What we can learn about UX from the NHS
You arrive off the long-haul flight exhausted but delighted to be at your exotic destination. The baking midday heat slaps you on the face as you leave the plane but you are soon cooled down by the air-con and warmed back up again by the queues in the airport terminal.
You make your way into the bowels of the airport towards the snaking queue for passport control. It looks intimidating. And slow. Certainly, it’s the last thing you need after half a day in the air.
You join the snaking system and as you walk round it you see a sign: “15 minutes”. A little later, another sign: “10 minutes”. Then “5 minutes”, and then you’re through. Of course, you would rather have just walked straight through passport control without a queue, however, the signage offers you a little bit of control, illusory or otherwise.
‘Humans unanimously benefit from knowing where they are in a process and how the process works’
There are few design principles which we dare deem universal (in deference to Jared Spool’s “it depends” mantra). However, humans unanimously benefit – and, subsequently, respond positively – from knowing where they are in a process and how the process works.
One of the best examples of this in action comes from a 2011 project delivered by a UK-based design consortium, and championed by the British Design Council, to explore if incidents of aggression and violence in accident and emergency wards could be reduced by improving the patient experience.
The project set itself lofty goals, including better supporting NHS staff, directly or indirectly reducing incidents of aggression and violence, delivering tangible and measurable cost savings, bolstering staff confidence and, ultimately, providing improved patient care through calmer environments.
Through extensive research, they defined the six key perpetrator characteristics (namely: clinical confusion, frustration, intoxication, anger, distress and isolation) and outlined how NHS staff could identify these early. The research was equally as enlightening in identifying triggers – events that would push an already susceptible individual into a violent incident – many of which focused on process. Examples include lack of progression, perceived inefficiency, inconsistent responses, staff fatigue and intense emotions.
The investment in understanding the problem culminated in the design brief centring on improving the wait (dichotomic as that might sound), improving perceptions and increasing clarity around place and process. In practical terms this meant things like letting people know early how long they were likely be there, giving people information to understand why someone who arrived after them may be seen first, letting people know they were in a process (check-in, triage, detailed assessment, specialist treatment, etc) and helping them understand what happened at each stage and why.
By simply explaining the process to people and effectively communicating rationale to them, the design project was able to reduce incidences of violence and aggression by 50pc.
‘At all times, you must ensure your users know where they’ve come from, what they need to do now, and what happens next’
We see examples of the importance of process in our usability testing and prototyping work all the time. Digital equivalences of the NHS project include:
- Breadcrumbs, to give users a sense of place and structure
- Progress indication, to allow users to understand what separates them from task completion, what is expected of them and what they get in return
- Navigational clarity, with primary, secondary and tertiary menu systems working harmoniously to provide the user with real control over how they move around
- Crystal-clear information hierarchy and content strategy so that the user first sees the stuff that matters most
Steve Krug famously reminds us in his tome Don’t Make Me Think that it’s not the number of clicks in a flow that frustrates a user, it’s the amount of thinking they have to do with each click that cumulatively builds cognitive effort.
A combination of the user’s demand to remain in control of the experience (we hate being sold to but love to buy) and our sense of fairness (we want to ensure the outcome enjoyed is worth more than the time invested) means we make the bold and universal claim that, at all times, you must ensure your users know where they’ve come from, what they need to do now, and what happens next.
By Gareth Dunlop
Gareth Dunlop owns and runs Fathom, a user-experience consultancy that helps ambitious organisations get the most from their digital products by viewing the world from the perspective of their customers. Specialist areas include UX strategy, usability testing, customer journey planning and accessibility. Clients include Three, Bord Bia, Firmus Energy, Kingspan, AIB and Tesco Mobile.
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