Find the moment, not the condition
Establish exactly when the risk arises. It was not the diagnosis; it was the few minutes a caretaker has to step away for registration, payment, or rest.
REFRAMING AN UNAFFORDABLE PROBLEM
Designing an Alzheimer outpatient handover
Our client is a public hospital, in the outpatient clinic that treats people living with Alzheimer's disease.
An Alzheimer outpatient looks like anyone else in a hospital corridor. The risk arrived in ordinary moments: a family member steps away to pay a bill, register, or use the toilet, the patient does not wait, and at the main door nobody can tell him from a visitor on their way out. A nurse had proposed GPS wristbands with mobile SIMs. In a public hospital serving low-income families, neither the hospital nor the families could carry the equipment cost or the monthly subscription, so nothing had been done at all. The design did not make the patient identifiable. It changed where he waits.
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— WHAT THIS CASE CAN SHOW
A business constraint, the decision it forced, and what Bold Group contributed to that decision.
This case describes a design. It has not been shown to be implemented, and no operating result is claimed.
01 THE BUSINESS CONSTRAINT
Start with the business condition, not the presumed answer.
An Alzheimer outpatient is indistinguishable from any other person in a hospital corridor. The risk arrives in ordinary moments — a family member steps away to pay a bill or register — and at the main door nobody can tell the patient from a visitor leaving.
02 THE ASSUMPTION THAT HAD TO BE CHALLENGED
The proposed answer was late, and unaffordable.
The proposal on the table was a GPS wristband, which locates a patient who has already left, and which carried a recurring cost neither the hospital nor the families could take on. The answer was unavailable as well as late.
03 THE DECISION BEHIND THE REDESIGN
How the question was worked.
If nobody can afford a device, what has to change about the place and the handover so that a patient cannot leave unnoticed?
The decision was to change where the patient waits and how the handover works, rather than to track a patient who has already gone.
Separate the device from the job
Establish what tracking would actually have achieved, and compare it with what the situation required, which was that nobody at the door could tell an outpatient from a visitor.
Design with what the ward already has
Build the answer from the ward, the nurses, a card, and a text message, so it carries no equipment cost and nothing to renew.
04 WHAT BOLD GROUP CONTRIBUTED
What we owned, and where this transfers.
Bold Group
Facilitated the design with the ward, working from the constraint the ward stated rather than from the answer already on the table.
The client
Under the proposed design, ward staff would operate the handover and the release check, and the hospital owns whether it holds under real conditions and real staffing.
This approach transfers when
- The obvious answer has been ruled out on cost, so the problem has been left open rather than solved.
- The risk sits in a short and predictable window rather than running continuously.
- The people who would operate the answer are available to help design it, because it depends on them to work.
05 WHAT THE DESIGN MADE POSSIBLE
What is known, and its limits.
Bold Group facilitated the design with the ward: the caregiver hands the patient to a nurse inside the ward and takes an identification card in return, is messaged when treatment ends, and the patient is released only to the card holder. The design uses what the clinic already has.
What this case does not claim
01No cost saving, incident rate, or adoption figure is claimed for this engagement.
02This is a design. Implementation and any patient-safety outcome are not established.
03Described anonymously, without identifying the hospital or any patient.