Articles by Category: Area Health Service project

Final website recommendations

Now that the intranet report for the Area Health Service has been reviewed and signed-off, I've had a chance to finish the report on the review of the website. This includes the following recommendations:

Strategic recommendations

• Focus on depth, not breadth
• Comprehensively restructure the website
• Provide complete facility information
• Empower the website administrators
• Use the website to reduce call volumes
• Implement a new content management system

Tactical recommendations

• Maximise the value of the homepage
• Eliminate duplication
• Eliminate ‘happy talk’
• Remove jargon and medical terminology
• Clearly distinguish between the intranet and website

In many ways, this was the easier report to write. In the end, it boiled down to: "Work out what the website is for, and do that well (and nothing else)".

Posted by jamesr at 11:11 AM | Permalink
Categories: Area Health Service project, Information architecture, Web development

Nice to be appreciated

My point of contact at the Area Health Service just sent through (out of the blue) a very nice testimonial on the project:

We are very impressed with the report, its findings and recommendations and that I believe you achieved a finer detail or level in your consultation because of your approach and rapport established with all staff and consumers. So many people commented on the whole consultation process that there was a buzz and I hope there will be a continued interest, but you managed to achieve a level of trust and respect with these people by taking an interest in them, their work and their needs that brought out more information than we had anticipated.

It's been a lot of hard work, but I'm pleased the end result, and it's good to see that my client is too...

Posted by jamesr at 04:32 PM | Permalink
Categories: Area Health Service project

Final intranet recommendations

All I've left to do on the Area Health Service project is to write the executive summary. The major recommendations have now been written, and reviewed. In bullet-form, this is what we identified:

Strategic recommendations

• Integrate the intranet into daily work practices
• Improve intranet resourcing
• Develop a staff directory
• Develop a knowledge-sharing culture
• Broaden the reach of e-mail
• Improve the management of e-mail
• Provide universal web access
• Align with the Balanced Scorecard
• Use storytelling to support organisational change
• Use the intranet to support geographically isolated staff
• Formalise the role of content authors
• Improve transparency of decision making
• Enhance the dissemination of news
• Develop an integrated intranet platform
• Expand the use of the intranet by nursing staff
• Enhance policy information
• Improve staff orientation
• Improve intranet skills of staff

Tactical recommendations

• Replace the search engine
• Improve site structure
• Maximise the value of the homepage
• Restructure key sections
• Define measures for the intranet
• Implement a content management system
• Schedule regular usability testing
• Enhance feedback mechanisms

You'll notice that many of these recommendations extend beyond a direct focus on the intranet, and address cultural and process issues.

This is not just the glib recommendations of a consultant. Instead, all of these have come directly out of the stakeholder interviews or usability testing, and are born from a recognition that the intranet does not sit in isolation of the broader business issues.

Posted by jamesr at 07:06 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

Intranet goals

I'm busy (very busy) writing the final recommendations for the Area Health Service project. One of the last activities we conducted was to sit down and determine a new set of intranet goals.

The old goal was as follows:

“To improve access and delivery of information to staff and customers through the effective and efficient use of technology”.

While this was fine, as far as it went, it tended to focus the intranet on delivering static information, without addressing the broader issues.

We have now replaced this with a more detailed set of goals, and this is the first draft version:

Meet management needs

• Support management processes, planning and decision making
• Support the implementation of the Balanced Scorecard
• Improve organisational efficiency
• Reduce business costs

Improve communication and knowledge sharing

• Support the sharing of knowledge and best practice
• Improve communication to, and between, staff
• Increase community involvement (both internally & externally)
• Enhance partnerships with external organisations
• Facilitate and support learning
• Encourage innovation
• Facilitate and support teamwork

Improve internal processes and practices

• Improve consistency and quality of information and processes
• Provide easier and more efficient work practices
• Provide a common platform for internal systems
• Improve the transparency of decision making

Improve outcomes

• Improve staff safety
• Improve patient care, outcomes and safety

Support cultural change

• Improve staff morale

These are more than just "high ideals", they help to set the direction of the intranet, and how it fits in the context of the whole organisation.

Posted by jamesr at 06:01 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

No demand for social news

I am busy writing up the final report for the review of the Area Health Service intranet and website. This is a draft recommendation that I thought might be of interest to the KM folks. Your comments?

