Sprinting to the Forest

We ran a hospital design sprint. It was awesome.

Last week one of my teams did something a bit ‘wild and crazy’ and countercultural. We conducted a design sprint at our hospital, and it was an absolute success.

For the past couple of months, I’ve been working with a small group in the Marketing and Communications department at the University of Vermont Medical Center that has been researching our visitors’ problems with navigation and wayfinding — where they get lost, how staff give directions, where the trouble areas of the hospital are, etc. We’ve learned an enormous amount about how our physical structure, interior and exterior signs, maps, naming conventions, and pre-visit materials may contribute to confusion.

Though we hadn’t yet pulled all of our findings together, there was a global Sprint Week event last week put on by Google Ventures, and we wanted to use this opportunity to push ourselves to prototype and test something — anything. This was a chance to test assumptions and observe the hospital environment and its inhabitants in a different way.

‘Great, we’ll do a design sprint!’ we said (‘we’ being me and Jeremy Beaudry, our hospital’s Design Strategist.)
‘What’s a sprint? You guys and your design jargon’ said our team.

They were right — ‘sprint’ is jargon (from the software development world — wikipedia says ‘a sprint is a get-together of people involved in a project to further a focused development of the project.’) The word ‘design’ also sounded a little scary — how could we design something when we hadn’t finished our research yet? Could this really be helpful so early on in our project? How could we have time to make and test something with actual users in only a week?

The questions and skepticism were good for us — we had to find other words to explain what we wanted to do and why it was valuable. Jeremy and I used terms like ‘design test,’ ‘mini-intervention,’ ‘assumption test,’ and ‘generative research.’ We emphasized that the purpose was really to continue our research — to learn by doing. And we promised our team that it was completely possible to pull this off in a week.

Our team put their trust in us. And thus we kicked off our sprint, which ended up spanning just 3 days.

Day 1 — Tuesday — Ideating

We gathered our core team in a room for an hour. This included me, Jeremy, Alex, Karly, Mike, and Rachel. I had put together a list of ‘big problems’ we had seen in our research, and our team took the first few minutes to agree on the problems, and then each person had 3 votes to place on the problems they thought were most significant.

At the end of voting, Rachel realized that one of the problems was a ‘super problem’ that directly affected all the others. And that was naming.

How we name things can really make or break someone’s ability to find their way. Our medical center has many different buildings, or wings; some are new, some are old. All together, these buildings together comprise two main zones of the hospital — one largely for inpatients, and the other for outpatients (or ‘ambulatory’ patients.) But there are no consistent, official names for these two large zones. Beyond that, the names for certain areas have changed over time, as new construction has changed the contours of the center.

This is our current map — I ain’t knocking it, nor am I knocking our hospital (it’s awesome) — but you can see how the buildings over time have become merged together and might be confusing to traverse.

It can be maze-like inside, and though staff are incredibly helpful and generous with their direction-giving, they tend to use different terms to refer to the same thing. The words they use might depend on how they perceive the space (the long hallway, the airport-looking space, the glass walls,) or how long they’ve worked at the medical center (the midwesterners out there know what I mean — I’m going to call it the Sears Tower until they pry my deep dish from my cold, dead hands.)

Compounding this whole problem is an element of ‘understanding’ — we found in our research that many people who do not work in a medical setting do not know what the terms ‘inpatient’ or ‘outpatient’ mean, much less ‘ambulatory.’ I’m ambulatory when I’m in an ambulance, right? Inpatient means the place where you check in for an appointment?

We felt we had a fairly good understanding of the problem. For the purposes of brainstorming in our meeting, we quickly developed a ‘How might we’ question:

How might we create a naming convention that helps patients understand where they are and where they need to go?

Our team then worked silently and individually, each person creating 10 ideas in 10 minutes. The team was supposed to think blue sky — no idea too crazy. At the end of the 10 minutes, each person presented their ideas, and we grouped duplicates before doing another round of voting.

Some of our ideas, with some of our voting dots, which were actually hand-drawn voting blobs

3 concepts floated to the top:

  • An iconography system (follow icons through the hospital)
  • Use of color as a guide
  • Natural world naming for sections of the hospital

We decided to mash up some version of the 3 of these ideas. Our hour-long meeting was up, and we were pumped for the next day, when we’d get together to develop the idea further.

