Brief


Client
Ann & Robert H. Lurie Children's Hospital of Chicago, Patient-Family Experience

Challenge
Redesign the hospital's 2nd floor check-in experience.

Team
Liying Peng, Faye Gong

Duration
April 2019 -June 2019
Target Users
Lurie's patients, patient caregivers, visitors and check-in desk concierges

My Role
Research Lead, Experience Designer

Research Methods
Immersive Research, Field Observation, User Interview, Concept Testing, User Survey, Focus Group, Competitor Study, Prototype Testing

Tools
User Journey Map, Qualtrics, Solidworks, Keyshot

Research Process

  
Limitations and Difficulties
Projects related to hospital, especially children's hospital, are always hard because of the difficulty in user recruiting and many constraints brought by hospital regulations. The research process was carefully designed in order to maximize the value of each precious research opportunity. At the project midpoint, our client showed special concerns on the viability of the concept, but was later successfully convinced by the quantitative results from online survey.

Design Outcome
An outpatient self-check-in lane that provides outpatient caregivers a more smooth and delightful check-in experience, while significantly shorten the check in waiting time for inpatient caregivers and other visitors. All design directions, design decisions and sprint plannings were driven and made by research results. 

Impact and Takeaways
The final design was presented to our client. Client was convinced by the evidences and logic that supported the research and the final design. The project triggered me to start learning more quantitative research methods. It also taught me the importance of choosing the right methods to communicate research results to audiences who were real decision makers of companies or organizations.





Process



Sprint 1 | Start from Observations


We started by knowing nothing about Lurie's 2nd floor check-in experience. Thus the top priority task of sprint 1 was to figure out the user groups and user journey of the check-in experience, as well as find some of the pain points as the entry points for further research.

Research Methods

#Immersive Research# We were lucky to have our first client meeting inside the hospital, so that we ourselves had an opportunity to immersively experience the check-in process as hospital visitors. We utilized this chance to conduct an immersive research of the whole check-in experience to get familiar with the process.

#Field Observation# Due to the special nature of hospital-related projects, our opportunities to reach users were very limited and valuable. Therefore, we decided to start from field observation to gather key observations and hypotheses before interacting directly with the users.

#11 Intercept Interviews# 11 intercept interviews were conducted with the patient caregivers and visitors in the hospital waiting area to quickly collect key user needs.​​​​​​​
Outcomes

#User Journey Map# 

#3 User Groups#

#3 Observations#​​​​​​​

#Caregivers' Main Pain Point#

#Preliminary Design Direction#

#3 Hypotheses#

#3 Initial Concepts# for 3 DIfferent Touchpoints




3 User Groups, 1 Single Journey

From the immersive research and field observation, we first got a general impression of the check-in process. The check-in desk located on the 2nd floor where users could take the elevator or the escalator to enter. The desk was designed to be a round shape for a welcoming feeling. Lurie's branding color blue and it's key interior elements marine animals were integrated to the whole environment. Due to the lack of windows, the light was dim. Sound of people talking made the whole environment noisy.

Users involved in the check-in experience could be categorized into 3 groups:


All 3 groups of users play important roles in the experience:




Visible Problems, Caregivers' Pain Point

Additionally, 3 observations involved with user pain points were noticed.

#Observation 1# Difficulty in Calling for the Next
Concierges need to raise their hands and use their own voices to call for the next caregivers or visitors in line. Because of the noisy and dark environment and the special round shape of the check-in desk, their raised hands and voices are hard to be seen and heard.

#Observation 2# The Ignored Badge Return Bucket
Many caregivers and visitors do not notice the badge return bucket, but re-queue at the check-in desk to return their badges to concierges in person.

#Observation 3# All Purposes in One Line
Though visitors and caregivers who have different degree of familiarity to the check-in process use the check-in desk for many different purposes, there is only one queue for the check-in desk.


During the intercept interviews, all caregivers we talked to expressed similar concerns:

#Caregiviers' Pain Point# the Long Line
Since caregivers carrying sick kids are in a negative and nervous mood during the check-in process, the long line indicating long waiting time further aggravates their anxiety.

The discovery of caregivers' pain point helped us defined our preliminary design direction:

#Preliminary Design Direction# Increase Overall Check-in Process Efficiency
Shrink individual check-in time; shorten connection time between individuals; reduce number of people waiting in line.




Possible Causes that Affect Check-in Efficiency


Based on the observations and the user journey, we made 3 hypotheses of the possible causes that affect check-in efficiency. 3 concepts were generated as corresponding potential solutions.

#Hypothesis 1# 
The difficulties for concierges to call for the next in line cause time waste between adjacent individual check-ins, and thus decrease the overall line moving speed.