No demand for social news

'I don't have time to get involved in the social issues at the area level': staff person indicating they don’t read the social news, except in their local newsletter.

'To me, they are just another thing I don’t want to know about': rural staff discussing the large volume of social e-mails they receive.

As part of the stakeholder interviews, staff were queried about the type of news they value. Not a single participant expressed any interest in receiving 'social' news via the various newsletters, even when specifically asked about it.

Instead, staff rely on their local social networks to hear about activities that are of interest to them. This could be conveyed via a local newsletter, face-to-face gossip, or e-mails.

As such, the area-wide newsletters should not be used to disseminate social and community news. Instead, they should focus on conveying details on broad initiatives, projects and building works.

Posted by jamesr at 01:05 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

Usability testing completed

Apologies for the lack of posts over the last few days. I've been incredibly busy running usability tests (3 days of 5 per day) at the Area Health Service, while sick with the flu. Looking forward to the weekend.

The usability testing went well, I think. We had a huge range of users, everyone from managers, community representatives to the apprentice gardener.

Overall, it didn't reveal any startlingly new information. It did, however, confirm the views developed during the usability evaluation of the intranet and website. For example:

• Most people ignored the options in the header and sidebar. They considered them "outside of the page", and simply filtered them out.
• There was an even mix between people who only searched, and those who only browsed.
• The high-level structure of the intranet is not well understood by users.
• The ad-hoc structure and layout of key pages causes considerable confusion.

Key tasks, such as finding a leave form, or booking for training, were almost impossible to do. Unless they had already had exposure to these sections, users universally struggled for up to 10 minutes trying to work out how to do them.

It was really interesting to see the mismatch between user success and opinions. Almost every user described the intranet as "pretty easy to use", despite struggling to find even the simplest of information. (Some users went around in a loop four times looking for the right page.) This highlights that you can't rely on user feedback to characterise the usability of a site.

Some observations and thoughts that surfaced during the testing:

• Ensure that the history is cleared in the browser before each test, otherwise the followed links will give the users strong clues.
• It's hard to construct activities that will take a consistent amount of time. Some people completed the whole exercise in 20 mins, while others were still struggling at 40 mins.
• It's not clear whether there is a lot of value to be gained in testing a site that is obviously broken. Perhaps waiting until some of the key problems had been resolved would have been better. (The proposal was developed before I had an opportunity to examine the intranet.)
• "Go with the flow" during the tests. For some users, they were so skilled that the tests were very easy. These users, however, had some really useful insight, so we explored that instead.
• If the usability testing goes quickly, use the remaining session time for a stakeholder interview. That way, you can get maximum value out of the time.

The only thing left to do now is work through the 115 pages of raw material, and develop the final report. A task for next week. I'll also report further on the results of the tests over the coming days.

Posted by jamesr at 10:55 PM | Permalink
Categories: Area Health Service project, Intranets, Usability & user-centered design

Frustration not an issue

One of the key questions used in the stakeholder interviews for the Area Health Service was: "What is the most frustrating administrative task that you have to do?". It was expected this would identify a raft of administrative and organisational hassles that could be addressed by the intranet.

Instead, here are the soundbites I collected relating to this issue:

'I just do': staff person indicating that they don’t get frustrated by administrative tasks, they simply manage day by day.

'There's no one big bugbear, I guess': response when asked about frustrating administrative tasks.

'I just get on and do it': staff person talking about the administrative tasks they have to do.

'Things that have to get done, part of the job': manager talking about the time spent dealing with administrative tasks.

In short, being part of the public service, staff simply took for granted that administrative tasks are difficult and inefficient. In fact, the word "frustration" did not, in general, generate any immediate recognition or associations.

This was a big surprise, as it is typically taken for granted that the intranet should be used to automate common administrative tasks, as one of the first steps. Instead, the following recommendation will come out of this review:

There is little short-term value in focusing on using the intranet to streamline organisational or administrative activities.

Instead, the following activities are likely to generate greater immediate benefits:

• Improve the structure and usability of the intranet, to allow staff to find the information already published.
• Use the intranet to deliver timely information and news.

