Nurses bear the brunt of the lengthy paperwork required when older people come to hospital. Up to 27 forms on entry- compliance can be affected: Peel
— Jacki Liddle (@jacki_liddle) August 3, 2018
Let me call attention to this part: 27 forms! I’m going to guess that compliance is most definitely affected.
I’m certain that there are very smart, caring people, who are working very hard to ensure that nurses are achieving full compliance in completing the 27 forms. But in those 27 forms, there’s undoubtedly potential for high risk errors, missing data, or just simple mistakes due to the huge volume of other work that nurses do in addition to admission paperwork.
A story about a bank
We recently worked for a bank where we improved a very detailed on-line form used by lenders during a home loan application.
The bank needed lenders to use this form for two reasons. First, to get new customer information in to the bank’s lending management systems. Second, to comply with various data capture regulations that all banks comply with. The bank knew that full compliance was a challenge and that anything less opened up lending and compliance risks.
Bank management told us what they had heard from lenders. To enrich our understanding, we worked the bank to create a timeline of activities so we could understand the place of the form in question in the wider work process. In two hours we covered a conference room wall in post-it notes (some UX cliches are true!) documenting the offical process and various pain points. Just this step was enough to give us a strong indication that it wasn’t the form that was the problem but how the form supported the wider workflow.
We knew we couldn’t change the wider workflow and we couldn’t change the underlying form software. We didn’t yet know what we could change, but at this point in the project we were happy to sit with that uncertainty.
Talking to Lenders
Next, we travelled around Brisbane for a week talking to lenders in bank branches. They showed us how they use the form and what else they were doing in parallel. Going into the field was essential. Where before we suspected there were workarounds, now we could see common workarounds and ones that were unique to different branches.
A Quantitative Turn
We also took System Usability Scale (SUS) measures from all the lenders we met. SUS has been around since 1996 and is a very robust survey with good support in the academic literature. We report SUS measures in a sophisticated way so we can make statistically robust claims about the wider. Triangulating the qualitative and quantitative research allowed us to create a strong evidence to use as we moved into re-designing the form.
Using evidence in a re-design
Because we had spoken with a wide variety of lenders, we knew which specific challenges they faced in each field on the form.
- Sometimes the language the form used was ambiguous, leading to poor quality or inconsistent answers.
- Sometimes the sort of answer the form required was too restricted to represent the range of answers customers give.
- Sometimes the question came in the wrong place in the form, requiring lenders and customers to flip back and forth through the form which wastes time and can lead to other questions being missed.
- Sometimes incomplete answers on the lending form had follow-on effects later in the process.
Working within the constraints we faced, we redesigned the form and took it back to lenders. We had the lenders use our new form and again collected qualitative and quantitative data from them. We produced statistical evidence of the improvement as well as rigorously analysed qualitative feedback.
The bank was very pleased with our re-design which is currently working its way through to implementation. Because we collected data before our re-design and after, the bank now has a way to keep verifying that the change persists.
All organisations face these problems
Organisations often change faster than their forms. Over time, the divergence becomes more problematic. The bank was facing a compliance and regulatory risk of lenders not using the form as they became more disgruntled with it. Our evidence based re-design greatly reduced that risk by re-aligning the form, the work process, and the wider policy.
User experience design helps make work better
Work is comprised of more than just forms. There are important underlying systems, policies that are implemented to comply with legislation or to enact best practice. But there are also, always, parts of work that can change.
When we work with organisations, we conduct research to understand which parts of work processes are necessary and which parts can be changed. Then we bring design expertise to bear on creating effective change. And then we gather robust qualitative and quantitative evidence show that how that change made a difference.
If you or your organisation has a challenge like the bank, or like Nancye Peel’s twenty-seven forms problem, you might need a user experience team who can gather data and create an evidence based change in your work environment that reduces risk and increases compliance. Get in touch.