Waiting… it’s a common human experience. All people experience having to wait at some moment in their life – whether it’s for a flight, in the supermarket queue or hearing bad news. It’s not something as humans we love to do but waiting is a universal experience that everyone can describe in some personal way. We’re living in a society with constant instant gratification. “Our food is fast, our internet is high speed, and our shipping is next day”. If we don’t have to wait for something why should we? So in the middle of the night when the excruciating pain hits why do we often have to wait hours when it comes to urgent care waiting rooms? Slide Change
A empty urgent care waiting room, with no wait time is simply unheard of. At first glance people can usually decipher the status of the room—is the room filled to the brim or relatively calm? Slide Change
This project is for everyday people like us that attend urgent care clinics. Not the appointment-led GP where you might wait for 20 minutes. But neither the high-stress environment of the emergency department. Slide Change
It’s the space between. Urgent care clinics provide non-appointment care and typically open seven days a week, from 8am until at least 8pm, many also offering after-hours care. These clinics play a vital role in supporting general services and keeping patients with mild to moderate illness and injury out of hospital Emergency Departments. Slide Change
In New Zealand there is approximately 2.5 million urgent care patient consultations per year, that’s almost 7 thousand per day! Slide Change
Upon arrival at urgent care, patients are put into triage, a process that is critical to the effective management of modern emergency departments. Triaging aims to ensure that those patients assessed as having the most urgent need, are treated more quickly than those patients with less urgent needs. It quickly became apparent to me that not many people know what Triage is, let alone understand it.
Educating patients on how urgent care works through the process of triage is an important part of this project. Just by learning that urgent care is not a first-in, first-served based system allows patients to understand why they might be waiting longer than others and enables them to trust the healthcare provider that they’re doing the best they can. Slide Change
A range of studies show that patients complain because of the lack of information, poor communication from staff and not understanding of the triage process. In my research, I found waiting times and the uncertainty of what to expect from the experience was the primary cause of heightened stress and anxiety. Slide change
Sitting in a waiting room can evoke a fear of ‘being forgotten’. It became apparent that patients are searching for reassurance, that they will be seen and not forgotten. In one of my questionnaires 87% of respondents confirmed that they have a need for reassurance in this space. The waiting room has come to represent a containment space of frustration for patients and doctors alike. Often clinics lack information and personal connection between nurses and patients which adds to the feeling of uncertainty. “Waiting in ignorance creates a feeling of powerlessness, which frequently results in visible irritation and rudeness”. These issues of heightened stress, uncertainty and poor communication informed my aim for this project. Which brings me to my central proposition. Slide change
Human-centred design can be used to facilitate reassurance through transparency in communication within an urgent care clinic waiting room to enable patients to understand the experience and feel more at ease whilst waiting.
I aimed to design a system that would enable patients to have a better waiting room experience. By making information accessible – including estimated wait time and how the urgent care process of triage works, patients should be able to understand the experience and feel reassured.
This led to my design output. Introducing Notify.
Notify facilitates reassurance in the urgent care waiting room by creating transparency in communication between staff and patients. It is a scalable system that can improve patient’s levels of uncertainty by making information accessible to them. Here’s how it works!
Slide Change – VIDEO:
The Notify Card is the first connection point users have with the Notify system, here we have a father and daughter arrive into urgent care, they are greeted by the receptionist, given a medical form and a Notify Card. This card is only used during the waiting room experience, patients return the card before leaving.
A QR code provides a recognisable connection point for all, a common icon used following the COVID-19 response and is a tool most of us know how to use.
Patients are to look for their personal ID number on the back of the card, this connects the patient to the the Notify Display Screen. The personal ID number on the Notify Card is displayed on the screen in a queue that allows patients to see how their situation compares to others in the room. The screen provides moving graphics to educate patients on the triage system. Triage has proved to be a good addition to any healthcare service, surveys show that patients feel as though they have been recognised and entered into the system
Patients are then able to scan the Notify Card QR code that takes them to the Notify progressive web app. The platform allows patients to have personal information at their fingertips, it is convenient, easy to navigate and provides reassurance through information.
My research proved most patients would prefer to use their personal device but should provide devices so that they don’t have to rely on them. The iPad kiosk provides another way for patients to connect whilst still keeping information private. These iPad kiosks are secured to stands in the room but can be unlocked to become portable.
