UPMC Presbyterian Neurosurgery Clinic Research process & findings Carnegie Mellon School of Design Service Design 路 Fall 2007 Melissa Cliver 路 Jamin Hegeman 路 Kip Lee Leanne Libert 路 Kara Tennant
What we were told Current Problems Wayfinding Wait time Work flow
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Territory Map for UPMC Neuro Clinic
Brain Tumors
Advertising
Tuesdays
family & friends Insurance/Payment Methods Uncertainty Empathy
Front Desk
Surgery
Waiting Entertainment
Waiting Room 16 Exam Rooms
MRI Scheduling
Hallway
Information
Space
Dr. Kassam
Communication Physician/Consult Room
Answering Questions
patients
Limited Privacy
staff
Phone Calls
70 Patients
Multitasking
Wayfinding
Overbooking
Will I be seen?
Screening
clinic Hospital Admissions
Accommodations
upmc
Parking
oakland UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
pittsburgh + · Kip · Leanne · Kara Melissa · Jamin
Stakeholders
Dr. Kassam
Staff
Patient
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Research Observation Interviews with staff & patients Surveys Data collection
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
What we saw and heard The patient experience through the eyes of design.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Welcome.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“Front desk people seem to be overwhelmed and not proactive about communicating.” —Press Ganey
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
So I’m here for 2-3 hours?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
There’s no space for us inside.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“This has happened before. My first visit took over four hours.” —Press Ganey
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Is there something for me to do?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“I’ve been waiting here so long I should start charging Kassam.” —Patient
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Is that your foot or mine?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Where did I put that paperwork?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“There’s no station.” —Lois
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Is the doctor even in there?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Biggest problem: “Keeping track of Kassam.” —Lois
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Is there a better way to communicate?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
I’m making a difference.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“When they come back and look great, that’s rewarding.” —Lois
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
How can I support my staff?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“We are his family.” —Debbie
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
So many patients, so little time.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Always in a hurry.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“Just for the record, I’ve only peed once.” —Dr. Kassam, 11:48 am
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Why the holdup?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
“Kassam needs to be cloned.” —Debbie
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Mean of Satisfaction
Quantitative Research Press Ganey Medical Practice Report
100 90 80 70 60 50
Positive Experience
40
Courtesy of registration staff Speed of check out process Speed of registration process Waiting area comfort/pleasantness Exam room comfort/pleasantness
30 20
Negative Experience
10
Wait in exam room to see CP Information about delays Wait before going to exam room
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Total Received Data
April 1 - June 30 2007
Jan. 1 - March 31 2007
Oct. 1 - Dec. 31 2006
July 1 - Sept. 30 2006
0
Melissa · Jamin · Kip · Leanne · Kara
Synthesis
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Who are the patients? new, pre-op, post-op
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Who are the patients? Young adult to elderly Wheelchaired Prisoners VIPs
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Patient Needs Feeling welcome Actual wait time Respect Space and comfort Distractions
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Who are the staff? Nurses Physicians Residents Fellows Administration
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Staff Needs Better workflow Locating Dr. Kassam and each other Communication Making a difference
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Dr. Kassam’s Needs Spend quality time with patients See everyone Support Staff Time
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
It’s more than wayfinding, wait time, and workflow.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
The experience is the relationship between patients, staff, and Dr. Kassam within the given space.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Experience
Dr. Kassam
Staff
Patient
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Service Blueprint of Presby Neuro Clinic PHYSICAL EVIDENCE
Front Desk
Waiting Room
Front Desk
Waiting Room
Front Desk
Hallway
Exam Room
MRI & Chart
Exam Room
MRI & Chart
Door Tag
Waiting Room
Check-out Room
PATIENT ACTIONS
Sign In
Wait
Check-in
Wait
Responds
Follow to Exam Rm
Wait in Exam Rm
Answer Questions
Wait
Ask Questions
Return Door Tag
Wait
Check-out, Pay, & Leave
Call Patient
Escort to Exam Rm
Line of Interaction
ONSTAGE CONTACT PERSON
Process
Welcome
Check Vitals & Ask Quest
Meet Dr. Kassam
Process & Check-out
Line of Visibility
BACKSTAGE CONTACT PERSON
Get Patient Chart
See Other Patients
See Other Patients
Grab Door Tag
See Other Patients
Chart in To Be Seen Bin
Brings Door Tag Back Chart Taken by Staff
Check Patient Location
Grab Chart from Bin
Write Rm # on Schedule
Take Away Chart
Place in Kassam Bin
See Other Patients
Kassam Gets Quick Review Check Patient Location
Dictation
Line of Internal Interaction
SUPPORT PROCESSES
Debbie’s Chart Cart
Records/ Database System
Door Tag System
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Bin System
Schedule System
Chart Storage System
Records/ Database System
Melissa · Jamin · Kip · Leanne · Kara
Service Blueprint of Presby Neuro Clinic PHYSICAL EVIDENCE
Front Desk
Waiting Room
Front Desk
Waiting Room
Front Desk
Hallway
Exam Room
MRI & Chart
Exam Room
MRI & Chart
Door Tag
Waiting Room
Check-out Room
PATIENT ACTIONS
Sign In
Wait
Check-in
Wait
Responds
Follow to Exam Rm
Wait in Exam Rm
Answer Questions
Wait
Ask Questions
Return Door Tag
Wait
Check-out, Pay, & Leave
Welcome
?