More broadly, I think this highlights the value of stakeholder interviews as part of any knowledge management project, just to challenge the current set of assumptions.

Posted by jamesr at 06:05 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

Card sorting completed

The card sorting session yesterday with the Area Health Service went well, and generated some good results. The high-level structure of the intranet has already been identified as one of the two biggest barriers to usage (the other being the search engine), so all eyes were on the results of the session.

Of course, this will hopefully be the first of several card sorting sessions, with additional sessions including other primary user groups: clinical staff, admin, etc.

The main menu items they came up with were:

• About us
• Management systems
• Projects & reports
• News & events
• Procedures, policies, guidelines & forms
• Staff development and recognition
• Units & services
• Safety
• Links

They also added two extra main menu items, to provide additional ways of finding information targeted at specific user groups:

• Clinical
• Admin

The session was a lot of fun as usual. Interestingly, the group was very egalatarian, with all participating equally. They walked away feeling pretty satisfied with themselves, and I think this will be the talk of the corridors for the next few days.

We started preparing for this at about 10am, and had the categories prepared and cards written (including a quick bite of lunch), by the time the users arrived at 1:30. They finished up by about 3pm, leaving us a small amount of time to prepare for the usability testing next week.

Posted by jamesr at 06:50 PM | Permalink
Categories: Area Health Service project, Information architecture, Intranets

Perfecting healthcare

As part of my recent work, I stumbled across a project by Hunter Health called Perfecting Healthcare Delivery.

This is truly knowledge management in action, and it combines the best of storytelling with personas. The project focuses on Maggie, a fictional 75-year old Hunter resident, who needs to make use of the hospital facilities.

By putting a face to the the community, the project aims to re-evaluate the entire healthcare system from a user-centred perspective. In this way, a range of issues and problems can be identified whole the entire patient interaction, not just relating to a specific service or system.

According to Hunter Health, a similar program in Swedent looking at patient inflow had these results:

• Admissions reduced from 580 to 460
• Bed days reduced from 3500 to 2500
• Neurology waiting times reduced from 85 to 14 days
• Gastroenterology waiting times reduced from 48 to 14 days

Already some interesting results have come from the project, and I think this idea could be applied in a number of different sectors and industries.

Posted by jamesr at 07:27 PM | Permalink
Categories: Area Health Service project, Knowledge management

Second day of stakeholder interviews

Near the end now of another long day of interviews at the Area Health Service. I've now talked with everyone from the senior executive, through admin and lower management, to clinical staff (doctors, nurses, and allied health).

What is interesting is that, despite the hugely different roles, responisibilities and working environments, some key themes are turning up again and again.

These include:

• Everyone wants to know what is generally happening within the organisation, such as building works, restructures, and the like. Even if they are located in rural areas.
• No-one seems to want to receive news about social events, preferring to rely on their own social networks.
• Lack of time is a serious limiting factor, across the board.
• The overall site structure issues and usability problems are preventing most people from using the intranet. (Luckily, it is the easiest to fix, in many ways.)
• Policies and procedures are a major issue across the organisation, and they warrant some serious attention on the intranet. (I guess this is not surprising in a health organisation.)
• The corporate phone directory is needed by everyone, but is just not meeting that need.
• Most information is being sourced from outside the organisation, which is surprising. A lot of resources are obtained from the Dept of Health site, and from other online resources. This suggests that most, perhaps all, staff need internet access to conduct their normal work.

I've also expanded out my questions about people's social networks, and seem to be making more headway now. Despite that, sessions have generally dropped to 45mins each, which might be due to increased experience or efficiency on my part. I certainly think that a good stakeholder interview can be squeezed into 45mins if required, with the full hour providing more than enough time for a chat at the end.

Posted by jamesr at 06:52 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

First day of stakeholder interviews

Well, I'm very tired now, having completed 5 hours of stakeholder interviews, with 30 minute gaps in between.

Overall, the questions held up pretty well. I haven't been successful in determining social networks, but the information gathering behaviours have been clearly identified.

As hoped, we have also identified a lot of other issues that are prventing wider usage of the intranet (primarily around availability of PCs, culture and available time).

One idea that occured to me after the first interview was to start documenting soundbites. These are brief verbatim comments from users about specific issues. I now have over a page of these, covering a wide range of topics, and they are incredibly powerful.

