UNHEARD AND OVERLOOKED

Introduction

Unheard and Overlooked is a redesign of the ER experience at St. Joseph’s Hospital (Hamilton) for patients with hearing loss. Our group was inspired by Stacy, a patient and advisor who shared deeply emotional accounts of how she felt invisible, misunderstood, and unaccommodated during multiple ER visits.

“I knew they must have called my name, but how was I supposed to know?” — Stacy

We sought to reimagine how healthcare systems could proactively identify and respond to communication needs — not just for those with hearing loss, but for anyone whose disabilities are invisible.

💡Design Challenge

Reimagine the emergency room as an environment in which healthcare processes proactively adapt to the needs of patients with hearing loss, ensuring they are truly seen, heard, and fully supported.

🔎 Process Overview

Methodology

We began by conducting interviews with four Patient and Family Advisors (PFAs), including Stacy. These weren’t just check-the-box conversations — they were deeply reflective, story-rich sessions that opened our eyes to how exclusion can be baked into even the most well-intentioned systems.

We mapped Stacy’s ER journey, built empathy maps, and surfaced recurring themes. Over time, a pattern emerged: the healthcare system expected patients to adapt to it — even when they were in distress.

We didn’t want to fix one moment. We wanted to reimagine the system.

🧑🏽‍🦱 Meet Stacy

Stacy has hearing loss. She’s used to navigating daily life with it, but the ER was a uniquely traumatic experience:

She couldn’t hear her name being called.
Staff spoke quickly and without visual aids.
She left with confusing discharge instructions.
She felt like “a number on a stretcher, not a human being.”

🧠 Key Insights

🤯 The Insight That Changed Everything

When Stacy said, "I felt like a number , not a human being," it hit us hard. The real issue wasn’t just a lack of tools — it was a lack of dignity.

So instead of designing "for" her, we began designing with her story.

Stacy's Journey Map

🤝 Our Turning Point

After lots of sticky notes, morph charts, and reflections, we narrowed down our direction. We asked ourselves:

What if patients didn’t have to advocate for their needs during an emergency?
What if the system remembered?
What if equity could be silent, scalable, and embedded?

🧐 Then We Asked: "How Might We...?"

So, after a few intense ideation sessions, hallway whiteboards, and a couple of honest “this-isn’t-working” moments, we landed on these guiding questions:

How might we redesign the ER so patients don’t have to advocate for their accessibility needs in crisis?
How might we equip staff with tools that make accessibility feel second nature?
How might we design a system that quietly meets diverse needs, without demanding extra labor from patients?

These HMWs weren’t just brainstorm prompts — they became our compass.

🛠️ Our Solution Bundle

From those questions came a collection of solutions, small on their own, but game-changing together:

🟣 Color-Coded Wristbands: At triage, patients are discreetly given wristbands signaling communication preferences — no awkward explanations required.
📺 Digital Queue Screens: Numbers are called visually, not just verbally, so no one misses their turn.
💬 Captioned Tablets & Visual Charts: In consultations, patients can read what’s being said and point to symptoms.
📄 Discharge Summary + QR Code: Patients leave with clear, readable instructions and a follow-up link — no medical jargon, no stress.
🧠 EMR Memory: Once a patient flags a communication need, it’s remembered. Next time, the system already knows.

Before vs After: Stacy’s Journey

🔄 Storyboard + What Changed — and Why

Designing with Stacy’s story taught us something big: accessibility isn’t about high-tech features or giant overhauls. It’s about noticing the friction and removing it before people get hurt.

Here’s what we adjusted after testing:

Intake forms aren’t realistic during emergencies. We focused on storing data from the first visit.
Doctors can’t always stop for long conversations — but a visual cue goes a long way.
Simpler visuals. Less clutter. More trust.

What Others Thought

Stacy :deeply moved by how thoughtful and clear the system felt. She highlighted the wristband designations and the ability to update communication preferences during intake as especially impactful.

"The wristband designations are awesome, and updating patient records to reflect communication needs is extremely thoughtful. You've made it very clear that this system supports equity and inclusivity for everyone." — Stacy

Other PFAs: Loved the wristband idea — they felt it was intuitive, respectful, and something that could be implemented quickly without disrupting existing hospital workflows.
Michigan students: Loved that this helped people with language barriers, autism, or sensory sensitivities too.
Instructor: Highlighted that the ideas were scalable — easy to implement, big impact.

🌍 Why This Matters and Who Else Benefits?

While Stacy’s experience grounded our design, we always knew she wasn’t the only one impacted by inaccessible environments. The interventions we designed are intentionally inclusive and benefit a much wider group:

🌎 Newcomers and ESL patients who may struggle with verbal instructions can now rely on visual signage and simplified summaries.
🧠 Neurodivergent individuals, such as patients with autism or sensory sensitivities, benefit from reduced auditory chaos and visual predictability.
💭 Patients with PTSD or anxiety disorders often fear having to explain their needs; wristbands silently communicate them instead.
👵🏽 Older adults or patients with cognitive decline can follow clearer consultation visuals and printed follow-ups more easily.
🧍🏽‍♂️ Busy nurses and staff get visual cues that help them prioritize patients without needing to ask or assume.

This wasn’t just a fix for one patient—it was a systems-level shift toward equity. And that kind of shift touches everyone. When you design for the edge, you often help everyone. The digital queue helps people with hearing loss and newcomers. The wristbands benefit patients with PTSD and nurses trying to prioritize. The EMR memory helps people who are too sick to speak.

That’s what we’re most proud of. Inclusive design doesn’t shout. It listens. And in the case of this project — it shows up quietly when it’s needed most.