Ready Department & Facility

status boards & analytics dashboards

The Ready Department is a set of Unit Status Boards for the Medical Surgical Unit and the departments that support them. We explored how real-time updates around a patient admission could triggers more effective movement of the patient from surgery to arrival in a Med/Surg unit.

The Ready Facility is a dashboard tool showing facility metrics that gives helpful information about how the system is performing as it relates to the movement of patients both into and out of the hospital along with utilization data for departments.

These concepts were validated and tested with pilot departments in Northern California.

Graciously funded by the Gordon and Betty Moore Foundation

My Role

Lead Designer

I led research, design and prototyping, with a focus on improving department connectedness to facilitate patient admissions.  This included: 

  • Design Strategy
  • Detailed workflow analysis & persona development
  • Workshop facilitation and management
  • Pilot site engagement and rollout
  • UX / UI designs and prototypes

The Team

I worked closely with the project manager, design researcher and process improvement advisor throughout the project.

Operational management professor Anita Tucker led Phase 1 research (whose work formed the foundation of this project and focused into the broader operational failures around patient admissions).

Stakeholder Involvement

Key leadership and front-line staff from ancillary and clinical departments actively participated throughout the project: research, design and prototyping service / digital solutions. 

 
 

Challenge

Connect hospital teams to improve the patient admissions process

In hospitals, the movement of patients is a very complex process.  There are many departments that need to work simultaneously to ensure there is a smooth flow of care for the patient from one level of service to another.  There are departments that focus solely on cleaning the room and getting the correct type of bed for the patient. There are departments that focus on managing the overall placement of patients as they are discharged and admitted.  Of course, there are the departments that provide initial care receive the patients and the planning that must go on to properly prepare for the care of new admits.

It is critical that each of these departments work well together to allow for a safe, smooth functioning process. Due to the complexity of the each of these separate systems, they work independently from each other with the hope that, when combined, form a complete system of care.  

Unfortunately, due to the complexity of the system, this is not always possible. Patient’s care needs change, rooms are not always available or clean when the patient is ready to be admitted and nurses are rushed to prepare for new admits with little advance notice.  

The over-arching goal of this project is to enable nurses and other health professionals to more effectively perform their job functions and collaborate with each other, so that they will be spending less time searching for supplies and more time attending to patients

 

Process

Research

Phase 1 research, which looked into the broader operational failures at the Medical / Surgical unit, had already taken place when I was brought into the project.  In the following research phase, we focused on understanding the current workflow processes around the patient admissions process.

To gain context, we spent 3 months conducting human-centered research at our two pilot units. We interviewed, observed, shadowed staff from Environmental Services, Post-Anesthesia Units, Medical-Surgical Units, Bed Management and more.

Below are workflow diagrams that helped the team understand the interdependencies between departments and the challenges faced by clinical staff. All the data was also extrapolated to a set of personas that guided the team throughout the project.

 

 
 

BASELINE METRICS COLLECTION

To complement our ethnographic research, we also identified and captured key metrics to measure the current process. These included:  

  • Surveys to evaluate the clinical staff experience

  • Manual collection of process measures such as time spent by staff to get ready for each patient admission, room readiness completion rates and patient flow metrics (e.g. how many patients were admitted, at what time and from what departments. 

Analysis of existing tools & Available metrics

We wanted to understand how departments currently measuring successful admissions and what tools do they use to measure department progress. This included looking at current bed management software tools, ancillary department supply chain metrics and clinical flow dashboards.  

 
 

Insights and Opportunities

This discovery phase led to a set of qualitative insights and design opportunities to improve collaboration between departments in their everyday workflow and as a facility. Below is a high-level subset of the insights and direction for design: 

Rapidly identifying relevant clinical scenarios for dashboard tools through storyboards

Over 25 storyboards were created, exploring various ways in which status boards and a facility analytics dashboard tool can support departments in managing patient admissions. These concepts ranged from (a) just-in-time information delivery based on clinical events (b) forecasting patient flow to manage staffing resources (c) communication strategies to facilitate inter-departmental collaboration. 

We held a workshop with clinical staff to review the storyboards and identify if the scenarios and the concepts address underlying needs. This helped us understand and prioritize the needs to focus our design efforts. 

 
 

Design Process: Status Dashboards

Based on feedback from the storyboards, we pieced out the core information that clinical staff need to support their day-to-day workflow. I sketched and wireframe designs for electronic status board tools for each of the departments. These early designs were taken to each department staff for feedback.  

PHYSICAL PROTOTYPE ON THE MED/SURG UNIT

I worked closely with staff to create physical prototypes that they can test immediately on the unit. We started with a large whiteboard with magnets to signify status updates. For several months, clinical staff manually updated the whiteboard based on upcoming admits and room status.  This helped us understand realistic clinical scenarios that can occur on the unit as well us identify opportunities to improve the information from manual and automated processes. 

WIZARD-OF-OZ PROTOTYPES

After initial feedback by individual departments on the wireframes, we wanted to test and validate these designs for how it could possibly improve inter-department communication and collaboration around patient admissions.  This led to a series of dashboard prototypes and development of realistic patient admission scenarios that require tasks from multiple departments.

We conducted the scenarios by using projections of the digital visualizations on the wall. This created a better way for the whole group to see the status boards and also helped them visualize how a wall mounted board may look (vs. a tablet or smart phone version).

Over 26 staff, from environmental services, nurses to managers thought-out-loud how they would use the digital visualizations through various patient scenarios.

 
 

Design Process: Facility Bed Management Dashboard

From our storyboard sessions, I created wireframes and early designs exploration a facility bed management tool that can be used by hospital leadership. We held information dashboard design sessions with key leaders from each department. Through these sessions, we identified potential new metrics that participants saw could be collected through the dashboards or process metrics.

 
 

Ready Department & Facility

RESULT | 2011-2012

We delivered concepts for dashboard tools for the department and facility to connect hospital teams around the patient admission process. These concepts were prototyped and validated via user testing with clinical staff.  

This work continues to influence and inspire stakeholders to build and pilot communication technologies across KP around bed management and supply chain efficiencies. For example, the status board concept evolved into a future pilot at selected sites in Southern California. 

 
 

Real-time Department Status Boards

With a real-time status board, each department can get information about the status around a patient admit in a way that triggers more effective movement of the patient from surgery to arrival in a Med/Surg unit. These include information around the status of each patient room, supply needs and projections of incoming admissions and discharges (e.g. patients leaving the hospital) between 'sending' units and 'receiving' units.

Dashboards were designed for Environmental Services, Medical / Surgical Unit, Post-Anesthesia Unit and Bed Management.

 
 
 
 

Facility Level Bed Management Dashboard

Facility Dashboards show facility performance measures that require departments to connect their care across departments to produce more and make informed decisions towards more effective patient care management.