Process
?
Call Patient
Escort to Exam Rm
?
Check Vitals & Ask Quest
?
Meet Dr. Kassam
?
Process & Check-out
Get Patient Chart
See Other Patients
See Other Patients
Grab Door Tag
See Other Patients
Check Patient Location
Place in Kassam Bin
Line of Interaction
ONSTAGE CONTACT PERSON Line of Visibility
BACKSTAGE CONTACT PERSON
Chart in To Be Seen Bin
Brings Door Tag Back Chart Taken by Staff
Grab Chart from Bin
Write Rm # on Schedule
Take Away Chart
See Other Patients
Kassam Gets Quick Review Check Patient Location
Dictation
Line of Internal Interaction
SUPPORT PROCESSES
Debbie’s Chart Cart
Records/ Database System
Door Tag System
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Bin System
Schedule System
Chart Storage System
Records/ Database System
Melissa · Jamin · Kip · Leanne · Kara
Service Blueprint of Presby Neuro Clinic PHYSICAL EVIDENCE
Front Desk
Waiting Room
Front Desk
Waiting Room
Front Desk
Hallway
Exam Room
MRI & Chart
Exam Room
MRI & Chart
Door Tag
Waiting Room
Check-out Room
PATIENT ACTIONS
Sign In
Wait
Check-in
Wait
Responds
Follow to Exam Rm
Wait in Exam Rm
Answer Questions
Wait
Ask Questions
Return Door Tag
Wait
Check-out, Pay, & Leave
Call Patient
Escort to Exam Rm
Line of Interaction
ONSTAGE CONTACT PERSON
Process
Welcome
Check Vitals & Ask Quest
Meet Dr. Kassam
Process & Check-out
Line of Visibility
BACKSTAGE CONTACT PERSON
Get Patient Chart
See Other Patients
See Other Patients
Grab Door Tag
See Other Patients
Chart in To Be Seen Bin
Brings Door Tag Back Chart Taken by Staff
Check Patient Location
Grab Chart from Bin
Take Away Chart
Place in Kassam Bin Kassam Gets Quick Review Check Patient Location
Write Rm # on Schedule
See Other Patients
Dictation
Line of Internal Interaction
SUPPORT PROCESSES
Debbie’s Chart Cart
Records/ Database System
Door Tag System
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Bin System
Schedule System
Chart Storage System
Records/ Database System
Melissa · Jamin · Kip · Leanne · Kara
Service Blueprint of Presby Neuro Clinic PHYSICAL EVIDENCE
Front Desk
PATIENT ACTIONS
Sign In
Waiting Room
Wait
Front Desk
Waiting Room
Check-in
Wait
Front Desk
Hallway
Responds
Follow to Exam Rm
Call Patient
Escort to Exam Rm
Exam Room Wait in Exam Rm
MRI & Chart
Exam Room
Answer Questions
Wait
MRI & Chart
Door Tag
Ask Questions
Return Door Tag
Line of Interaction
ONSTAGE CONTACT PERSON
Process
Welcome
Check Vitals & Ask Quest
Meet Dr. Kassam
Line of Visibility
BACKSTAGE CONTACT PERSON
Get Patient Chart
Grab Door Tag
See Other Patients
See Other Patients
See Other Patients
Chart in To Be Seen Bin
Brings Door Tag Back Chart Taken by Staff
Check Patient Location
Grab Chart from Bin
Write Rm # on Schedule
Take Away Chart
Place in Kassam Bin Kassam Gets Quick Review Check Patient Location
Dictation
Line of Internal Interaction
SUPPORT PROCESSES
Debbie’s Chart Cart
Records/ Database System
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Door Tag System
Bin System
Schedule System
Chart Storage System
Melissa · Jamin · Kip · Leanne · Kara
Opportunities
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Embrace wait time. What if we inform, engage, and comfort patients?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Enhance flow. What if the staff has fewer tasks, less distraction, and better communication?
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Balance Dr. Kassam. Support his efforts to help patients, but also find time for himself and support his staff.
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Next Steps. Participatory design Work with staff and patients Develop concepts
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara
Thank you!
UPMC Presbyterian Neurosurgery Clinic · Research Process & Findings
Melissa · Jamin · Kip · Leanne · Kara