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COMFORT
COMMUNICATION
PRIVACY
Supply individual space
Reduce patient contact with people other than doctor,nurse, and
pharmacist
Security of information (why visiting)
Information about conditions, medicines, basic health
improvements
Directive information: What to do (Wayfinding) and where do you
go (Info finding)
Security of information (give the appropriate information)
Alert system (when is your turn)
Reduce Contact with Patients
Materials of Space
Keep Informed of Visits Progress (Where are you at in Line)
Allowing Individual Behavior/ Environment
INNOVATING AUNIVERSITYCLINIC'S CHECK-IN AND WAITING
EXPERIENCE
Description:
*WATKINS MEMORIAL CENTERSTUDENT HEALTH SERVICE CENTERUNIVERSITY
OF KANSASMISSION:Student Health Services supports the students
learning experience through the delivery of high quality affordable
healthcare services and innovative pro-grams that promote the
health of the student, University and community.
Our objectives:
Give privacy to users
Improve communicationReduce stressGive information to users
Reduce germs in waiting roomImprove comfortReduce waiting
timeGive users something to do while waiting
NURTURING U
OUR MAIN GOAL:IMPROVE the WAITING EXPERIENCE atWatkins
MemorialCenter SHS*
SOLUTION STRUCTURE:
The Nurturing U project stems from a need to improve the
check-in and waiting experi-ence for patients in the Watkins
Memorial Health Center, located on the Lawrence campus of the
University of Kansas. The main goal of this project is to improve
the patient waiting experience inside of the main Watkins waiting
area. A final product then emerged that reflected the teams
Evidence-Based Design (EBD) ap-proach to solving the discovered
problems.
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By the 1960s, the university had outgrown Watkins Memorial
Hospital, opened in January 1932. The hospital, the gift of
Elizabeth Miller Watkins and named for her late husband, could not
be expanded because of its hillside site, so a larger, more modern
hospital was planned for the playing fields southeast of Robinson
Center. George Hampton & Associates of Wichita and State
Architect Kenneth R. McCain designed the dark brick building with
medical director Raymond A. Schwegler. It cost $3.65 million, paid
largely by student fees, and retained the original name.
Its 60,000 square feetincluded 34 inpatient beds;a clinic; a
laboratory andX-ray facilities; apharmacy; allergy and
immunization, physicaltherapy and psychiatrictreatment areas;
andadministrative andbusiness offices.
The Ralph Canuteson Memorial Library is named for the first
student healthdirector (1928-65). In 1988 the facilitys name was
changed to Watkins Memorial Health Center.
A major expansion and renovation costing $5.6 million, designed
by Lawrence R. Good & Associates of Lawrence and completed in
1997, created more physicians examining rooms, a gynecology clinic,
a mens clinic, and an urgent care clinic. The health center offers
treatment and educational programs in general medicine, sports
medicine, nutrition, allergy management, physical therapy,
immunizations and radiology.
A wellness re-source centeroffers education and support in
nutrition, fitness, alcohol and drug use, sexual behavior, and
stressmanagement.
Watkins Memorial Health Center
Student Health Centerand the Waiting experience
SHS is commited to support students learning experience that
requieres a considerable amount of time. Waiting at the Healthcare
facility for more time than expected can interfere with a students
academic activities.
An experience analysis showed that a students typical waiting
journey proceeds as such: check-in line, waiting room for nurse,
exam room for doctor, for prescriptions at pharmacy, at the lab for
testing.
