

In 2012 actually again on vacation in New Jersey,

I was driving the minivan through an intersection, when a car on

the cross street decided to jump off a stop sign, and t-bone our minivan.

Which, to be fair, is a traditional form of greeting in New Jersey.

>> [LAUGH] >> So, the car was drivable.

Our car was drivable, theirs was not.

Ours was drivable making some worrying noises admittedly.

But suppose it hadn't been.

Suppose it had been hit in such a way that it couldn't go anywhere.

In America, we have AAA.

The American Automobile Association.

I guess here you just have V-Automobile Association, so well done to you

>> [LAUGH]

>> And one of the things at least for

AAA, when people think of AAA, they think of roadside assistance.

Can you tell me where on here there's roadside assistance?

It's a trick question, it's actually down here.

And the actually once you get there is legendary roadside assistance.

One of the many reasons to join AAA.

Wait, but what if I want roadside assistance?

I mean, you would think that it's showing me this because it

wants me to be a member.

I am signed in as a member when I took the screenshot.

It turns out that the automobile association here,

I looked at the website, not a lot better.

Sorry, at least in the mobile, you have to scroll a very long time

before you get to the I need roadside assistance thing, okay?

As supposed to the AAA mobile app, we're boom, roadside

assistance is number two and I actually like that better than it being number one,

because it's closer to the center, instead of having to go all the way up to the top.

It's a little thing, but road side assistance, bam, so great.

And their old mobile site was very similar.

Road Service, first thing, right?

Taking the assumption that if somebody's coming to the AAA mobile site,

they might need some help.

They might be actually on a roadside in the middle of Pennsylvania and for

those of you who are not familiar with American geography,

Pennsylvania is nothing but forest basically and a couple of interstates.

And there's two cities at either end.

That's pretty much Pennsylvania.

And by the way, it's about 600 kilometers long.

So yeah, this is actually,

it's interesting AAA is both done wrong and done right.

The desktop site completely buries the whole, I need roadside assistance.

And okay, you might think to yourself Who's going to be

on the desktop site if they need roadside assistance?

The last two times I called AAA for roadside assistance,

it was because I had a car in my driveway that wouldn't start.

And so I went inside to go on to the AAA website while I was on

the phone doing things like calling our kid's daycare to say

I will not be there to pick them up as I thought I would, car will not start.

Right?

So it's not enough to say nobody will ever use this in this context.

Yeah, maybe they will and you just haven't though of why.

It's really not to us to judge whether users are gonna be doing.

Okay.

So, I don't want this to be all about people who are doing things wrong, for

all the world is terrible.

Okay, I actually want to go back to medical imaging for

a Crasis design success story that is nothing short of incredible.

So medical imaging is really amazing.

I mean,

we can take pictures of the insides of people without having to cut them open.

That's Star Trek level stuff right there.

The thing about it is that unfortunately the equipment that makes that possible,

tends to look like a cross between the Jetsons and

THX1138 with just a few undertones of HR Giger thrown in for flavor.

They're in these usually spare and harsh and

antiseptically white rooms which I guess the design

theory there is that you're communicating to the patient that white room is clean?

And therefore, safe medically.

Unfortunately, it also tends to communicate the message of,

this is an incredibly alien environment.

I'm kind of freaked out, just looking at that picture.

Now, I want you to imagine what it's like

if you're a small child that needs medical imaging.

Okay, you're already in a generally unfamiliar environment.

Your parents are probably giving off all kinds of stress signals because they're

scared, and no matter how hard they try to hide it you can tell.

In fact the harder they try to hide it the more scared you're probably getting

because of your parents are hiding something, that is probably really bad and

you're being shown this enormous machine.

And remember, half the size and

is everything looks twice as big to them as it does to us.

This enormous machine that looks like it's built to vaporize you.

And some strangers like, yeah, you're just gonna lie in here.

All right.

It's a wonder that any kids ever get image at all.

So I want you to meet the GE Adventure Series.

These are complete user experiences that are built around medical imaging equipment

with a whole bunch of different themes.

Now they have a mission statement where they manage to get all the right

buzzwords, somehow they put leveraging in there, but

honestly, this headline is their actual mission statement.

It's perfect.

From terrifying to terrific.

The core goal here, is not to just make things look pretty,

it is to reduce sedation in children.

Because the thing about medical imaging,

is that, as incredible as it is, it's not Star Trek quite yet.

You can't just wave a thing at a kid, or any patient, and

then it just have a 3D map of the inside of them.

Medical imaging requires the patient to lie perfectly still for

the length of the scan.

And with MRIs, that can be a very long time.

I don't know about you, but I can't even get my kids to lie still for

that long when they're calm, let alone when they're freaking out.

So typically if a child needs to be imaged,

they are given general sedative, general anaesthetic in order to knock them out and

completely immobilize them for the scan.

There are a lot of problems with sedation, the rarest of which, but the most

serious is that anaesthetic can some times produce a side effect that leads to death.

