Hospital Quality Reporting (HQR) Service Design Case Study

Objective

To develop a holistic view of program touchpoints, both online and offline, visible and invisible to the customer, in a service-oriented framework. These visuals will allow HQR stakeholders to:

• Better understand that our products as multifaceted services – enabling better outcomes for users and patients
• Ground the team in foundational understanding of the system and the main user journeys – enabling us to deliver faster
• Enhance a shared understanding as we learn more – through living documents

Problem

HQR stakeholders lacked a shared understanding of the comprehensive HQR customer experience, including digital and offline services. At times, this lack of context put decision makers at a disadvantage and led to siloed planning and prioritization of human-centered design and development work. 

Goals

Leverage human-centered design research methodologies to illustrate how the existing customer experience maps to HQR touchpoints by:

• Developing a service blueprint that focuses on the front-end components, the back-end components that support them, and the touchpoints between the two.
• Developing journey maps to illustrate the steps a user may take to interact with HQR, their goals, the challenges they face, and how they feel throughout the journey. Focus on three different product areas (Quality Improvement, Security & Access, Data Submissions).

Stakeholders

HQR Application Development Organization (ADO)

• Lesley Humphreys, HCD Lead with Bellese
• Tyreek Houston, UX Researcher with Ad Hoc
• Fan Huang, UX Researcher with Ad Hoc

Interview Participants (titles and organization types only to respect anonymity)

• Quality Coordinator, Hospital
• Senior Director of Quality Data, Hospital System
• Quality Nurse Reviewer, Hospital
• Meaningful Use Project Manager, Hospital System
• Quality HQR Reporting, Hospital
• Quality Manager, Hospital System

HQR Community and Management

Approach

(EXAMPLE) We used our HCD process to structure our research and design activities. This process continuously evaluates the user experience and engagement so that all work completed is focused on improving design and providing value to customers and end users. There are 4 total stages, and within each stage is multiple phases where HCD activities take place to support the goals of that phase.

• Strategize phase: We prepared a research strategy which included what type of research studies we would conduct and why, and what artifacts would come out of each study. We discovered the end user's needs, pain points, and challenges through secondary/existing research, a heuristic evaluation of PRS 1.0, areas for improvement, and user interviews.
• Design phase: We ideated new solutions to address our problem statements via wireframes and created low-fidelty prototypes to test and evaluate with PRS 1.0 users. Simultaneously we conducted card sorts and surveys to help prioritize features and validate user needs.
• Customer Engagement & Experience Improvement Cycle: Throughout each activity there has been multiple collaboration and analysis sessions with the internal team and CMS stakeholders. We leveraged Miro, an online whiteboarding tool to facilitate these sessions to document data flows, tabular analysis and user flows.

(Perhaps: Research, Design, Socialization, Implementation)

Methodologies & Activities

• 7 interviews with hospital staff across the country
• Analysis of 3 years of existing HQR customer research
• Data aggregation from multiple studies, tagging for themes and notable information
• Synthesis of customer findings with existing system knowledge, especially for behind-the-scenes insights
• Leverage SAFe Agile framework for the development of service design artifacts
• Socialization with HQR stakeholders and the CCSQ HCD Community of Practice (recording)

Challenges

(EXAMPLE)

• Finding the true picture of data - "we don't know what we don't know"
• Determining the source of truth for the data and who owns the data
• No PRS subject matter expert (SME)
• Many moving parts, dependencies, and availability of key stakeholders
• Lack of prioritization for this effort across dependent ADOs

Results / Metrics

HQR is using these service design artifacts to prioritize roadmaps and create a shared understanding of the HQR customer experience.

What's Next?...

The HQR Human-Centered Design team is now preparing to develop personas, a common component of a service design framework. Personas are fictitious representations of customers based on data. These artifacts provide a customer-centric narratives that complements service blueprints and customer journeys.

The content of this case study was provided by Lesley Humphreys, HQR HCD Lead.

Service Design Artifacts

(Click to enlarge)

HQR Service Blueprint

HQR Journey Map - Quality Improvement

HQR Journey Map - Security + Access

HQR Journey Map - Data submission