Creating a support system for pre-surgical patients, in order to relieve stress.
This iOS app helps connect pre-surgical patients with individuals who are currently undergoing, or have undergone similar procedures. This gives patients a better idea of what to expect, helping them manage pre-surgical stress and improve their post-surgery outcomes.
Project Type: Academic
Timeline: 3 weeks
Roles: UX Researcher, UX Designer
Tools: Figma, InVision
Conduct research that builds an understanding of patient experiences for an initiative aimed at improving healthcare. The initiative aims to place people and patients at the center of healthcare by more deeply understanding patient needs and experiences, while improving patient outcomes. Based on your research insights, explore a potential digital solution.
To tackle this challenge, I followed a design-thinking framework. This user-centered approach is non-linear and allows for innovation through multiple rounds of feedback and iteration.
The perioperative period can be a stressful time for patients. A growing body of research suggests that preoperative educational efforts, related to improving nutrition, exercise and well-being, can boost not only patients’ personal experiences, but their physical recovery as well (Weiner, 2019). Understanding pre-operative patient needs is crucial to ensure that patients receive the support they need.
Psychological factors, such as anxiety, depression, and catastrophizing can contribute to negative post-operative outcomes, including increased pain. Post surgical pain delays recovery and discharge (Khan et al., 2011).
Stress management training pre-operation was found to reduce depression and fatigue during the post-surgical period in breast cancer surgery patients (Garssen et al., 2013).
The ERAS (Enhanced Recovery After Surgery) society provides tailored guidelines to optimize patient health before surgery.
Following these guidelines improves clinical outcomes and patient satisfaction, proving that it’s worth investing in pre-operative patient support.
Pre-admission counseling and education can reduce anxiety and improve post-surgery outcomes.
The way perioperative care is usually done is, I tell a patient in 34 days, I’m going to take out two-thirds of their liver. Then all the patient can do is wait, which can be so challenging psychologically. Now we are giving patients something they can do. We empower them to have some ownership over their outcomes. That really changes the mental model they bring into the operating room.
- Michael Englesbe, MD University of Michigan Medicine
How might we reduce stress in perioperative patients in order to improve their post-operative outcomes?
I believe that patients feel stressed during the perioperative period and don’t have access to resources that could help them manage this stress.
I will know I’m right when I see the following feedback from the market: Post-operative patients report high stress levels before and after surgery.
In order to better understand the perioperative patient experience, I conducted 5 interviews with adult Canadians who had undergone at least 1 surgery in the past 5 years.
After completing the interviews, I compiled a list of pain points, motivations and behaviours expressed by my interviewees. From this list, I identified the following themes and insights:
Patients’ experiences are more positive when they feel listened to and are treated with respect. Trust in healthcare teams eases worry.
Patients view regular visits to their primary doctor as integral to staying healthy, alongside regular exercise and a healthy diet. Living a long life and healthy life is a strong motivator.
Patients conduct independent research before reaching out to their primary doctor. In some cases, independent research occurs because there is a lack of support from healthcare teams.
Perioperative support focused on physical health and doesn’t address other patient needs.
Connecting with friends, family, or peers who went through a similar operation was important for reducing stress and providing emotional support.
I assumed that patients were experiencing significant levels of stress during the perioperative period and didn’t have the resources to manage their stress.
However, my primary research suggests while users do experience stress, they’re able to manage it. In particular, speaking with friends and family who have undergone similar procedures makes patients feel supported and helps to reduce stress and worry.
I took the information I gathered during the interview stage and synthesized it to create a persona. This allowed me to keep my users’ perspective at the forefront of my design process.
After creating my persona, I revisited my design challenge and initial "How Might We." Before conducting primary research, I assumed that patients were experiencing significant levels of stress during the perioperative period and didn’t have the resources to manage their stress.
I found that while patients do experience stress, they’re able to manage it. In particular, speaking with friends and family who have undergone similar procedures makes patients feel supported and helps to reduce stress and worry. Patients want an easier way to connect with peers who have undergone similar procedures.
How might we connect preoperative patients to peers who have undergone similar procedures in order to provide additional support?
With my revised HMW in mind, I began authoring user stories to identify the main tasks that my users might want to perform.
I selected “Chat with a Peer” as the core epic because my users told me that this was the most effective way to manage pre-operative stress. Users found comfort in hearing about their procedure from a patient point of view. In some cases, users may have a hard time finding peers who have undergone a similar procedure, so designing a solution that addresses this challenge could have a large impact.
Epic: Chat with a Peer
Persona: Pre-operative Patient
Main Task: Message a Peer
Subtasks: Complete Questionnaire, Review Search Results
As a pre-operative patient:
After creating my task flow, I was ready to start sketching out low-fidelity solutions. I created a UI inspiration board using InVision and drew inspiration from a variety of sources, including other medical apps such as OpenCare.
I selected the most compelling exploratory sketches, based on their adherence to my users' existing mental models, and translated them to wireframes. I started with lo-fi wireframes, and after adding copy, completed my mid-fidelity prototype which was ready for user testing.
In order to ensure that my designs were intuitive for users, I conducted 1 round of usability testing, with 5 users. This gave me the opportunity to obtain practical, real-time feedback, which I incorporated into my designs.
Users were given the following scenario:
You’re a pre-operative patient and your scheduled surgery is coming up. You’re feeling a little nervous and you want to better understand all aspects of your upcoming surgery in order to feel more prepared. You can assume that you’ve already signed up for the app and provided information about the type of surgery you’ll be receiving, your location and other relevant details.
Problem: When users tapped “Start Over” (either accidentally or out of curiosity) their previous search was immediately lost, which lead to frustration.
Solution: a) I applied a primary button style to “Resume” and a secondary button style to “Start Over” in order to prevent accidental taps.
b) I added a confirmation modal, which is displayed when users tap "start over" to prevent errors.
Problem: Users were scanning questions and didn’t always understand what was being asked. Additionally, they felt like there were unnecessary taps and that the process could be more efficient.
Solution: In order to draw users’ attention to the question, I increased the font size. I also included a “Help” button, so that when users don’t understand the question they can read additional details to help them answer. Finally, if users don’t have a preference, the main button will display “Doesn’t Matter.” If the user does make a selection, the button text reads “Next.”
One round of user testing highlighted the most pressing usability issues, however it’s important to test my revisions to ensure they’re appropriate solutions. I would like to conduct additional rounds of user testing with pre-operative patients to understand if their needs are being met.
I’ve focused on the experience of a pre-operative patient, but in order to connect with peers I need to consider the experience of post-operative patients as well. Their experience with this app would look different, and therefore require additional primary research, persona development, and ideation.