NIHR CLAHRC NWL Improvement Leader Fellow Sunita Sharma presented her improvement project being done at Chelsea and Westminster Hospital NHS Foundation trust at the Jonkoping Clinical Microsystems Festival 2018. The project focuses on improving women’s experience during inpatient postnatal period by adopting a design thinking approach. Read her abstract below.

Sunita Sharma @ Jonkoping Clinical Microsystems Festival 2018

openspeechAdopting design thinking approach to inpatient postnatal care in a busy National Health Service hospital in United Kingdom.

Authors: Sunita Sharma ¦ Nina Dalton ¦ Rachel Matthews


Whilst women’s satisfaction with maternity services remains high in United Kingdom (U.K), experience and satisfaction with postnatal care has consistently remained lower than the care received in pregnancy and labour.  It is now well recognised that poor postnatal experience can result in a negative impact on the mother’s physical and mental health and bonding with the new-born.

The model of delivery of in-hospital postnatal care in the U.K in most maternity units has not changed for decades. To tackle this long standing challenge, the team is adopting the principles of design thinking and quality improvement methodology. This will support a people-centred approach to explore and understand experiences of users and service providers and to adopt an iterative process to identify solutions whilst maintaining an empathetic outlook.


The quality improvement project was commenced as part of the Hospital’s Established Leadership programme and Perfect Day programme, in collaboration with Maternity service user representatives (Local Maternity Voices chairs).

Based on the design thinking approach, during October 2016 and March 2017, new mum’s and partners who had used the service and the staff working on the ward were interviewed by a range of clinical and non-clinical staff to explore their experiences through the different steps involved in their hospital stay. Delivery of service was observed by a number of staff to understand how the environment impacted experience and how the experience translated in real life. A co-design workshop was undertaken with 65 attendees in July 2017 and a number of themes of importance to users and staff were identified. Emotional journey mapping and process mapping was undertaken.


The approach helped identify a wide range of themes, which impact experience of people involved in receiving and delivering care. Themes identified during the interviews of the new mums could be defined as ‘wanting to feel loved’, ‘adjusting to motherhood role’, responsibility to other family members, recuperating from labour and delivery and caring for the baby. Clinical, administrative and managerial staff interviews highlighted experiences relating to systems in place and the negative impact of busy periods on their experience also.

During the co-design workshop, some of the other themes identified included the user need for the service to see the user as a family unit, compassionate care, consistency in information shared, joint working amongst different health professionals, continuity in care, need for setting realistic expectations and postnatal plan.


This is the first time we have adopted a design thinking approach to address the need to improve experiences during in-hospital postnatal care. Through this approach we have begun to understand what the lived experience is on the postnatal ward for the mums and those who deliver care. It has also revealed the complexity of the task of improving postnatal experience, on a background of service pressures in busy national health service hospitals. Through engagement and support of the users and the wider hospital team (clinical, administrative and managerial) we have started to develop quality improvement projects in areas recognised that may have maximum impact. (1)074489-simple-red-glossy-icon-alphanumeric-quote-close2

Contact Sunita to hear more about this project ¦ twit @SunitaS2016

(1)Adopting design thinking approach to inpatient postnatal care in a busy National Health Service hospital in United Kingdom. Sunita Sharma, Nina Dalton, Rachel Matthews