Healthcare Design
Street Medicine
Provider Burnout
Systems Thinking
Designing for Dignity
Project Analysis · Design Practicum 3 · Spring 2026
A human-centered design industry project for the Salvation Army, targeting Anaheim’s unsheltered homelessness crisis.
Partner
The Salvation Army · Harvey Mudd HCD course
Methods
7 expert interviews, POV statements, HMW ideation, 3-prototype parallel testing
Output
3 iterated prototypes with stakeholder-validated learnings and a scoped roadmap
Context
The Salvation Army has a bold target: reduce unsheltered homelessness in Anaheim by 50% by 2029. CalOptima Health’s Street Medicine team is on the ground making that happen, and our group’s mission was to find a way to meaningfully support that team.
Early on, we found our primary issues upstream of the patients themselves. Through in-depth interviews, we discovered an invisible barrier to care: provider burnout and turnover. These providers faced fragmented charting systems, no space to process the weight of the work, and no visible feedback that what they were doing actually mattered. If the providers burn out, the whole system collapses.
“The fundamental idea behind street medicine is to meet individuals experiencing homelessness on their own terms and where they are.”
Research
We interviewed seven healthcare professionals spanning public health, emergency medicine, internal medicine, fire and paramedic response, peer support, enhanced care management, and healthcare system design, based across Florida and Southern California, most affiliated with the Salvation Army or CalOptima.
Emergency & street medicine providers
ER residents, fire captains, paramedics on Advanced Provider Response Units
- JTBD: maximize time with patients, not with charting systems
- Navigating multiple charting platforms simultaneously during a single encounter
- Contextual, relational patient data gets lost because existing forms have nowhere to put it
Physicians experiencing burnout
Internal medicine doctors, ER residents carrying emotional load
- JTBD: find a community that understands the specific weight of this work
- Work bleeds into personal life because there’s no clear endpoint to a shift
- Peer support exists informally but has never been built into the workflow structurally
Peer support specialists
Community outreach workers with lived experience of homelessness
- JTBD: build real trust with clients over long, nonlinear timelines
- Success looks like small wins: an appointment kept, a name remembered, a connection held
- Trust is the intervention — shared perspective sustains it across months and setbacks
Healthcare system designers & administrators
Enhanced care management, healthcare design strategists
- Medical spaces are hard for outsiders to access; on-shift providers are in a different headspace
- Any intervention needs to be institutionalized and hospital-sponsored to actually reach providers
- Scalability is an early question, since solutions need to travel across communities
Problem
The research pointed to two problem clusters that reinforced each other. Fragmented documentation created friction at the point of care, and the emotional cost of that care had nowhere to go after the shift ended. We built POV statements around the four most impactful interviews to hold both in focus.
Continuity of care. A fire captain-paramedic juggling multiple charting systems needs tools that let patient context travel with the patient, so he can focus on compassionate, holistic care instead of data intake that already exists somewhere else.
Provider support. A third-year medical resident coming home exhausted and emotionally burnt out needs a community that understands his pain, so he can engage with patients and family without compassion fatigue eroding both.
Trust as the product. A peer support specialist building hard-won trust with unhoused clients over months needs recognition of small wins, because when the client measures success by the appointment kept, that small win needs to be reflected back.
Work-life boundary. A burnt-out physician trying to separate work and personal identity needs agency over her time after a long shift, because when work has no clear endpoint, it quietly expands until feeling truly off-duty becomes impossible.
Ideation
We generated HMW questions across both tracks — continuity of care and provider burnout — then ranked ideas by effort and impact. We built three concepts in parallel rather than sequentially, which forced cleaner thinking about what each one was actually solving.
Prototyping and Testing
Three prototypes, two rounds. We built all three concepts simultaneously and tested each independently. Each had a distinct hypothesis, so the feedback we received was actionable rather than general. The second round incorporated expert feedback and pushed each concept toward a more realistic, scoped version.
Charting system redesign
Hypothesis: providers skip context not because they don’t value it, but because forms give them nowhere to put it
What worked
- Structured fields for qualitative context felt faster in practice than free-text paragraphs
- Captures relational data, trust-building moments, and patient context alongside clinical data
Critical feedback & pivot
- Cross-system travel isn’t realistic — street medicine already runs on Epic and Care Traffic Control
- Pivoted: narrowed to a Street Medicine iPad tool for a single team, making documentation real-time rather than siloed
Peer support group
Hypothesis: shared wins and struggles alongside lived-experience perspectives would reveal real patient impact and reduce compassion fatigue
What worked
- The concept resonated strongly with providers experiencing burnout
- Cross-professional perspective (lived experience alongside clinical) surfaced as uniquely valuable
Critical feedback & pivot
- Medical spaces are inaccessible to outsiders, and on-shift providers can’t context-switch into a support mindset
- Pivoted: reframed as a mandatory, institutionally protected team meal or activity off-shift, hospital-sponsored
Share and Shoutout Board
Hypothesis: regularly recognizing small wins would increase feelings of support and reduce burnout over time
What worked
- Tested in real life at CMC’s Dean of Students office, getting high engagement within 48 hours — a strong adoption signal
- An in-class showcase surfaced strong demand for an “I learned” section
- Users defaulted to typing over handwriting, so the digital format felt easier
Critical feedback & pivot
- Must be HIPAA-safe, meaning zero patient identifiers
- Validated as feasible by stakeholders; builds on existing models (workplace shoutout displays, Polls for Good, Chrysalis-style recognition)
- Pivoted: a digital iPad version integrated into existing Street Medicine iPads, with the “I learned” section added
Takeaways
- The brief is just a starting point. We were prompted with a homelessness problem and found a provider burnout problem inside it. Following the research rather than the prompt led to a more honest and impactful solution space.
- Expert users will kill your assumptions faster than anyone else. Our cross-system charting hypothesis felt really good until we actually tested it with a single stakeholder, who proceeded to dismantle the idea in seconds. That’s exactly the point of testing with the people closest to the problem.