This is storytelling in action, and I think these will be the most valuable product of the whole stakeholder interview process. The plan is now to sprinkle these through the final report, underlining the points being made, and making it all concrete.

Posted by jamesr at 07:20 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

Refocusing an intranet

I've just finished another two days of work with the Area Health Service, and I'm back in Sydney. The review of existing documentation and reports is now complete, as is the expert review of the current intranet.

Overall, the current intranet scored high marks. It is consistent, fairly well structured, and the majority of the content is well-written and to-the-point. There is a lot of good information on this intranet.

And yet, looking at the web usage statistics, it is clear that the intranet is not being used by most staff. The question is: why?

Unlike most intranets, it's not due to a lack of promotion or training. The intranet is run by the Public Affairs group, which has a strong grasp of the human and communication issues.

Certainly, lack of time is a critical factor. Most of the staff, especially the clinicians (doctors, nurses, etc) have very little time to browse the intranet. Another issue is lack of access. At present, there are only about 2500 networked PCs for a staff of 9000, and this particularly impacts upon the non-management groups (again, nurses are a good example).

Based on my reviews so far, and the discussions with the intranet team, we have developed a provisional strategy for refocusing the intranet to increase usage:

• Provide news and communication
  At present, the intranet is a repository for information, which while valuable, does not encourage repeat visits. By using the intranet as a platform for news and person-to-person communication (such as discussion groups), the intranet gains a new focus, and the flood of corporate e-mails is reduced.
• Focus on tasks
  At present, the intranet is not a place to "do things", instead it is only a source of reading materials. The intranet must become a "better way to do things" if it is to be successful in the long-term.
• Restructure along processes and subjects
  While there is considerable information on the intranet, it is grouped acording to organisational unit. By restructuring this to match business processes, and general subjects, the intranet can be made more "user focused".

It has certainly become clear that the issues and challenges facing the Area Health Service are very different to that in a normal corporate environment. The lack of universal access to PCs alone makes it much bigger than just an "intranet" problem.

What will be interesting is what will come out of the stakeholder interviews and usability testing, and what strategy changes will result.

Posted by jamesr at 05:30 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management

History of a health intranet

Just got back from the initial meeting with the Area Health Service. I spent most of the day finding out more about the history of their intranet, the challenges of their culture, and their future plans.

Overall, I was very impressed with how far they had managed to get, considering that they have had essentially no budget, and the intranet is just one year old (next week).

The intranet was initially created by a single person within Public Affairs, and there are now just two staff dedicated to managing the entire system. They have implemented a simple distributed approach, with each department or group using Dreamweaver to create and publish their pages.

This in itself is far from exciting. What really caught my attention was their recognition of the non-technical aspects of the intranet. This is a small selection of the what they have implemented:

• Built interest in the intranet in a low-key way, through presentations and talks.
• Trained users in how to use a web browser, and provided extensive phone support.
• Trained authors in how to create pages.
• Encouraged everyone to contact them directly if they had any questions or problems.
• Built a momentum, so that departments are now approaching the team asking to be added to the intranet.
• Sent out a "what's new on the intranet" e-mail every two weeks.
• Ensured that that there are frequent references to the intranet in the various newsletters that are published.
• In short, marketed the intranet extensively.
• Developed a "contributor's kit" to help new departments get up to speed. This includes a corporate style guide, detailed instructions on how to use the authoring tools, and guidelines for good writing style.
• Publicised the intranet via corporate letterheads, newsletters, e-mails and groups.
• Encouraged each department to conduct similar marketing efforts for their own subsites.
• Established a "web interest group" of all the various contributors and webmasters. This is a "community of practice", where they share best practice, obtain feedback on new designs, and learn techniques.
• Developed a standard template, structure and appearance across the entire intranet. Enforced this, despite the decentralised manual authoring.

And this is just the selection of their activities that springs to mind. They have done amazing things to turn around a very change-resistant culture, and to develop a large and structured intranet.

Of course, there are plenty of issues outstanding, and that is what we will be exploring during the next month.

Posted by jamesr at 09:15 PM | Permalink
Categories: Area Health Service project, Intranets, Knowledge management