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1. Waited in Line for 5 Minutes to Check-in.2. Checked-in- Was
asked to Scan ID, Reason for Visit, For Current Address and
Insurance Information3. Directed to Sit in the First Waiting Area-
Waited for 15 Minutes. Wanted to sit in the second waiting area
because it is more se-cluded (away from all the sick peoples
path-way). Watched two girls come in for Allergy Shots. 4. Directed
by Nurse to Weight Station.5. In Exam Room- Nurse took Vitals,
Asked Again the Reason For My Visit. She Entered the Data on the
Computer. I told her I needed a form signed after the visit. She
then said the doctor would be in shortly. I waited 10minutes for
the
Doctor to come in. He asked if I was excited to be going to
Russia. I said yes. He then said we would begin the exam. During
the Exam he checked my chest, my spin, my ears, my eyes, he then
asked a series of questions about where I would be staying in
Russia. I said St. Petersburg. He informed me that I needed to get
two shots and gave me a handout on Important facts about Russia. He
signed my form and told me to get an ocial stamp after I stop by
the shot room. 6. Directed by the Doctor to the Shot Room- Was told
she was busy and that I need an appointment to meet with her.7. The
Appointment Desk- I then went to make a follow up Shot appointment
and
have my form signed. There the lady stamped the form and asked
if I was free for an appointment now. I said yes.8. I was directed
to sit in one of the rst two chairs in the waiting room. I waited 5
min-utes.9. I was told by the Shot Doctor to come into the Shot
Room. In the Shot Room- I was asked what shots I needed and why. I
told her and then she made me read two handouts and then nally
administered the shots. She then made me sit there 10 min-utes for
them to take eect. She then told me if I felt any of the side eects
to come in immediately and tell the doctors what I was experience.
She wished me luck.10. I left the building.
CUSTOMER JOURNEY MAP
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No distinct signage differentiating the waiting areas (flu
waiting area and other)
Lack of privacy and individual seating
Posters are not legible
Uncomfortable seating
Nothing to do
Unaware of how long the wait is
A line forming to check-in
Privacy invasive due to telling secretary out loud reason for
visit as well as other personal information such as address, phone
number, insurance provider
GATHERING DATA THROUGH ETHNOGRAPHIC AND LITERARY RESEARCH
METHODSTHE DESIGN TEAM POINTED OUT THE MORE IMPORTANTSITUATIONS IN
THE CURRENT WAITING EXPERIENCE
CURRENT WAITING EXPERIENCE
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PERSONAS
Frank Bartels is a 19 year old, Sophomore Finance Major at the
University of Kansas. He has Sever Allergies and requires weekly
allergy shots.
Frank is instructed to arrive at the campus clinic 15 minutes
early. When he arrives, he checks-in by scanning his KU card and
verifying his information (address, phone number, insurance).
He then proceeds to one of two waiting areas. He doesnt know
which area to sit in so he sits away from patients who are coughing
and appear to be sick. He doesnt want to catch what they have.
While Frank waits to be seen he checks his Face-book and plays
on his iPhone. After about 7 min-
Sarah Jones and her boyfriend Mike Brown are Psychology Majors
at the University of Kansas. They both are feeling sick and decide
see a doctor.
They arrive at the campus clinic without an appointment and hope
to be seen fast. They give the secretary their information.
They then head to the waiting area and look for a place to sit
that will allow them to sit together. They are unaware of how long
the wait is so they have a seat and start talking. After about 5
min-utes of waiting, Mike starts complaining of being hungry.
Frank
Sarah & Mike
Dr. Kosary
utes on his phone, Frank becomes bored and wishes he knew how
much longer the wait is.
10 minutes after his appointment was suppose to have begun; a
nurse calls his name. He approaches the nurse and heads back to
have his weight and vital check. The nurse then leaves and Frank
waits for Dr. Kosary to come in to give him his shot.
Dr. Kosary arrives 7 minutes later and gives Frank his shot. She
then reminds him to make his next appointment.
Frank leaves the exam room and decides to call the clinic later
to make the appointment.
Another 30 minutes passes and a nurse finally calls the couples
name. The couple gets up to follow the nurse to be weighed and have
their vitals taken. As Sarah has her vitals checked she asks Mike
for a little privacy.
The nurse then leaves and Dr. Kosary comes into the exam room.
Dr. Kosary determines that the couple has the flu and places a
prescription for them.
Mike and Sarah then leave the exam room to go to the Pharmacy.
It then takes 20 minutes to fill the prescription.
Dr. Kosary is a Physician at Watkins, the University of Kansass
campus clinic. She has been a Doctor for the past 15 years and sees
on average 4 patients an hour.
She begins her day by seeing her first patient, Frank Bartels.
His visit takes 5 minutes and then she stays behind to finish
processing his informa-tion for his file.
