Task Awareness in the ED
Role: User Experience Designer & User Research | Team: Agile scrum team | Status: MVP released to users
The Challenge
When emergency department physicians have unsigned and/or incomplete work, this often affects the hospital's ability to bill and receive payment. We have noticed that there is an influx of physicians who have incomplete work. When a physician doesn’t complete a task, a Chart Reviewer/HIM coder often creates another task, resulting in more tasks that pile up, that the physician may or may not see.
The main priority for physicians in the ED is providing patient care. The incomplete work that often piles up is usually unsigned orders and notes for patients who have already been discharged. These patients are not present in the department, therefore an added challenge is how to motivate physicians to complete work that they may view as less important.
This project spans multiple teams and products, with a large swath of stakeholders to coordinate and collaborate with.
Hypothesis
In our ED product, our providers do not have access to an inbox. In the inpatient department, the inbox is where all incomplete tasks and administrative work collect. We believe that by introducing the inbox to the providers, we will be surfacing tasks to them that they haven’t had easy access to previously.
Providers will be able to see new tasks as they come in.
Providers will be able to quickly access and take action on tasks in their inbox.
Seeing as the majority of “clarify” tasks (which come back to the provider from the HIM coder) are often a result of the provider not seeing the initial task (e.g. "Please sign this order”), we believe that surfacing these tasks to the provider will result in a reduction of clarify tasks.
Research
Multiple rounds of user interviews were conducted at the beginning of this project. I began by interviewing providers to understand their current process for completing this work without inbox access. I moved on to showing users high level sketch concepts, and then synthesized the feedback into a proposed design solution.
We've found that providers have work shifts with a lot of variability due to the unpredictable nature of the ED. We’ve found that they will work on more administrative or clerical tasks when they have downtime between patients.
We’ve also found that providers with prior knowledge of the inpatient inbox, will access it to get to their tasks, and will “work their buckets” from there. They will navigate back to the Emergency Department when they need to return to the tracking board. They notice that the inpatient patient list is to the right of their inbox, but they disregard it, “it would be nice if that was a list of my patients, or the tracking board”.
Proposed Solution
We have a strong hypothesis that by just adding access to the inbox from the department will increase the completion of tasks. Since the tracking board serves as homepage for the ED users, I wanted to make sure that the inbox solution did not prevent the user from seeing the information on the tracking board.
The final design introduces the inbox as a widget at the bottom of the page, which when clicked, slides up to reveal the users tasks. The content of the tracking board condenses, but is still accessible with the horizontal scroll. The user can then scroll through their inbox and complete tasks, while switching back to the full tracking board when necessary.
Through collaboration with the Task Awareness team, both teams have come to the realization that a department agnostic inbox would be to the benefit of all users. 58.38% of our providers move between the ED and other departments (20.91% ambulatory, 37.47% inpatient). We believe that a department agnostic inbox would benefit our users, especially since we believe they move more fluidly through the “departments”.
We have reviewed this design with users, and the response has been positive, with offers to be alpha users. As this design moves into alpha, we will be able to learn more about how physicians (and nurses) actually use this feature.
