A case study on the perioperative experience.

The focus of this study is on the patient’s experience throughout the perioperative process: the period around the time of a surgical operation. From 2018 to 2019, there were over 100,000 caesarean section delivery surgeries and around 75,000 knee replacement surgeries conducted in Canada. These two common surgeries highlight how many individuals are going through the surgical or perioperative process each year.

A study by Goldsmith, L.J., Suryaprakash, N., Randall, E. et al. found that patients who didn’t receive adequate informational, clinical or personal support reported having a more negative perioperative experience than other surgical patients. Although surgeons were perceived as important sources of information, many patients felt that their surgeon did not provide the type of information that they actually wanted to know.

This research piqued my interest becaue it was more qualitative and highlighted the emotional aspects of the patient’s experience. I used this information to create a question that would help direct my efforts throughout my design process.

How might we provide better quality support to surgical patients going through the perioperative process in order to decrease feelings of anxiety and fear?

UX Research

In order to answer this question I conducted 10 interviews with individuals who had gone through a perioperative experience. I developed a research strategy by listing my assumptions, creating a hypothesis and then structering questions to uncover pain points and frustrations. Some of the questions I asked throughout my interviews were:

  • What thoughts crossed your mind while in the surgery preparation room?
  • What was your first reaction after the anaesthesia wore off?
  • What was your relationship like with your specialists/surgeon?

Findings and Analysis

Although I created a persona and journey map, I had been working on this project on and off again for some time and needed both a refresh and a deeper understanding. My journey map had alot of information, but I needed to narrow the focus of my project. This is why I decided to create a moodboard with images that I felt represented each theme and encapsulated the patient’s experience. It helped me to better emphathize with my end user’s experience.

Gaining empathy for the end-user and contemplating each theme

1. Patient’s don’t realize the vulnerability and physical exposure involved in the perioperative process often making them neglect the importance of having social support.

Photo by National Cancer Institute on Unsplash/Photo by Ava Sol on Unsplash

3. The quality of patient care greatly decreases during post-op and recovery.

Photo by Ava Sol on Unsplash

5. Patients are not aware of how serious surgery really is and the impact it will have on them both physically and mentally.

Photo by Günter Valda on Unsplash

I discovered that I could also summarize these themes into a few major insights:

Patients want to be given choices.
Patients want to understand the choices provided.
Patients want to have those choices respected.

I created user stories for each of my themes, prioritized which ones would make the greatest impact and then created task flows.

User Stories that were most impactful
Task flow for choosing a procedure

After creating flows and user stories, I started sketching out concepts, developed wireframes and then conducted user testing which allowed me to make some major iterations. If I had more time, I would have conducted another round of testing, but as this was a conceptual prototype, I decided to move on to prototyping.

High-Fidelity Prototype

Foresight is an app that guides patients through the surgical process from diagnosis to recovery.

The timeline feature shows patients what to expect throughout their surgical process. The information incorporated into this feature will help patients with planning, asking their doctor questions and understanding what kind of support they may need at each step of the process. It was important to add visuals to help communicate all of this information while highlighting opportunities for patients to exercise their agency.

When patients click into an event, they are able to see checklists or “kits” that suggest a short list of items that may help the patient better prepare for wherever they are in the process. “Common questions” is where patients can see questions that are commonly asked so that they can better advocate for themselves. They can also create their own questions by clicking on the floating action button in the global navigation.

I felt that both the questions and timeline feature combined were the primary feature of this application because they really depended on the other in order to have the effect that I was going for: increasing patient’s knowledge of what to expect throughout the process so that they can make more informed choices, advocate for themselves, and feel more prepared.

Questions + Lists

Users can view the lists they have created which are organized by the doctor that they are meant for. When a user adds a question in the application, they are asked to choose which doctor this questions is for. If a user chose “surgeon”, then their question would be added to their “surgeon” list “.

Once a list is created, the user has the option to schedule a notification so that they can be reminded of their list of questions at their next appointment with that doctor. They can schedule a notification by connecting to an external calendar so that their list of questions is sent to them by notification as they are heading to their appointment (depending on their preferences). This enables the patient to better advocate for themselves throughout the process.

Social Community + Support

In the social feature, users can view other patients’ experiences within a social feed that is organized similarly to the timeline feature. Users can view social posts associated with either pre-operation, surgery day or post-operation. I did this so that the user could view information relevant to where they are currently in the process.

Patients can indicate if they have found a particular post helpful by clicking on an icon at the bottom of each post. They can sort their feeds so that the posts that other users have found to be most helpful float to the top of the feed.

Next Steps

A potential use of this project could involve giving surgeons access to this application so that they can input more personalized timeline events and provide better support and care to their patients throughout their surgical process. A surgeon could provide even greater detail to the timeline feature. For instance they could show a patient who would be in the operating room on the day of surgery, making the patient feel more at ease during the surgical preparation period.

I also believe that the solution would be even more impactful if it was created collaboratively with healthcare professionals. If I had more resources and access, I would like to have collaborated with healthcare staff who are part of the patient’s experience throughout this process and ideate on potential solutions that were not limited by a digital scope. Hopefully services and products continue to be made in order to increase patient’s feelings of agency and dignity throughout this process as I believe it will positively impact both patients and doctors alike.

UX Designer with a background in psychology and linguistics