As part of the Contextual Inquiry and Project Management course, my group worked with the University of Michigan Hospital's Emergency Notification System on a project to improve their processes, which are chaotic and frequently run over cost. Specifically, we focused on the Code D, which is an event in which more than 5 injured patients are expected to be arriving at once at the hospital. The Code D is the most complicated of the emergency notification processes the hospital used and it was our hope and the client's hope that improvements recommended for this system would be applicable to other processes.
As the most senior member of our group, and the member with the most real-world work experience, including previous user research experience, I was unanimously chosen to take on a leadership role and guide our group through the contextual inquiry process. As project manager, I made sure that we had regular weekly meetings, assigned fixed roles to other members, and that we stayed on track by providing weekly agendas.
My group interviewed seven different people involved in the Code D process, which included employees of four different but connected organizations (the hospital, emergency management, the paging group, and the women and children's hospital). After each interview our group organized our rough field notes into affinity notes. We used these notes to create a large wall-sized affinity diagram, a tool for organizing and making sense of large sets of ethnographic data.
Click here to explore the affinity wall at full size.
I used data from the affinity wall and from the interview interpretation sessions to create rough visual models on whiteboards to cover different aspects of the organization.
One of my responsibilities was to create the final version of the most important model for our project: the sequence model, which I decided to do as a swimming lane model in OmniGraffle. This model shows the flow of a Code D, from start to finish, with all involved parties, when they get involved with the process, when they leave, and how they involve other parties in the process.
Click the image above to see the full, scrollable version
In addition to the swimming lane, I created the combined cultural model, and contributed to the communication flow, the physical model, the cultural assessment, and the artifact model.
After examining the process, I decided that the problems with the Code D stemmed mostly from a lack of preparation, and not from breakdowns within the process itself. I discovered that the main bottleneck was the fact that only one person was in charge of maintaining and organizing the entire process, and this person was extremely overburdened.
My recommendations were to hire additional Emergency Management employees, and if that was not possible, to at least explore disciplines such as the MBA program to find interns and part time employees, in the hopes of finding more qualified help for Emergency Management. I also recommended implementing an automated notification system, such as the one currently used by the University of Michigan proper, as this would reduce much of the human error inherent in the process.
I discovered during our inquiry that when the paging group received the contact list for Code D, they physically tore the list in half and gave it to two different paging operators, because it was too long for one operator to handle in a timely fashion. This caused a variety of problems, and one recommendation was that the list be pre-split by Emergency Management before being given to the paging group. This is an example of a very small change, but one with wide-reaching positive consequences, and one that would not have been discovered without my evaluation.
My final recommendation was to implement online training programs, so that doctors and other busy emergency professionals could receive much-needed additional training on their own time, without straining hospital time and financial resources.
My recommendations were well-received, and according to our client liaison, several of them are going to be implemented immediately. My final presentation was given to the client liason and again to the board of directors of the hospital after the client was extremely impressed.