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Nurse/Patient Solution Queue Management System

BACKGROUND CONTEXT

There is a problem with both patients and nurses when face at the beginning of the patient's journey in the hospital. Currently, nurses are pre screening patients for covid and triaging them outside of the hospitals since they aren’t utilizing virtual waiting rooms. This has become a manual process which is both exhausting to nurses and patients. Patients can be easily overlooked and communications between nurses can be missed. In addition, covid can be transferred between patients and nurses through this interaction phase.

OVERVIEW GOAL

We want to eliminate the manual process and create an application that will streamline and help the nurses move patients from the pre-screening and triage stage to their corresponding waiting rooms.

How can we create an application that will help nurses move patients through pre-screening and triage stages with the least amount of physical contact involved?

ROLE

As the main UIUX Designer, I performed all the project roles in the preliminary stage from research to design and presented what the final product would have been.

PREFACE

In the preliminary stages and a POC - proof of concept, we didn't discuss the baseline for what success would be and dive into details about what the definition of done would have been.

DURATION

3 months

More context

Nurses send the patients to the corresponding waiting rooms based on their covid status. The hospital has set up 4 waiting rooms:

● 1 room for covid positive patients that needs to be seen first

● 1 overflow room for covid positive patients

● 1 room for covid negative patients that needs to be seen first

● 1 overflow room for covid negative patients.

Challenge

Citlali Clinic Group was brought on to help create an application that will help the nurses move patients from the pre-screening and triage stage to the corresponding waiting rooms. They are currently doing this manually with paper charts they are using to tally patients.

User Interviews

The user interviews consists with mainly nurses that are stationed outside of the hospital in the screening and triage tents. Since I wasn't able to interview any nurses from inside the facility, I would have to make an early assumption on what their tasks will be and see how it fits with the flow based on their experience.

Biggest takeaway

Why? Automating the patient queuing system will alleviate unnecessary crowding. It will help eliminate the long lines since stated - the longer the line, the longer it takes to go to the waiting room.

Assumptions

Assumption 1

Why do nurses have to physically go to the overflow room when needed? - We know the nurses doesn’t have any indicator for when patients in regular waiting room has gone to see the doctor (answered in Q4) so we can assume patients doesn’t have any indicator that they had been moved up in their queue and wait in the regular waiting room.

assumption 2

Who are they? - We assume the nurses try to call the doctors to check if the doctors have seen the patient. Maybe they’re talking about the nurses inside the facility. We will move forward with the assumption that nurse randy is talking about the doctors.

The last assumption was from earlier. We can assume there are separate nurses taking the patients to see the doctors and that they are using the same technology as what the outside nurses are utilizing - a pen and paper to tally the incoming patients.

Mind map

Why a mind map? It’s perfect for brainstorming and visualizing concepts, it makes it easier to present and communicate ideas. It’s an effective way of getting information in and out of your brain and a creative and logical means of note-taking and note-making that literally maps out your ideas.

Using a mind map to brainstorm, I was able to map out key factors that will help build the must-have list in order to achieve the overall interview goal which is to help patients queue up from a safe distance and to help nurses distribute incoming patients to their corresponding waiting rooms.

Must-have list

The mind map and other research I’ve gathered help built together the must-have list to order to achieve our overall goal:

1. As a screening/triaging nurse, we want to see how many patients are in each waiting room

2. As a screening/triaging nurse, we want to track patients’ location - which room they’re currently in

3. As a system, we need to validate patients entering and waiting in the correct rooms

4. As a patient, we should have the ability to see the wait time

5. As a Nurse, we want to be notified if patients are moving to another room or had already been seen by a doctor

Swim lane flow-chart diagram

Let’s talk about flow chart diagram. Why am I using a flow chart diagram? The flow chart diagram is a strategic diagram that allows the steps in a process, workflow or algorithm to be ordered in a sequence and displayed graphically. It’s used for visualizing, analyzing and communicating about the steps and outcomes in the workflows.

Competitor analysis

The purpose of a competitor analysis is to understand the competitor’s strengths and weaknesses in comparison to ours or mine and to find a gap in the market. As part of my research I want to make sure to analyze and summarize what impact the information will have on the design. Carrying out a focused and thoughtful UX competitor analysis can help get valuable insights that can help change or influence the design elements of the product.

Success in queue management systems*

• Virtual queuing

Efficient software that is linked with various other systems and tools to allow the customers to sign-up through different channels such as smartphone applications, SMS, calls, QR codes, etc. The virtual queue management system not only facilitates the customers and visitors but also reduces or eliminates the wait time.