This is Natalie, she connects to the Notify web app through NFC technology. Despite the recognisable quality of QR codes, they are not the way of the future. Therefore the Notify Card also has near field communication technology embedded, this provides a contactless and convenient connection to smartphones. The new iOS 14 NFC tag feature now means both Android and Apple phone users can connect contactless. Something not readily available just a few months ago.
The frequently asked questions feature enables patients to stay informed, they are able to learn about the way the urgent care system of triage works and addresses questions that the patient maybe be asking including why they may be waiting.
Natalie has been waiting an hour but has been learning about the triage process, so is not left questioning when others come into the waiting room and are seen by the doctor before her.
The update feature enables patients to access information about the state of the clinic – including their estimated wait time, triage number, how many beds are currently available, what staff are working, and when the waiting room was last cleaned. Each of these features have been chosen and informed by my primary research of talking to people and the users needs.
The update feature allows Natalie to check her wait time,
to see if she has enough time to go bathroom before being
seen by the doctor.
The messaging feature allows patients to be connected. It is important that patients feel like they are being seen and constant communication is a great way to facilitate reassurance.
This is Samuel, he often has panic attacks when in the waiting room but is able to message the nurse for assistance. The messaging function came about through testing my web app when I realised I needed to introduce a way for patients to reach out and notify staff. Sometimes patients feel overwhelmed and so having 2 quick buttons to notify the nurse address this. The nurse greets him and attends to his needs.
Notify facilitates reassurance in the urgent care waiting room by creating transparency in communication between staff and patients. The system empathises with the user’s worry and resolves their uncertainty by making information accessible to them.
I used an array of methods to test my solution and assumptions. For a few weeks I was stuck deciding on my strategy. Battling tensions were a constant challenge as the concept of privacy and protocol always remained. Slide Change
Having a system that worked for everyone and making personal information accessible without giving away other peoples details was difficult. Slide Change
I constantly tested the logistics of the touchpoints to the point where I had spent weeks trying to decide whether a kiosk, handbook, app, screen or check-in, would work best for my aim. I ended up deciding on my touchpoints through the use of role play scenarios. Slide Change
This was a moment that narrowed down my scope and audience of the project. I gathered a few people together to act out different personas. One persona said when discussing my idea of a kiosk that he “personally, wouldn’t want to get out of his seat more than he’d have to, he’d rather just sit and vomit in a bowl”. In conjunction with feedback I had in a questionnaire I realised a personal device option would be more beneficial and whatever it was needed to be portable.
I also used questionnaires to gather user wants and needs. Because my target audience were people in urgent care it wasn’t hard to find people that have done the experience before. The answers of my questionnaires informed many of my system’s features including the format, tone of voice, visuals and approaches to learning. For example, one question asked what methods to educate would be best in regards to the triage scale and the majority of answers referred to visually representing triage in colours with a sleek clean style and a few words to explain what they meant. Slide Change
Questionnaires were very beneficial in this project and informed my design approach although because of my reasonably wide audience balancing feedback proved difficult. Everyone had their own opinion on waiting room issues and how I could fix them. I had to constantly come back to my central proposition to remain in the scope of my project. It was easy to get excited about the many problems I could solve. In hindsight I should have tested my strategy in an actual urgent care waiting room with a room of people but this proved difficult to do considering how COVID impacted the clinics I contacted.
Although, during this project my mum had to go into urgent care twice, unfortunate for her but selfishly, it enabled me to test my project on a very small scale. It can’t be said her insights could represent the room of patients but were important in the development of Notify. Small details such as how fast the tv is moving and how loud the music was were all considered.
Looking back at this project I am proud of the system I have managed to design. In my initial research I learnt so much about the psychology of a waiting room and how our mind subconsciously affects our experience satisfaction. I would have loved to widen my scope to integrate methods for distraction, this could include games and breathing exercises. This would help manipulate patient perceptions of wait time which affects the quality of care more than the actual wait time. I decided this wasn’t focusing on communication and therefore was outside of my scope for this project.
Thanks for your time listening this morning, to Ben, thanks for taking a day out of your schedule to listen to our presentations and Tim and Tim thanks for being such great lecturers, always there for a chat or critique when we need it most.