I designed a pre-op education module that helps orthopedic patients prepare for their surgeries.
Background
An important goal in the world of orthopedics is to ensure that pre-operative patients are adequately prepared for surgery. A common method employed to this end is the pre-op joint education class. The specifics of the class can vary across organizations, but generally speaking, it’s an hour-long informational session taught onsite at the hospital by a resident nurse. The lesson touches upon a variety of surgery-related subjects, such as how to bathe a wound post-operatively, what to bring on the day of surgery, and the importance of having a care partner. It’s imperative that patients attend these sessions, as studies have shown that these more “optimized” patients are more likely to have positive surgical outcomes.
However, pre-op education is not without it’s challenges. This is in large part due to the limitations of the class’s in-person format, many of which were communicated to Force’s product team by the providers at Northside Hospital in Atlanta in early 2019. They said that, while teaching onsite has its advantages, there are a host of difficulties, including low attendance rates for patients who live far away, difficulty measuring patient comprehension of course material, and inability to scale.
After hearing these challenges, I huddled with Force’s product team to review what we had learned. We agreed that the while the problems the providers at Northside were facing seemed to offer an opportunity for design intervention, there was still a lot that we didn’t know about the problem space: who are the patients? What are their motivations for taking an orthopedic education class? What do they not like or find frustrating about the experience? We recorded these questions, among others, and began making plans for discovery.
My Role
The project team consisted of a user researcher, a product manager, and myself. Along with conducting user research, my responsibilities included information architecture, UX and product strategy, ideation, wireframing, and front-end design.
Research
To learn more about the onsite class, we broke up our research into two distinct methods:
First, we interviewed fifteen patients who either had attended or were scheduled to attend the class. During these conversations we tried to uncover specific details about the patients’ challenges, goals, and routines, as we hoped these insights would help inform our solutions.
Second, we conducted an ethnographic study of a pre-op class at Lenox Hill Hospital, in New York. We opted for discretion, sitting at the back of the room and observing as Lenox Hill’s resident nurse educator led an hour-long session for a few dozen pre-op patients. Witnessing this process in person was an invaluable discovery tool, as we were able to observe small, albeit significant nuances of the onsite experience. We took stock of facial expressions, body language, and behaviors (notably, one of the patients was playing Candy Crush on her phone during the lesson). These details helped paint a richer, more human-centered portrait of the problem space.
Definition
We wanted to make sure that all of our insights from this initial round of research were documented in a way that preserved our focus on the end-users, and aligned other stakeholders on the users’ core goals and challenges. So after we regrouped and mapped out our findings, I created three goal-directed personas representing pre- and post-op orthopedic patients. Our primary persona, Steve, embodies the majority of users we interacted with. He looks forward to having surgery so he can “get his life back,” but is skeptical that a pre-op joint class is really necessary.
Next, we mapped out Steve’s journey from his initial decision to undergo surgery to attending the class, highlighting his prominent behaviors and emotions at each step in the process. We expanded on his feelings of skepticism, but also emphasized his trust in the class instructor, since this was a recurring sentiment during our interviews. A few patients even suggested that the perceived trustworthiness of the instructor eased their anxiety toward the surgery, and also enhanced the credibility of the curriculum.
Next, having defined some of the key traits of our target users, we synthesized the raw data from our research and extracted a few problem statements to use as a springboard for ideation:
Pre-op patients perceive joint education class to be a non-essential part of their care plan
Pre-op patients consult a variety of unverified, non-clinical resources for info before surgery
Pre-op patients do not know what to expect from class, which is an added source of pre-op anxiety.
Ideation
With the core problems defined, it was time to brainstorm possible solutions. For this session, I looped in a cross-functional team of representatives from engineering, marketing, and product, all of whom offered their own unique perspectives on the problem space, and apprised us of relevant technical and operational constraints to consider before proceeding with design.
The session was extremely productive, yielding many strong ideas. We debated their relative merits, held a vote, and ultimately landed on three proposed solutions that I would incorporate into a prototype to test on our users:
Having the instructor emphasize the class’s importance at the beginning of the module
“Patient Stories,” (testimonials) to mitigate patients seeking third-party info
Itemized syllabus to reduce ambiguity around class, alleviate patient anxiety
Design
An objective I had while creating the initial wireframes was to make the patient’s progress in the course as unambiguous as possible, as I assumed that any confusion there might compel a user to prematurely exit the module in frustration. So to minimize drop-off potential, I designed a side panel UI - a pattern fairly common in e-learning platforms - to guide users throughout the course sequence. I also aimed to make the media content front-and-center, while still maintaining a clear hierarchy of information.
After establishing the module’s basic layout and flow, I added Force branding so that we could test the design in high-fidelity.
Test
We tested an initial prototype of the class module with five orthopedic patients, all of whom were Force users. In these first tests, were were looking to measure:
How well users understood where they were in the progress of the course
How intuitive the quiz experience is
Users’ general feelings toward the “Patient Stories” feature
User understanding of the importance of the course as it relates to their post-op success
Results
The prototype performed well, meeting the majority of our key usability criteria.
However, there was one major usability hiccup that needed to be addressed:
The majority of participants, when asked to which page they might be taken after clicking the “Continue” button on the quiz page, said they would be taken to the next section of the course. In actuality, clicking the button takes the user to the next quiz question. This error was problematic because, as I discovered during our interviews, any ambiguity around the pre-op experience, no matter how seemingly trivial, could be a potential source of anxiety for patients.
So after this first round of testing, I returned to my designs and tweaked the button copy on the quiz, replacing the generic and ambiguous “Continue” with more specific language.
Before
After
Fortunately the iterations paid off, as each participant in the next round of usability tests was able to correctly anticipate where they would be taken after clicking the button.
Introducing Force Pre-Op Joint Education
Next Steps
The module launched on the provider-facing platform in October, and we’ve been busy tracking its analytics with an emphasis on the following metrics:
% correct answers per quiz question
Time spent on each quiz question
Course attendance
Course completion rate
Engagement with “Patient Stories”
At the same time, we’ll be periodically soliciting user feedback to see if the new solution is effectively addressing any of the original pain points related to patient indifference and anxiety toward the class.
This was an exciting and deeply challenging project, and I’m hopeful that the end result will make pre-op education a little easier for patients and providers.