• Separate dashboards

Any good queue management system should have separate user dashboards with dedicated interfaces to increase efficiency. This feature also makes the administration easier and more manageable. There are usually three main interfaces or dashboards in a queue management system:

1. Customer or in this case - the patient Interface

2. Agent or the nurse Interface

3. And then finally the Admin Interface

The customer interface is always separate from the other two.

• Remote management and Real-time monitoring

Management manage the queuing system and handling some other system administrative tasks while they are not sitting inside the office. The real-time monitoring is also providing real-time system updates and live information about the ongoing customer flow and other queuing data.

Initial sketches

I always begin the process with some sketches. I think it’s a great way to start any process when mocking up wireframes. From the research I’ve gathered and the must-have list to help achieve our overall goal, I was able to sketch out what the interface would look like. This is also a quick look to solidifying the fluidity of the workflow for the separate portals.

Brand guidelines

Usually I utilize the colors and typography from the client’s brand guidelines so that we’re keeping the brand identity consistent and recognizable for both the clients and their customers. For this assignment, I came up with a brand guideline based on the brand tone of voice for healthcare organizations. Going with the brand tone of voice we get a lot of blue and green. 

Once I applied the brand guidelines to the lo-fi screens that I mocked up, the only thing left was to linked them and add the interaction details to get it ready for prototyping.

Addressing the concerns

We can definitely see the visual separation between negative and positive patients designated rooms, what a full room looks like and what an empty one looks like.

We know where patients are when we click the corresponding wait rooms to see the list of patients on the right panel. It also shows the patient’s detail information and the estimated wait time in a card like format.

QR codes are scanned when patients are entering a room that’s how the systems updates and tally the patient on the waiting list. Scanning into the wrong room will not allow the patients to enter and it will also let patients know that they scanned into the wrong room. This information will show up on their phones on a refreshed page.

The nurses stationed outside in the screening and triaging tents no longer will have to physically walk into each waiting rooms to check if patients have been moved to another room. They can now be notified by other nurses inside the facility and communicate updates through the messaging system. Patients that have been seen can be found on the seen patients tab located on the side of the menu, it makes it easier on the nurse to know exactly when the patients has been seen too.

User testing

Utilizing maze - which is a powerful rapid testing platform that allows me to run in-depth tests with or without prototypes. I was able to capture feedback on the portal design that I built out for this assignment. I set out 3 missions to gather data on what worked and what user struggled with in the workflow. The first one which is on the Walk-in registration, the second being able to assign a patient to the negative waiting room and the third for seeing a specific nurse’s profile information on the messenger chat.

Out of the 3 missions, the last mission seems to be the most difficult one for the testers to complete. The task was to have the user create a new chat. Apparently this screen took the longest for a user to test and 11.11% of testers got away from the expected path. In addition to that, there was a 67% for the misclick rate.

I followed up with each user to understand why the misclick rate was so high and the reason being is that the new chat icon was placed on the bottom of the screen and they had a hard time locating it on the page. Another follow up question I asked was where they expected to see the create new chat button and they responded somewhere near the top area. 

Taking their feedback, I moved up the create new chat icon up near the top where it is more visible and towards the left side since it’s natural for users to read content from left to right, up to down. 

With the design iteration, I tested with 10 new users and saw that the misclick rate went down to 33%. That is a huge 34% decrease from my initial user test and bought the usability rate score from 51 to 74 - I have to say, that’s a big jump!

***Usability score is calculated based on KPIs - mission success and duration, test exits and misclicks.

Conversion rates and KPIs

In my team, we would usually work closely with the business stakeholders and project manager to determine what success would be and how that would look like for this application. We’ll probably work out what would be considered the most viable and meaningful data points. We want to make sure our product is unique and engaging and we want make sure no data is overlooked. So far, from what I gathered - we can pull data from the conversion rate of patients confirming their rooms when they scan the QR code to enter their waiting rooms. Another conversion rate would be the facility nurses inside that would be switching the status’ of the patients to “seen” which will mark the end of the initial workflow. We also want to find out how long the whole patient journey will take since from the nurse’s interviews, the average process for each patient from beginning of their journey til leaving the facility would be about 40 mins.

Conclusion

I would say the application offers the nurses capabilities to track patients all around from which waiting rooms they’re in to whether the patients have seen the doctor. It definitely provides them the ability to send out messages to other nurses instead of physically walking over to them to ask about a patient. The system also fulfills the patient goal of queuing from a safe distance and knowing their estimated wait time.

The data can easily be skewed from nurses forgetting to change the status’ of the patients to “seen” which will negatively impact the success of a project completion. I believe our next steps would be to have follow up interviews and testing to come up with solutions so that we can improve the process of involving them in the decision-making process in hopes of reaching a broader consensus on the application.

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