Imagine being the person to have to greet someone who just had a series of confusing instructions like these. Then imagine having to be the person to give them more confusing instructions, or to tell them they have to wait an hour, or to have to turn them away…

 

Following the redesign of patient check-in and patient flow systems in an ambulatory care unit, staff satisfaction data were not showing trends as favorable as efficiency metrics.

I was tasked by the clinic’s director to conduct qualitative research on the question to compliment their survey findings through interviews and focus groups with staff.

Skills employed

  • I conducted focus groups with both clerical front desk staff as well as nursing staff. I developed the focus group protocol based on both on questions from leadership and staff satisfaction survey findings.

  • I conducted interviews with administrative and clinical floor leaders, using an interview guide adapted from the focus group protocol.

  • I transcribed and de-identified all findings and results, organized into themes, and translated them into my recommended next steps for clinical leadership.

 Findings and Lessons Learned

What I found from these conversations was fascinating, and both surprising and not surprising at the same time. Many staff members expressed that although the patient flow redesign made their work more streamlined and orderly, how they felt in the clinic was barely affected by these improvements. Satisfaction rates seemed to drop with staff rank, and several staff members expressed that they felt unsafe, exposed, and unsupported not by the operational systems of the floor but by the staff culture.

I wish I had had a design framework at the time, and had been allowed to work on co-designing and testing potential solutions to these team dynamics. Unfortunately this was not the brief I was given, and although my results clearly pointed to team social and cultural dynamics as the fulcrum point of these issues, leadership was looking for quicker fixes. But what this work taught me is that empathy often yields unexpected results. It also taught me that sometimes a project brief will have you set up to find the right solution to the wrong problem.


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