#Concept# Calling for the Next Light
Provide more obvious signal for caregivers and visitors in line and reduce time and concierges' effort to call for the next.

  
#Hypothesis 2# 
Caregivers and visitors who requeue at the check in desk to return badge add unnecessary numbers to the total people in line.

#Concept# Dolphin Feeding Badge Return Bucket
Utilize more visible elements and more interesting returning process to encourage badge return bucket usage.

  
#Hypothesis 3# 
.Time spent by the concierges asking for caregivers or visitors' visiting increase time for each individual check-in, and thus decrease the overall line moving speed.

#Concept# Standardized Workflow
A sacrifice concept to explore the possibility of reduce unnecessary repeated conversations and shrinking individual check-in time.






Sprint 2 | Find the common Pain Point


In sprint 2 we got the opportunity to talk to the check-in desk concierges. We aimed at finding a connection between caregivers' needs and concierges' needs in this sprint that could lead to a more decisive design direction, since the concepts we generated until this point were all focusing on very small touchpoints.

Research Methods

#5 Concierges# At the beginning of sprint 2, we finally got the opportunity to talk to the check-in desk concierges, who were also important users of the check-in experience.

#Concept Testings# We brought our 3 concepts to test them with the concierges, in order to test if our hypotheses were true and gather their feedback on the concepts.

#In-depth Interviews# Along with the concept testings, we conducted in-depth interviews with the concierges as well, by using the concepts as the conversation starters, to seek for design opportunities from their perspective.

Outcomes

#2 Iterated Concepts# for 2 DIfferent Touchpoints

#Concierge Tasks Framework#

#Concierges' Main Pain Point#

#Final Design Direction#

#Main Concept# for the Whole Experience


With the Surprise We Brought to Them, We Learnt Their Thoughts


The first two concepts, Calling for the Next Light and Dolphin Feeding Badge Return Bucket , received very positive feedback from the concierges. Feedback for the third concept Standardized Workflow faulcified our third hypothesis, but triggered many valuable conversations and pushed us to further explore the cause behind low efficiency.

#Results# Calling for the Next Light
Concierges were surprised by this concept. Many of them said they never realized that the "calling for the next" process could be improved, until they saw this concept. We were so happy that the concierges loved the concept. Meanwhile, the fact that they had been accustomed to such an obvious inconvenience ensured us that by deeper conversations with them, we could uncover more insightful opportunities. Additionally, the concierges also reminded us that, because their workstations were arranged along the round shape of the check-in desk, the lights above their heads may be difficult to see for people in the queue.

#Iterated concept# Cylinder Calling for the Next Light
Based on the feedback, we later iterated the concept by changing the light shape to a cylinder that could be seen in all directions. The improved Calling for the Next Light was retained as an important touchpoint of the whole experience design.

   
#Results# Dolphin Feeding Badge Return Bucket
Concierges confirmed our hypothesis that badge returning had become an extra burden to their already heavy workload. Concierges also lively showed us another pain point of the current badge return bucket. Because of the poorly design of the bucket, collecting the returned badges from the bucket was also very hard. 
When concierges opened the bucket, a lot of badges fell directly from the bucket to the ground, thus concierges had to picked them one by one from floor.

#Iterated concept# Dolphin Feeding Badge Return Bucket with Inner Drawer
This concept was also iterated based on the feedback we got. A wheeled inner drawer was added to simplify badge collecting to a single step process. This was also retained as an important touchpoint of the whole experience design.


#Results# Standardized Workflow
Conversations triggered by this concept all led to one fact: the individual check-in time is unshrinkable. Concierges all talked about how their conversation flow was designed avoid unnecessary repeatedness. Our third hypothesis was falsified. However, the valuable conversations triggered by this concept provided us a fresh view on the check-in experience from the concierges' perspective.



Despite the Stresses, They Love What They Do


Our most intuitive feeling during the interviews with concierges was that though the work caused a lot of stress, they really love what they do. The tasks concierges need to take at work can be synthesized to a 2x2 framework of difficulty of completion and their moods related:

We noticed that tasks fell into Quadrant I and IV were all about providing direct help in person to people, while tasks in Quadrant II were more tedious must-do tasks. The only data point in Quadrant III: Visually See the Long Line was described as the most stressful thing they had to face everyday. 

