BeanWell

Status: Execution Category: Health Policy Partners: TDRI Team: Plu, Parn, Knot Slug: beanwell

Problem

In Thailand, approximately 45% of chronic kidney disease (CKD) patients under the Universal Health Coverage (UHC) scheme begin dialysis in an unplanned or emergency manner — linked to poorer quality of life, emotional distress, and higher system costs.

Patients and families lack timely information and structured decision-making support. At the same time, policymakers lack integrated mechanisms to translate patient experience into actionable policy reform. This disconnect between policy research and frontline service design results in missed opportunities to prevent emergency dialysis and improve long-term outcomes through humanised policymaking.

Solution

Integrating policy research with service design to redesign the dialysis decision period. Using Human-Centred Design and Experience-Based Co-Design (EBCD), the project:

• Synthesises existing policy evidence

• Captures real patient and provider experiences

• Co-designs improved decision-making pathways

• Develops a Policy Blueprint and service redesign model

The project also establishes a cross-institutional policy researcher network capable of applying participatory design methods to future health policy challenges.

Goals

Short-term

• Strengthen collaboration between patients, frontline workers, and policy institutions

Long-term

• Reduce unplanned dialysis rates among CKD patients

• Increase uptake of advance care planning and shared decision-making

• Lower avoidable emergency care costs within the UHC system

• Institutionalise participatory, humanised policy design practices in Thailand

Highlights

• Field research through in-depth interviews with CKD patients, caregivers, clinicians, and policymakers

• As-is Patient Journey Mapping, Stakeholder Mapping, and Affinity Mapping

• Theory of Change formulation and co-design workshops with patients, providers, and policymakers

• To-be Patient Journey Map reflecting redesigned service pathways

• Policy Blueprint outlining actionable recommendations