She then sees 11 more patients before her lunch break, including
Sarah and Mikes visit, which takes 20 minutes to complete.
At noon Dr. Kosary takes her lunch break and realizes she forgot
her lunch at home. She only
has an hour for lunch and the closest place to eat is a 20
minute away. She wants to be able to order something healthy
quickly and also satisfy her frequent chocolate cravings.
After lunch, she sees 12 more patients before her afternoon
board meeting with the clinics adminis-tration.
Todays meeting was about a survey which showed that students
were not satisfied with the amount of time being spent waiting for
a doctor in the exam room. This meeting informs Dr. Kosary that she
needs to update patients if a delay occurs during their visit. Once
finished, she leaves to go home.
To know how long the wait isTo not get sick when visiting the
doctorTo have options of things to do as he waitsTo make
appointments quicklyTo not repeat the same information more than
once during an appointment
GOALS
To be seen in a timely mannerTo have privacy even when visit is
joinedTo know the waiting timeTo sit together To not be hungry
GOALS
To See Patients in a Timely MannerTo Have Access to FoodTo
Satisfy Chocolate Cravings To Update Students of the Delay in Their
Visit
GOALS
Total Appointment Time: 85 MinutesTime Spent Waiting: 55
Minutes
Total Appointment Time: 47 MinutesTime Spent Waiting: 32
Minutes
Personas use storytelling to engage social and emotional aspects
of our brains, which helps each team member [of the design team]
either visu-alize the best product behavior or see why the
recommended design is good(Goodwin, 2009:229).
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PROTOTYPING APPLICATION
Paper Prototype
PDF Prototype
Signage to match the waiting areaAlerts are goodConfirm/dismiss
bar is confusing on 1 minute arrivalI dont need an alert every five
minutesTell me when the halfway point is
INSIGHTS
It is pretty straight forwardWhat is QR Code?Needs sound with
alertsCan I use my phone to check-in?
INSIGHTS
Students were given a prototype of
a smart phone application to use
throughout their visit at Watkins.
The students role-played a hypo-
thetical situation of checking-in
and waiting at Watkins. They were
handed a smart phone prototype
and asked to check-in using the
kiosk and then proceed to the wait-
ing area.
Students used gestures to show
how they would use the application
as well as think aloud protocol. This
enabled them to ask for help and
give feed back on areas of the in-
terface that confused them.
This testing allowed the design
team to see which areas of the in-
terface needed improvement.
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PROTOTYPING KIOSK
Paper Prototype
PDF Prototype
Needs a change tab to fix informationNeeds to Work Without A
SmartphoneCan I recieve text messages?Needs buttons on home page to
mark activityReminds me of a self checkout at the super market
INSIGHTS
The kiosk could avoid linesCouldnt it be online and done from
home?Confused tries to immediately scan QR code I avoid talking to
people so this is a good thing
INSIGHTS
Students were given a prototype of
a kiosk to use as a check-in possibil-
ity instead of the traditional check-
in line. The students role-played a
hypothetical situation of checking-
in at Watkins. They were handed a
smart phone prototype and asked
to check-in using the kiosk.
Students used gestures to show
how they would use the kiosk as
well as think aloud protocol. This
enabled them to ask for help and
give feed back on areas of the in-
terface that confused them.
This testing allowed the design
team to see which areas of the in-
terface needed improvement.
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PROTOTYPING SPACE
Post-It Prototype
Sketchup Prototype
Good to have individual spacesI am not interested in interacting
with other peopleA small couch for two people if you come with
someoneChairs surrounding a coffee tableWants chairs with cushioned
armsSide tables for your stuffNice to have vending machines
INSIGHTS
Split waiting areas: that is goodAquariums: could be nice to
look at and entertainingCaf: healthy food would be good. I would
like tea or fruit drinks. Maybe a hot drink and a sandwich. People
may be sleepy and like to eat while they wait here. Would use it
after fasting if I knew there was food there to eat.