This 2x2 framework of concierges' feeling and attitudes towards their job helped us see 3 clear design opportunities of the check-in experience from the concierges' perspective:

#Design OPPORTUNITIES# For Concierges
• Improve the experiences in Quadrant II
• Enhance the experiences in Quadrant I and IV
• Resolve the problems in Quadrant III 

We were happy that the tested concepts Calling for the Next Light and Dolphin Feeding Badge Return Bucket the their iterations exactly improved the Quadrant II experiences. But then the following challenge we decided to face was to resolve the problems in Quadrant III:

#concierges' Pain Point# Visually Seeing the Long Line​​​​​​​​​​​​​​



The True Reasons Behind the Common Pain Point


At this moment we were so lucky to find that the concierges and the caregivers were sharing the same pain point: the long line. Aiming at solving this common pain point, which we believed should be the key of the whole project, we digged deeper into the real reason behind the long line based on all the research and testings up to that time. 3 key reasons were identified:


Of the 3 causes of the long line, we noticed the only one that we could see design opportunity: single line option. We decided to modify our design direction focusing on resolving this problem while meeting other user needs in the same time.

#Final Design Direction# Create an Additional Check-in Lane
HOW MIGHT WE create an additional check-in lane that can largely shorten the current check-in line.





Design for Some, Benefit All


By the end of Sprint 2, focusing on our final design direction and based on all the research done by then, we generated a completely new concept that set the tone of our last 2 sprints. 

#Concept# Outpatient Only Self-check-in Lane

#TOUCHPOINT# Self-check-In Kiosk
Our client stated that they would prefer a new check-in experience without additional labor costing. Self-check-in kiosk is a good choice for labor saving

#TOUCHPOINT# Concierges' 1 to Multiple Assistance
Machine mistakes are always avoidable. By adding human assistance from concierges can provide concierges opportunities of tasks they prefer to do.

#TOUCHPOINT# QR Code on Confirmation Letters:
Code scanning is the most efficient and feasible method for identity check in self-check-in kiosks. The digital and physical confirmations letters which are existing touchpoints in the current experiences are great media to carry the codes.

#WHY Outpatient Caregivers#
• Outpatients and their caregivers take 70%-80% of total Lurie daily visiting population
• Outpatients check-in procedure is simple and concise compare to  visitors and inpatients
• Outpatients visiting instructions are highly standardized compared to visitors and inpatients
• Outpatients and their caregivers have less emotional attachment to the hospital than inpatients

#TOUCHPOINT# Cylinder Calling for the Next Light

#TOUCHPOINT# Dolphin Feeding Badge Return Bucket with Inner Drawer

The two iterated initial concepts were integrated to the main concepts as important touchpoints. 




Sprint 3 | Set the Tone and Start To Build


Goals for sprint 3 were three. To validate previous research results and viability of the main concept with quantitative research methods, to more deeply empathize with the caregivers, and to solidify the main concept.


Research Methods

#Online Survey# Our client expressed concerns on the viability of self-check-in kiosk after reviewing our main concept at the end of sprint 2. Therefore, we decided to use an online survey to study caregivers' attitudes toward self-check-in kiosks and to validate our previous research results as well.
With the kindful help of Lurie Patient Family Experience Department, we distributed an online survey to Lurie's patient care givers. A total 245 responses were gathered.

#Focus Group# In the midpoint of sprint 3, we had the chance to attend Lurie's Family Advisory Board Meeting. There we presented the work we had been doing and conducted a focus group interview with the Board members, who were all Lurie's patient caregivers, to gather their feedback on the concept.

#Service Safari and Competitor Study# We visited the Shirley Ryan Abilitylab in Chicago to study their self-check-in experience and users, as another reference line for our further design and testings.



Outcomes

#Validation of Concept Viability#

#Validation of Research Results#

#Design Principles#

#Main Concept Iteration# 
Needs Revealed Through Data


At the end of sprint 2, our client expressed concerns on the viability of implementing a self-check-in lane, which was completely new for them. Client was wondering about the payback of leverage such technology and effort to built the self-check-in lane. Per the client's feedback, we decided to conduct an online survey to gather user feedback on a larger scale. 

#Survey Design#
The survey aimed at study caregivers' attitudes towards self-check-in and validate our previous research results. The survey was distributed to Lurie's outpatient caregivers with the help of Lurie Patient Family Experience Department. The survey consisted of multiple choices and likelihood questions, focusing on overall check-in experience, check-in waiting time and self-check-in kiosk as well as OR codes adaptabilities. A free-response text box was also provided at the end of the survey. 

#Results and Impact#
After the survey was distributed, a total of 245 responses were received within 2 weeks. The survey results showed that 78.5% of the outpatient caregivers were willing to adapt to a self-check-in lane. 92.9% of the outpatient caregivers were familiar with OR codes and were not objective to use QR codes in the self-check-in process. 88.5% of the outpatient caregivers would arrive early long before their appointment time because of their concern of the check-in waiting time.

