RCN Hackathon Resarch Day
Understanding administrative tasks undertaken by nurses.
When: October 2016
Where: Royal College of Nursing, London
Research Tools: User Journey Maps, Personas
Nurses in the UK find themselves burdened with a large volume of time consuming administrative tasks. I participated in a research day at the Royal College of Nursing (RCN) organised by the XDs. The goal of the research was to prepare for an upcoming hackathon aimed at alleviating some of the most painful areas of nursing administration. I helped facilitate the creation of user journeys and personas for expanding the hackathon brief.
In a research day at RCN, nurses, managers and administrators were asked to help locate key pain points in the routine administrative tasks carried out by nurses in their day-to-day activities. The information gathered is to be used at a two-day hackathon event in late November 2016. The goal of the hackathon is to create prototype solutions to the problems uncovered through research. The research day was organized by the RCN and the XDs, a non-profit group experience designers. My role was to help facilitate the creation of user journeys and personas for expanding the hackathon brief.
Refining the brief
Early discussions with participants focused on explaining the hackathon concept and gathering their initial thoughts on the administrative tasks nurses perform. Participants quickly identified some key areas of concern:
- the volume of admin tasks
- the repetition of admin tasks
- time pressure on nursing staff
- fear of audits
Participants had mixed feelings about whether there was a clear distinction between administrative tasks and clinical care. Because participants are themselves the end-users, we asked them to help us create personas to give to the designers. We were particularly interested to find out about about the kinds of technology participants regularly use because we anticipate this information being a priority in a hackathon context. It turns out that most participants use Apple devices such as iPads and iPhones; solutions hoping to leverage existing devices should be designed for those platforms. Participants were split into three groups and asked to consider different cases in which a patient would receive care from nursing staff: a heart attack, pregnancy, and cancer treatment. These were used to create patient journeys, with a particular focus on the administrative tasks that nurses would have to carry out at each step. While each case presented distinct patient journeys, each with their own challenges, some common themes emerged.
Movement of People and Settings
Moments when patients change settings or when care is handed off to another team emerged as pain points for nurses. For example, a GP’s electronic record system is unlikely to communicate directly with a hospital’s record system. District nurses and other healthcare providers (e.g. McMillan) are also likely to have their own systems. This results in the repetitive collection and entry of patient information. It is likely that this is a pain point for patients as well as nurses.
Different Record Keeping Systems
Participants expressed frustration with the number of different record keeping systems that nursing staff are expected to be familiar with. For example, there may be separate systems for patient health records, the operating theatre, pharmacy, and the hospital booking system. Furthermore, these systems will vary from location to location. Participants seemed to want more standardisation.
Because of the variety of record keeping systems, there is a great deal of unnecessary repetition in the administrative tasks that nurses carry out. The same information must be gathered for multiple systems. This is particularly frustrating due to the time pressures placed on nurses. At the same time, however, it is important to distinguish this from repetition that is necessary to discover if the patient’s situation has changed.
The electronic systems used by nursing staff were described as being ‘unfriendly’ from a user point of view. Cumbersome interfaces coupled with a high volume of repetitive tasks makes the systems themselves a pain point for nurses. Because the systems are difficult to use, it is more challenging to enter information on the go. In some cases, particularly emergency situations, this can mean that nursing staff have to remember information for later entry.
The research day led to a clear focus for the hackathon event: data. The most significant pain points all involve the collection and entry of data in some form. Some of the preliminary solutions discussed included:
- Auto-completing patient data so that it only has to be entered once.
- Physically attaching information to the patient through an electronic device.
- Extracting existing patient information through an interoperability layer.
Based on the information gathered during the research day, it was possible to create a more focused brief around these issues, and present them with sufficient depth for the hackathon teams to develop realistic solutions.