INSIGHTS
Students were first given a Post-It
prototype of the furniture and
asked how would they like their
space to be arranged. This infor-
mation was then used to generate
a Sketchup prototype of the space
to see what Watkins would poten-
tially look like. In the Sketchup pro-
totype students where asked if they
would use a caf, how they felt
about aquariums, sky tiles, and a
digital waiting cue display.
Students used gestures to show
how they would use like the space
to appear as well as think aloud
protocol. This enabled them to ask
for questions and give feed back on
areas of the space that confused
them or that they liked.
This testing allowed the design
team to see which areas of the
space needed improvement.
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AQUARIUMS
Provide patients with a view
Distract patients while waiting
A natural stress reliever
CAFE
Offers alternative waiting area
Provides patients and staff with healthy food and drinks
Also provides the south end of campus with dining options
CHECK-IN KIOSK
Allows patients to check-in without speaking to a person
Allows patients to keep their information private
Prevents long check-in lines
Students can use their phone or id card
HELP DESK
Directs all incoming traffic
Could be a triage nurse for patients without ap-pointments
Allows patients to speak with a person instead of a machine
PHARMACY WAITING AREA
Distinguished those waiting for medi-cation from those who are
seeing a doctor
Prevents the spread of germs
BLUE WAITING ZONE (HEALTHY PATIENTS)
Reduces the spread of germs
Single and small group seating available
Comfortable seating
REDESIGNING THE WAITING EXPERIENCE
WEIGHT STATION
Gives patients privacy when being weighed
Offers a smooth transition be-tween the waiting room and the
exam room
RED WAITING ZONE (SICK PATIENTS)
Reduces the spread of germs
Comfortable seating
Single and small groups seating available
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PROPOSEDPATIENT JOURNEY
Log into appAnd check intoClinic remotely
App produces Qr code
Goes straight to watkins
and checks in via the
self-serve kiosk
Kiosk produces QR code for use by medical staff
throughout rest of visit.
Visit number produced tohelp students track wait times
via message screens.
QR code can be sent to phoneor printed onto a card.
Patient makesAppointment
OR
OROR
Have qr code
Scan student ID
Red zone For sever illness
Blue zone For moderate ailments
Cafe
Dont have qr code
Pre-check-in Arrive at watkins
Check-in Using kiosk
Proceed to Waiting area
Message screens showCurrent wait times
Turn alert sent to Phone via text
Nurse seeks out Patient in waiting area
Visit alerts produced
AND
OR
AND
001224
With smartphone
Without smartphone
Calls clinic
Via website
Ask for helpSHS services
CHECK-IN Schedule AnAppointment
GO TO KIOSK AND SCAN QR CODE
GO TO KIOSK AND
CHECK-IN
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HELP DESK AND CHECK-IN
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Ask for help SHS services
CHECK-IN Schedule AnAppointment
GO TO KIOSK AND SCAN QR CODE
CHECK-IN
ALLOW NURSE TO SCAN QR CODE
CHECK-IN
YOUR CHECK-IN IS COMPLETE
Please go to the red zone. You will be seen in 15 min
MAP
ALERT5 MIN REMAINING
MYSHS
ALERT1 MIN REMAINING
MYSHS
MOBILE TECHNOLOGY
MOBILE TECHNOLOGY
CHECK-IN KIOSK
SMARTPHONE APP
CHECK-IN SCAN QR CODE SWIP KU CARD
Hi FrankWould you please confirm your information
Ask for help SHS servicesCHECK-IN Schedule AnAppointment
CHECK-IN SCAN QR CODE SWIP KU CARD
START SCAN
CHECK-IN SCAN QR CODE SWIP KU CARD
NAME: Frank Bartels
ADRESS: 4101 w24th Pl. Apt. 512
MOBILE: 862 220 8760
INSURANCE PROVIDER: Seven Corners
ADRESS: 4101 w24th Pl. Apt.CHECK-IN SCAN QR CODE SWIP KU
CARD
DONE
CHECK-IN SCAN QR CODE SWIP KU CARD
Hi FrankWould you please confirm your information
NAME: Frank Bartels
ADRESS: 905 Avalon Rd.
MOBILE: 862 220 8760
INSURANCE PROVIDER: Seven Corners
DONE
Your check-in is complete
Appointment Information:Wednesday May 9, 2012 / 10:30 a.m. / Dr.