The data indicated that our main concept was on a right track that was targeting the needs of most users and could be easily adapted by the them. Meanwhile, the survey results and the number of responses we received completely convinced our client that self-check-in was a direction that worth to be explored. 

#Additional Outcomes#
Most responders utilized the free-response text box to further tell us their thoughts and concerns. 
In addition to their expectations for the potential self-check-in lane, we also harvested many concerns on it. These concerns evolved to the design requirements we kept into considerations moving forward. 

#Design Requirement# Support parking ticket validation in the self-check-in process

#Design Requirement# Provide solutions or alternatives to machine failure conditions

#Design Requirement# Ensure sanitation




All, for Your One


The opportunity to attend the Lurie's Family Advisory Board Meeting provided us a valuable chance to speak directly with real Lurie patient caregivers. We utilized this chance to conduct a focus group interview with them for more feedback on the main concept.

A total of 9 board members attended the meeting, 6 of them were outpatient caregivers. We first presented the work we had been doing to them, then sat down and detailly walked through our main concept with them to ask for their thoughts of the concept.

#Outcomes#
Board members all showed strong interests on the concept. Some of the feedbacks were consistent with the online survey results. Lurie's insistants on its care and love for the patients and caregivers were the for them to choose and trust it. For us as researcher and designer of one of Lurie's experiences, this meant that though we integrated machine elements into the experience, the same warmth and care should be consistent with what the excellent Lurie concierges were offering. Based on this we defined our design principles:

#Design Principles# 



Competitor Study


Before we started to push the concept to further details, we decided to conduct a competitor study of the check-in experience in Shirley Ryan Abilitylab, a physical medicine and rehabilitation research hospital based in Chicago. We were hoping to gain some pointers for our own future work by studying their strengths and weaknesses. We conducted service safari to experience their check-in experience and intercept interviewed their visitors and concierges. Results that inspired us were sorted out.




Concept Iteration


Based on the design requirements, design principles and takeaways from competitor study. We iterated our concept to a more detailed version. 

At this point, Faye and I divided the design work to 2 different parts. I took the primary responsibility of designing the physical touchpoints, while she took the digital touchpoints. Prototypes for the check-in kiosk and UI were built for further testing in sprint 4.






Sprint 4 | Test to Refine



Sprint 4 we mainly focused on prototype usability testings to further iterate the design for each touchpoints.

Research Methods

#In-context Testings# For further iterate the detail features of our touchpoint prototypes, we conducted in-context testings with 10 users


Outcomes

#Iterations# 
• Kiosk height
• Kiosk desktop area
• Kiosk desktop arrangement
• Call for concierge light color
• UI Keyboard Popup
• Badge number selection







Final Design and Impact



The final design was presented to our client through a user journey of how an outpatient caregiver utilizing the outpatient only self-check-in lane to finish the check-in process. Detail explanations of the key touchpoints and the research behind each touchpoints were also presented. 


Client Feedback and My takeaways

#Power of Quant#
Although Faye and I believed that self-service should be the right direction for a large hospital like Lurie, our client had kept showing concerns about the payback of spending resources to implement self-check techniques until being persuaded by the online survey results and the subtleties of our final design. This was the first time I saw the importance of utilizing quantitative research methods to validate qualitative research results, also was the trigger for me to start learning more quantitative research methods and data analyse skills by myself.

#Importance of Research Evidences and Logic#
After we presented the final design, our client mentioned to us something very valuable. She said, as a hospital department that advocates for patients and their families, the hardest part of their job was not finding problems and coming up with solutions, but convincing the hospital and its investors that the investment in the solution would be worthwhile for the hospital. The research and design we presented and the logic and evidences we stated to support the research, she said, were things that she could confidently propose to the hospital and its investors. 

#Begin with Researching the users, End with Convincing the Decision Makers#
The the beginning of improving or providing good user experience is research, while the ending is successfully convincing the decision makers, because the decision makers are the ones who own capabilities to actually deliver the experience to the users. This is something I learnt from talking with Barbara who had worked in the patient experience field for more than decades. It is so important for experience researchers to choose the right way to communicate the research results with decision makers of various backgrounds. Though impactful stories can be very touching, the logic and evidences behind the stories are usually what really matters to many decision makers.

A new bullet point was then added to my research principles: 
Study the audience like the users, then design a story for the audience to communicate users' needs.


User Journey



Check-in Kiosk



Check-in UI



Other Touchpoints






Thanks to

My team partner Faye

Our client Barbara Burke from Lurie Patient-Family Experience


Special Thanks to

All Lurie concierges and patient caregivers who spent their valuable time with us
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