A client project @General Assembly to optimise medical staff recruitment (and possibly save the NHS billions in the process)
Despite boasting the world’s fifth largest workforce (one behind McDonald’s), staff shortages remain a chronic ailment of the NHS. In 2015 it emerged that £ billions were being spent on recruitment agencies to fill gaps, with the media spotlight falling on temporary (locum) doctors pocketing eye-watering sums to work hourly shifts. Ever since, health trusts have been under considerable pressure to reduce spending on agency staff, with mixed results so far.
Enter our client: Circular Wave. Founded by James Foxlee, a doctor exasperated with dysfunctional NHS recruitment, Circular Wave provides a platform for NHS trusts to manage their own staff more effectively. This allows free movement of registered doctors between hospitals without recourse to expensive agencies.
Like many start-ups, CW had nailed their core functionality or Minimum Viable Product — a desktop platform for trusts to advertise shifts and an app for doctors to search and apply for them — but had not had the time or resources to perfect the user experience.
Our team of three UX Design students at General Assembly was briefed to improve the interface of their smartphone app, specifically the “My Availability” feature where candidates could block out dates on which they were unavailable, hence avoiding irrelevant notifications.
“ Our experience has to be lightning fast and intuitive for candidates. If we don’t get the experiences right we will lose users. James Foxlee, Co-Founder Circular Wave
First we did a screen-by-screen audit of the current Circular Wave app and compared it with both direct and indirect competitors (ranging from shift management platforms to phone calendar apps). Though this gave us an overview of the market, it yielded little information that could deliver directly on the brief without speaking to users.
To complicate matters, the NHS staff using the current app were located over 250 miles away in northeast England and we had no time to schedule phone interviews or visit them in person. Thankfully, one of our team, Jessie, a doctor herself, had begun texting her medic friends as soon as we had been given the brief.
Tracking down these contacts saw us visit three teaching hospitals (and admittedly several pubs) across the capital where junior doctors agreed to be user interviewed. As well as answering open questions on shift booking and time management, we asked them to carry out a number of tasks using the existing app, including booking a day shift and inputting dates on which they were unavailable.
Using affinity mapping to explore the responses revealed two key findings:
1) Circular Wave’s MVP “worked” for the majority of doctors who did variable shifts; it saved them time calling and emailing admin staff at hospitals and allowed them to select shifts in advance.
2) None of the doctors saw the value of the “My Availability” feature, designed to deselect days on which they were unavailable.
In fact, there was a clear preference to “pick and choose” from a long list of hospital shifts. Junior doctors in particular were keen to select from a range of specialties to broaden their experience.
There were four main pain points surrounding the user interface of the app 1) confusion over the My Availability calendar which appeared to duplicate the shift calendar, 2) difficult to read calendar icons, 3) unclear confirmation messages and 4) no option to add a booking to a phone calendar.
Taking a pivot on the brief
While we could understand our client’s intentions –avoiding pestering doctors with irrelevant notifications– our research had showed essentially the opposite. Users wanted a full selection of shifts and a clear way of booking them (and avoiding accidentally booking them) and seeing whether or not they were confirmed, pending or available.
We agreed with Circular Wave to pursue a new direction, using the statement “How might we make booking shifts clear and visible to users”.
Designing a solution
A half-day design studio created several ideas to take further. One was to combine the list view and calendar view onto one screen to avoid users having to track between different calendars. This evolved into a new home screen with a three-button menu allowing users to tab between available shifts and shifts they had confirmed or applied for.
After a prolonged debate among the team ;), we opted to base our calendar design on the Google Calendar app. The reasoning was that Google offered an API that Circular Wave’s developers could integrate and overall its design displayed events (in our case medical shifts) more effectively than for example Apple or Samsung’s calendars. For more on the calendar wars try here!
After testing with a paper prototype we found that the three-button menu at the base of the screen could be simplified to two without losing significant functionality. It also removed any hard-to-reach areas in the all-important “thumb zone” of the app. Adding colour at mid to high-fidelity allowed us to distinguish booked (blue blocks) and applied for (blue border) shifts clearly in both calendar and list view.
The next pain points to address was the unclear shift booking flow and the lack of integration with users’ calendars. To do this we added a clear state change to the buttons and additional pop-ups to both confirm sending your application to the hospital and adding the date to your phone calendar. A red colour was added to the withdraw button to imply that this was not something to tap casually (doctors had expressed concern that accidentally pulling out of jobs would be affect their reputation with hospitals).
We then retested the app with the two junior doctors and three non-medical volunteers (just scraping the Nielsen minimum of five users). Using a rainbow spreadsheet to track the feedback we found negligible differences between the two groups which hinted that the app was intuitive enough for a wide range of users.
The main issues concerned moving between months in the calendar (unclear to those who were not native users of Google Calendar) and whether to display all available shifts in the calendar as well as the list (though we felt this would clutter the design badly). Overall we felt confident enough to present the high-fidelity prototype and our research findings back to Circular Wave in a 20-minute presentation.
Client feedback and conclusions
We received a positive response from the client, who were impressed and, in some cases, surprised by what doctors had to say about their app. Up until now their team had operated in classic start-up mode, removing bugs and responding to error reports from users while fundamentally leaving the UI alone. The benefit of a relatively short UX audit were clear.
We were blown away by the quality of work that was produced by the UX team, but more importantly by the way they had gone about producing it. James Foxlee, Co-Founder Circular Wave
As a UX team we learnt that you shouldn’t be afraid to question a brief, so long as you have the research to back it up and a way of explaining the benefit to the client.
I’d like to thank Circular Wave for being so open-minded and allowing us to work on their “baby” (and big love to my fellow team members, Jessie Ke and David Lang!). Here’s hoping more NHS Trusts see the benefit of making life easier for their doctors with some simple health tech.