Matching staff to patient demand is critical in a hospital setting to provide for patient safety and quality of care.

In this project, I worked with a group of analysts to determine why a nurse staffing program was not being used and redesign it to effectively meet the needs of multiple stakeholders, including: floor nurses, charge nurses, hospital human resource managers, and department managers.

Image source: Flickr, Presidencia de la Republica Mexico

When I started on the project, I was tasked with evaluating the current software which the hospital was using to track patient demand and staffing availability. If necessary, I was asked to recommend changes to the software, or a complete redesign if a drastic redesign was necessary.

From previous research conducted by analysts on site, I knew some of the basic user groups and stakeholders would be inpatient nurses and hospital administrators. My first several weeks were spent interviewing these stakeholders and conducting contextual inquiries.

Personas

I then went through my notes and created working personas, outlining user goals, motivations, and frustrations related to staffing tool and their workflows which intersected with it. I also created scenarios from these personas to illustrate to developers the ways in which users were interacting with the tool and the frustrations they encountered.

While I found that the program which was in place did a moderate job in accurately calculating patient work demand, nurses disliked it because of the amount of manual entry the tool required and its difficulty of use. Working with the program also took them away from their core responsibilities of caring for patients, which further embittered nurses.

These revelations led to a complete product redesign in which our team automated work demand calculations by pulling from patient electronic medical records (EMR), and began working to create a more user-friendly interface which took less time to use.

My focus on this project, was the redesign of this interface.

Creative Design Sessions

For several weeks, I led sessions with several analysts in which we brainstormed and sketched many different interfaces and flows for the information architecture of the system. We based these designs and flows on the needs articulated in the personas I had created.

Design Critiques

I then sketched and refined several of the most promising ideas, bringing them to our group on a regular basis for design critiques.

Wireframes

As the sketches progressed, I created wire frames using Balsamiq.

I then further refined the sketches in Illustrator for medium fidelity wireframes. Next, I printed out a series of these wireframes and conducted paper prototype usability testing.

Doing prototyping in paper allowed me to rapidly iterate and retest several cycles of design within a several week span.

Focusing Testing

Prior to usability testing, I created a list of the thematic areas I wanted to test. My usability tasks and questions centered around these themes.

Usability Testing

This is an excerpt from the usability script used during one of several paper prototype usability tests.

Notes from the usability tests were analyzed for major themes, user failure points/frustrations, and general interaction patterns.

These results were used to inform and update the foundation of initial functional stories I wrote for developers. The stories then formed the foundation of the interface and interaction design of the staffing software iterated on next.

Building Empathy

In the next phase of the project, I collaborated with the development team to create an additional backlog of stories.

At regular milestones when functional software was produced, I conducted usability tests which I recorded and provided to the development team. These recordings included video of the user's screen along with audio and video of the user themselves.

These videos were tremendously helpful in creating empathy for our users among analysts and the software team. Through this empathy, we were able to create a better, more functional, software product that the nurses actually used.

The nurse staffing software that our team created is now successfully being used in over ten departments of a major East Cost hospital to help ensure adequate staffing for patient needs.

Photo credit: ILO. Flickr