Kosary
Please go to the red zone. You will be seen in 15 min
MAP
The design team thought this would be an area that the could
incorporate mobile technology. The phone and texting could be used
as a paging system for patients. A time breakdown could show
patients how long their wait is and updates of 5 minutes and 1
minute could tell the patients when to head back to the waiting
room and when to get ready to meet a nurse
To reduce the waiting in lines and allow the students to not
share their information with other people , the design team
proposed a Check-in iosk. This system could use a QR Code that
would be a part of the application and allow them to check-in by
scanning the screen of their phone. If students do not have smart
phones then they can also use the current method of scanning their
student id.
Choosing the service(Check-in, Schedule appointment,Help, or
more services)
Scan QR Code Putting the smartphone with the QR code over the
screen to scan it
Confirming informationsuch adress, phone numberand insurance
provider
Editing the adress information
Confirming theinformation is correct
Check-in completeSynchronizing informationwith the smartphone
Guiding the patient to thenext step: Going to a waiting zone
Interactions with the Check-in Kiosk Screen
Interactions with the Mobile App
Initializing the App Choosing Check-inService
Receive directions Choosing Map Alert 5 min Alert 1 min Showing
QR codefor the Nurse
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RED ZONE
51080
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Designed for those pa-tients who are more sick this zone will
help to re-duces the spread of germs, offes a comfort-able seating
and also has spaces fo small groups.
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BLUE ZONE51080UP
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Designed for those patients who are more healthy, this zone will
help to reduces the spread of germs, offers a comfortable seating
and also has spaces fo small groups.Patients can choose staying in
this zone or going to the cafe area.
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CAFE/LOUNGE
The design team decided to add the addition of a caf to the
existing structure of Watkins Health Center because it provides
patients with an alternative area to wait in, it reduces stress,
prevents boredom, and puts patients in control of the time they
spend waiting.
Research shows that people will experience the waiting as
shorter when: 1. they have something to do while waiting (Faessen,
2008). The design team thought this could be accomplished by adding
a caf; a
common college hangout spot, to the health center. A caf could
give patients control with respect to their physical surroundings
(Faessen, 2008) when visiting the doctor. It would also provide a
positive dis-traction (Faessen, 2008) by offering students a drink
while they wait or a healthy snack. K. Wilson says in The Ecology
of Waiting, giving visitors a choice of how to pass the time, by
providing a variety of amenities and distractions, helps reduce
stress, boredom, and anxiety associated with the waiting process
(Wilson). A
caf would offer patients an alterna-tive choice to a waiting
room set-ting. Patients can grab coffee and come back to the
waiting area to wait or they can remain in the caf and keep track
of their waiting time via the application on their phone or a
display board that keeps track of the patients que.
These ideas were then generated into a low fidelity prototype
sketch up model and students were inter-viewed to see if they liked
the idea of a caf being attached to the health
centers space. Nurses and staff were also interviewed to see if
they would like a caf as well.
After interviewing students and staff and seeing that this would
be a viable solution to the waiting experi-ence, the design team
was let in on the insight that a caf could not only provide
nourishment to the health center but to the south end of campus as
well. A nurse informed us that the closest restaurant was about a
15 minute walk or drive. Students interviewed said they
would like to have healthy choices to reinforce the healthcare
aspect. That coffee would be good as they were leaving the facility
but tea or a smoothie would be a better choice while waiting to see
a doctor. An-other insight was that some test doctors run require
fasting and after these tests it would be nice to have something to
eat. The nurses of the facility requested, Some unhealthy option as
well such as chocolate be-cause sometimes you just need a fix for a
craving.
51080
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1020
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Offers an alternative area to wait in
Provides patients with food and drink
Provides doctors and staff with food, drink, and snacks
Prevents boredom
Reduces stress
Puts patients in control of time spent waiting
Provides south end of campus with dining options
Health options: Coffee, tea, smoothiesSweet treats, Hot
meals
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PHARMACY
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1020
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Designed to distin-guish those waiting for medication from those
who are seeing a doctor
WAITING AREA