Day 2 — Wednesday — Refining

Four of us gathered for an hour and a half to start envisioning our prototype and test. We revisited our ‘How might we’ and winning concepts, and spent another 20 minutes silently sketching ideas. Each person then presented again, and from this session we crystallized a plan.

Our quick sketches as we refined our concepts.

We would create a zone system in the hospital based on 3 ecosystems: Mountain, Forest, and River. The Mountain zone would represent the outpatient/ambulatory area, and the Forest zone would represent the more inpatient-oriented area. The River would be the main path that would “flow” between and through these two zones.

‘A river runs through it.’ ‘Float down the lazy river to the forest.’ We could start to really envision it.

The team decided to test this idea in the hospital for a 2-hour duration on the following day. Jeremy modified a hospital map to overlay these ecosystem zones, and he created temporary (yet quite polished-looking) signs to post up within the hospital that would lead visitors between these zones.

Here is a quick overhaul of our floor map, which removed some extraneous info, faded out staff-only areas, and highlighted our 3 ecosystems. It’s soothing on the eyes, IMHO.

The excitement built.

Day 3 — Thursday — Testing

We gathered early at the main level of the hospital. We began putting up signs leading people from the Mountain, along the River, and into the Forest (also colloquially called the ‘old’ part of the hospital, which I am now realizing could be considered an Old Growth Forest — the metaphor is never-ending.)

Jeremy, with his socks matching his shirt.

We felt a little bit rogue. We’d let the important relevant higher-ups know what was going on, but we got a lot of intrigued and amused looks from staff as we placed our signs. We explained what we were doing, and they seemed excited about the concept.

We chose ‘mountain’ for this area of the hospital because it is tall and made of rock.

With all of our signs placed, and having done a final walk-through to ensure we’d covered our path well enough, we placed ourselves near a main entrance with the modified paper maps and a tall sign that said ‘Need directions?’ and waited.

Soon our first visitor in need of directions appeared, and, after determining that they were not in an emergency situation and that they needed to get to the ‘Forest’ zone, we asked them if they would be willing to try out a new way of getting through the hospital. We then followed them through on their journey, and asked for feedback along the way.

Floating down the lazy river in our tubes.

The feedback was very positive. Because this was just a prototype, we were careful to get our testers all the way to their destinations — the map didn’t always get them there. A few quotes from our testers:

“It’s like the outdoors!…the others aren’t having as much fun as us.” — a little boy
“I could have used this yesterday. I needed a GPS.” — a grandma
“That’s perfect. That’s really neat.” — staff from a hard-to-reach area
“Even if you can’t read you can get there!” — older couple

What we learned

  • We considered this concept test successful — we had near universal positive and enthusiastic comments from both visitors and staff. Staff passing by were interested and intrigued, and asked a lot of questions.
  • The metaphor of the natural world was immediately grasped by folks — even those who were not a part of our ‘intervention’ but who saw the signs posted up. The visitors we shadowed seemed confident about getting into the Forest, and they seemed able to locate themselves on the map well as they traveled through, given the environmental cues (the signs we placed.)
  • Doing this quick sprint helped lift our team’s energy, and it got each team member in a mode of learning through action.
  • Our team realized how much we could accomplish through quick rounds of design and testing.
  • Our design test helped get our project out in front of staff, increasing visibility of this particular project and helping to slowly build organizational comfort with this type of experimentation.
  • We’d probably need more than just icons to lead the way: we realized while walking with a woman who did not have good sight that she wasn’t always able to see the next one down the hall. So we may need additional cues.

Our 3-day sprint was a dream-come-true for me. The ability to learn by trying something new and fun with real patients, while working alongside a team of people I like and laugh with — I couldn’t ask for anything better.

Here is a quote from Don Norman in the Future of Design that summarizes some of my thoughts about the importance of this design sprint:

“Designers do their research by designing. Instead of long periods of deep analysis, thought and planning, designers move rapidly to experimentation, to construction of artifacts or new procedures which they use to probe the world relevant to the issue at hand, using the responses as evidence on how to proceed. Instead of deep, abstract thought, it is deep embodied thought, embodied in action, in physical structure, and informed not by abstract principles but by the real evidence of the responses to the probe.”
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