Company: Cisco
Project Duration: 12 months
My Role: UX Design and UX Research
The Team:
1 UX Designer (me)
1 UX Researcher (me)
1 Product Manager
3 Developers
1 Database Engineer
1 Integration Engineer
What is the Clinic Huddle Board Application?
The Clinic Huddle Board Application is an alpha version of a native smart-board application that runs on Cisco’s 55” Webex Board™. It is used to provide insight into key clinic metrics at daily clinic huddle meetings attended by doctors, nurses, and staff. It enables collaboration and empowers clinicians to make data-driven decisions about the operations of the clinic during the meeting and throughout the day.
The Purpose
The motivation behind the Clinic Huddle Board Application was improving communication within clinics. Miscommunication in healthcare has tremendous cost - it’s estimated that miscommunication in hospitals resulted in $12 billion annual waste. The Clinic Huddle Board Application sought to improve communication within the clinic, specifically targeting operational and process failures.
My Role
I led UX Design and UX Research throughout the project. In addition, I picked up the product management responsibilities part way through development after the current product manager transitioned off the team for another role.
The Outcome
The Clinic Huddle Board Application is currently in pilot within the Stanford LifeConnections Clinic. Since it was implemented, attendance has increased, task tracking has improved, and the clinic is on track to exceed performance metrics from the prior year.
Process Overview
Discovery began with secondary research. I combed through resources from the American Medical Association and observed clinical huddle footage that was publicly available. From this, I worked with the development team to scope the work and put together an early concept to communicate the idea to internal and external stakeholders. The early concept generated buy-in, and enabled access to resources to refine the concept through primary user research. Primary research consisted of user interviews with clinicians and contextual inquiry, observing clinic huddles as they occurred and documenting the space. Synthesis of primary research data generated insights that further informed the design, guiding how data was visualized and the interaction flow of task capture. I designed a prototype and worked with the team to launch a pilot in the on campus clinic at Cisco. As we learn from the pilot, I’m currently working to update the interface and modularize UI components for future productization.
Secondary Research
American Medical Association Guide for Daily Huddles
My initial research included a literature review of best practice documentation for huddles, reviewing videos of clinic huddles that were available online, and looking into documentation about huddle-like meetings in other domains including retail and hospitality. From this I found several key insights that informed the early concept:
Huddles typically begin with staffing and logistical information
Two critical discussion points for huddles include the available appointment capacity that day and each providers next available appointment
Timing is crucial for a successful huddle
Early Concept
From this, I designed an early concept to communicate the idea to internal and external stakeholders.
As much as the early concept captured the vision of a clinic huddle experience, it also was the first foray into a native smart-board application at Cisco. Experimenting with the modality of a large screen in this early concept provided foundational learning about scale and layout.
I had the opportunity to share the early concept with clinicians and gain some early feedback.
What didn’t?
Check-In met resistance with clinicians
Section Timers were largely ignored
The appointment filling capability was out of place and compromised the brevity of the meeting
What worked?
Overview of Clinic metrics
Physician Schedule Summary
Ability to Filter Schedule
Custom Text Entry for Flexibility
Primary Research
The next phase of research consisted of interviews with clinicians, contextual inquiry, and documenting the set up of physical huddle boards in several locations.
Key Insights:
Tasks were assigned verbally but not recorded: with clinician’s going to see patients directly after huddles, it was easy to forget tasks that had been assigned during the huddle meeting if the task was not recorded
Troubleshooting discussions would derail huddle meetings: needed a method for directing troubleshooting discussions to another time
Updating the physical huddle board’s was time consuming and prone to errors
Clinicians and staff liked huddle meetings: they reported feeling motivated and closer as a team
Prototyping
Building on the initial concept and insights from primary research, I built out low-fidelity wireframes for a pilot version of the application to be tested at Stanford LifeConnections Clinic. I iteratively refined the wireframes through multiple rounds of informal testing with clinicians at Stanford. For the final round of testing, I coordinated with the clinic administrator to access actual data and set up a Webex Board™, so that clinicians could participate in a huddle meeting using the wireframes with real, timely data.
Huddle Information Architecture
From my research, it was clear that successful clinic huddle meetings had one thing in common: a routine flow that brought awareness of data to the clinic staff. This time was the only time most clinicians were looking at operational data the other parts of the day are patient focused.
There was too much information to visualize on one dashboard so I had to consider how to cluster the data into a series of views. To do this, I performed a card sorting activity with 5 members of the clinic. Below I’ve highlighted key views in the wireframes.
Kick-Off View
Every huddle I observed in my research began with a short kick-off to beging the meeting. Some started with a quote and other’s started with shout outs. In this view, participants get a chance to review shout-outs that had been left the previous day.
Today’s Numbers
After kick off, clinicians jump right into to the data, reviewing the outlook for the day. This provides a sense of how busy it’s going to be and the opportunity to generate tasks for foreseeable issues.
Yesterday’s Numbers
After discussing the outlook for the day, particpants take a look at performance metrics from the previous day. This provides an opportunity to acknowledge issues that occurred and open up a dialogue for improvements.
Provider Schedule
The provider schedule screen provides an overview of all appointments scheduled in the clinic. It highlights potential bottlenecks, as well as showing who might have bandwidth to lend a hand.
Survey Results
Here, results from two patient surveys are displayed, along with selected patient comments.
Clinical Results
Clinical results give insight into how the clinic is performing from a population health perspective. One example is the cancer screening rate of patients that meet qualifying criteria.
Iteration: Visualizing Operational Data
The visualization of operational data is a key component of the huddle experience. As can be seen below, the visualizations changed quite a bit as I gathered feedback from users and coordinated with developers to ensure feasibility. In the first iteration, bar graphs showed historic data with the most recent metric highlighted. However, this turned out to be overwhelming to consume when tested. The second iteration simplified and added emphasis with sizing. Visually, it fell a little flat when tested. In the third version, visualizations are used for key metrics - it struck a balance with richness of data and the attention of users when I tested again.
Component Creation: Appointment Drill-Down
As the prototype moved from wireframe to high-fidelity, so did the level of specificity of the the design. I began to build the design for some of the reusable components in the Clinic Huddle Application.
The boundary states of the appointment drill-down pop-over, along with an example in between.
Pilot Deliverable
To deliver the pilot, I worked with a vendor to build out the interface using their framework. Hence, the final UI was created within the constraints of their framework but used Cisco branding where possible.
Results and Next Steps
Task Tracking has increased: since the deployment of pilot, the number of tasks tracked month over month has increased 9% (huddle generates an average of 10 tasks a week)
Wait time has decreased since the deployment of huddle from an average of 11 minutes to an average of 7 minutes.
The clinic administrator has had to clock fewer overtime hours since the introduction of the Clinic Huddle Application.
There have been modest improvements in the population health metrics. The total number of care gaps has decreased by 4.5% since the introduction of the clinic huddle application.
As the team learned from the pilot, we worked to hand-off the project to the business unit which will continue the work of productization. To assist, I updated the UI to align more closely with Webex Teams™ styles.
