Backstory eTriage is a kiosk product designed to automatically assess and triage patients on arrival into A&E and urgent care departments. Patients book in with their personal details and information about their symptoms, which are then sent into the department’s triage queue. As eTriage deployed in more and more sites, our product team faced a challenge: how to present clear and safe signposting information to patients based on their circumstances, all while balancing the many different protocols for directing patient flow. Result Working with our customers and product team, I was able to design a flexible patient signposting flows — a sought-after feature that allowed eTriage to meet the complex needs of our customers.

Designing with the language of patients and staff

eTriage was a completely new way of booking into urgent care. Although many patients were familiar with GP practice check-in screens, the triaging part of the booking process was not commonplace when the product first went live in 2018.

We were lucky enough to run discovery directly in collaboration with our pilot site, the Queen Mary Urgent Care Centre in Bexley, in south London. As part of contextual inquiry, I interviewed patients, tested early click-through prototypes, and observed (with permission) the booking and triage process.

Language and phrasing emerged as a common theme in the feedback we received. For example, we found:

• “Next of kin” was not a phrase people commonly recognised
• The length and phrasing of certain triage questions was a challenge
• An emoji-based pain scale, although commonly used in clinical practice, was proving difficult for certain neurodiverse patients

eTriage was ultimately adopted by the Queen Mary UCC, the first of many A&E and urgent care departments to follow.

How eTriage helped keep patients safe during COVID

During the first wave of COVID our NHS customers, unsurprisingly, asked us to help them stop symptomatic patients from booking in via the eTriage touchscreen. I designed a warning screen which directed users to reception instead. Later, as protocols changed, we quickly adapted our infection control flow and related messaging. Departments could choose to either disable the COVID warning altogether, ask patients to confirm they’re asymptomatic before booking in or ask patients which COVID symptoms they had and then route them to the relevant infection control area.

Adapting our content to patient flow complexity

The clinical demands of COVID weren’t the only ones driving new signposting flows inside eTriage. As the product evolved, I also designed messaging and flows to guide those who:

• arrived with emergency symptoms
• arrived with a child (some departments have separate waiting areas for those attending with children)
• were immunosuppressed or had had chemotherapy or radiotherapy
• had been referred by another health service
• had certain demographic characteristics, such as being under 15

The precedence and level of customisation needed for each type of signposting added to the complexity of the work. Several things helped us achieve a consistent and clear result:

• working with customers to understand which messaging could be standardised and which scenarios would lead to the patient’s booking being aborted
• collaborating with the engineering team to understand what level of flexibility in copy structure was feasible
• breaking up the copy to allow for greater flexibility

The result was a booking experience that was much more closely aligned with the signposting patients would normally be given when arriving in A&E and urgent care — and a product that better reflected the real world needs of our NHS customers.