But the more the bigger problems are that it just takes a long time.

There's an hour of setup time.

There's the actual scan and then probably two hours of recovery afterwards.

That's taking up a bed for

three hours at least and hospitals only have so many beds.

Sedation is expensive.

It makes the whole process slower and it has medical risks.

So reducing the incidence of sedation is only a good thing.

Now, the story you hear about the Adventure Series is that a lone visionary

at General Electric, Doug Dietz,

shown here, realized that this was a problem and decided to change it.

That's part of the story but it's not the whole story.

In fact he did realize this was a problem and he wasn't in a position to change it.

But right around the same time the staff at The Children's Hospital of Pittsburgh

coincidentally also in Pennsylvania had realized that this was a problem and

set about trying to fix it.

What they did was they bought some decorations I think at a local party store

and put them up in the CT scan.

Preparation room and

basically created a treasure chest full of a random assortment of toys.

And promised the kids that if they lay still for their scan they could

have their pick from the treasure chest at the end of the procedure.

The payoff was incredible.

Nothing short of astonishing.

In 2005, at the Children's Hospital of Pittsburgh, they sedated 354 children for

CT Scans and remember general anesthetic, completely unconscious.

Two years later in 2007, they had to sedate four children.

Using minimal design to sooth fears and calm anxieties,

they cut their pediatric CT sedation rate 99 %, in two years.

Furthermore, thanks to the almost complete elimination of that time that was

necessary, that three hours that I mentioned, over those two years the wait

time for an elective CT scan, went from 17 days, to zero.

And over that two years, the number of CT scans they did went up 15%.

So their scans went up 15%, the sedations dropped 99%, and

the wait time fell to zero.

Instead of waiting two-and-a-half weeks to find out what was wrong with a child,

they could find out that day, or maybe the next.

I want you to imagine how much anxiety and dread, those children and

their families were spared in those two years, and for that mater,

how many children who didn't have two and a half weeks, had their lives saved.

I have spend half of my life and all of my career in and around design.

And this is far and away the greatest active design that I have ever seen.

And they did it collaboratively, between the Children's Hospital of Pittsburgh and

GE Medical division, at weekly conference calls,

bringing in experts from a whole host of fields.

Music therapists, aroma therapists, child life specialists, industrial designers,

visual designers, they did user research on children,

to find out if their ideas had any traction.

Imagine doing user research on a cranky four-year-old, right?

They looked at every aspect of the problem.

Not only did they make the experience better for families and children,

but also for the people who had to operate the equipment.

Right? As many as components as possible needed

to be easy to repair.

They needed to be easily cleanable.

The components had to be durable so they could stand up to all that cleaning,

and also children.

They had to be hypoallergenic.

They had to be made from materials that would not interfere with

the imaging systems.

The manufacturer had to be environmentally friendly and it all had to be affordable.

And they did it.

They got all of that for a cost of less than $50,000 per room which sounds like

a lot, but when you find out what the actual imaging equipment cost,

that's closer to a rounding error.

So this is the pirate island theme.

Awesome.

There's also a space adventure, also awesome.

The concede here being that the kids are going to a trip through a wormhole and

the spaceship engines will make a lot of whirring and whooshing and

clanking sounds those are actually the sounds of the CT or the MRI but

they don't tell the kids that, they leverage the imagination right?

So in 2009,

the children's hospital at Pittsburgh opened a brand new facility where they

used the adventure series across all of their types of medical imaging.

CT, MRI, PET, and so on.

Now, MRIs typically take much longer than CT Scans.

Some MRIs can take more than an hour.

So there's still gonna be some sedation of children, possibly also adults.

I don't know the last time I tried to lay perfectly still for an hour, but

I doubt it went well.

But they opened this brand new facility, and

in the first two years the facility was open, across all types of imaging,

the number of sedations that they did dropped 25.2%, but

the number of scans that they did went up 66%.

If you normalize those numbers,

that is more than a 50% drop in pediatric sedation rate.

All that happened because professionals took a look at what they were doing

through the eyes of people in crisis, through the eyes of clouded by fear and

stress.

They made the experience of getting a CT, of getting medical imaging so

enjoyable, they have children who throw temper tantrums when the scan is done and

they have to leave the room.

When is the last time a user threw a tantrum for

having to walk away from your design?

We often say the design is a thankless task because when you do good work it

becomes invisible.

But today I have set you with the most thankless task of all.

I've asked you to do things that will never be noticed.

Things will be ignored in precisely the way the design often aspires to be,

because if your design helps someone who's in the middle of a crisis situation,

whether it's personal or medical or

whatever it is, they're not going to notice what you did.

They're not going to see the roadblocks that aren't there.

But you will have helped them in the most profound way,

simply by not adding to their burdens.

So if you do that well, they will never thank you.

So instead, let me thank you now in their place.

And when you do launch a solution that will help them get in touch with me

directly so that I can thank you personally for using your experience,

your skills and your compassion in service to those who most need it.

Thank you.

>> [APPLAUSE]