Hospital Queue Management

As a part of one of my projects at ThoughtWorks, I was requested to assess the MHC process (Master Health Checkup Unit) and improve the experience for a multi-speciality Coimbatore based hospital.

To build an understanding of the scope and problem areas, we conducted a thorough usability analysis, which was structured as follows:

  • Contextual Enquiry
  • Persona and Task Analysis
  • User Journey Analysis
  • Competitor Analysis
  • Paper Prototype Testing

Contextual Enquiry
We started off by visiting the floor of the MHC unit for a contextual enquiry. This enabled us to understand the different personas, their behaviour, the activities they perform, and the problems they are facing. We spoke to a range of people, from patients through to those running the unit and the doctors, all with varying levels of literacy, backgrounds and experiences . The diversity in our user group provided a multi-faceted interviewing approach, we had to modify our language to resonate with the different understanding levels of the users, devise questions based on the changing situations, and constantly keep a look out for infrequent user groups who otherwise would have been difficult to interview (emergency patients, young patients etc.).

Persona Mapping

With the information we obtained from the study, we were able to identify 5 main personas, these included

  1. MHC Supervisors: The first point of contact for the patients, they invite them to the hospital, greet them on arrival, take down their medical history and
    personal details, and recommend the most appropriate MHC package.
  2. Receptionists: They enter the patient details into a computer from the forms which are captured by the supervisors, and generate the billing.
  3. MHC Coordinators: They guide the patients between tests and assist with any problems. Their role begins once the patient completes billing.
  4. Technicians/Doctors: These are the lab assistants who run the tests, they call out patients or receive them from the coordinators.
  5. Patients: They go through the tests in the MHC package

User Journey Analysis
Together with the personas and the task analysis, we were able to construct independent user journeys, which were then consolidated. Below is a high level patient journey, which highlights the different personas who play a role at various stages.

Screen Shot 2017-02-27 at 11.46.18 AM

From this we highlighted the points of friction for the different user groups.

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Solution Envisioning
Mapping out the user journey and highlighting the points of intervention, allowed us to devise hypotheses and propose a solution, which would address the main points of concern. This resulted in the recommendation of a Queue Management System, which would:

  • Give coordinators/ supervisors visibility of patients
  • Re-route patients to different stations depending on wait times
  • A visual display to show patients which test to go next
  • Ensure the ability for technicians to see which patients they are currently serving and who is up next

We also anticipated the following benefits for the users:

  • Each coordinator would be able to handle more patients since they will have access to patient status (tests completed/pending) without having to ask patients
  • Lesser coordinator intervention will be required since patients will know where to go next
  • Increased patient satisfaction since patients will know queue status and expected wait times
  • Proactive intervention from supervisors and coordinators to prevent wait times from building up
  • Technicians would be able to deal with patients in a more orderly manner

Competitor Analysis and Feature List Creation
Before getting into the design, we completed a competitor analysis, to understand what else was in the market, what were some of the pitfalls and what worked well. This helped us outline the features we would be including:

  1. Add patient to queue after billing
  2. Enter token number at each station to update status
  3. Visual display of current and next person for technicians
  4. Supervisor/Coordinator view of patient status
  5. Manage tests for patients
  6. Handling inter test dependencies
  7. Dashboard displaying the queue

Paper Prototyping and Usability Studies

When devising the screens, we had to keep in mind that many of the users were not very familiar with technology, and so interactions had to be obvious and information easily digestible. Secondly, since some of the patients had low literacy levels, the patient queue dashboard had to be designed for accessibility. Taking into account such factors, we came up with a first set of paper prototypes. These were tested with staff at the hospital, who were told to put themselves in the shoes of the different user groups.

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Paper Prototypes of the queue management system

Screen Design and Go Live

With the feedback from the studies, we started the design of the screens. The process followed the ThoughtWorks Agile practices. We regularly updated the stakeholders of our progress, dealt with requests as they arose and modified designs based on constraints and technical limitations.

The solution went live in December, below are a couple of screens from the system.

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Takeaways and the Users’ Views

During the course of the engagement we identified some key takeaways, these include:

1. Despite differences in background/literacy between and within user groups, there was consistency in the tasks they were trying to achieve and the points of friction

2. For users with low literacy levels, empathy is more important than solutioning

3. Users who are unfamiliar with technology can be apprehensive about changing the current process, it is important to build trust and confidence in the new solution and train them appropriately

4. Simplifying the process is sometimes more important than utilising existing infrastructure

Coupling these factors with our usability techniques was highly beneficial in obtaining the desired outcome. We captured the feedback from the end users in various formats.

Here’s what the MHC staff and technicians had to say:

UserFeedback (1)

Patients also pitched in their feedback, this video, shows us their view on the new queue management system.

Overall, the project was a great experience in running an end to end design engagement. We had the opportunity to apply several UX practices, were provided with highly valuable time with the end users; which enabled us to easily validate our design decisions, and even got to see the solution live in action!