BREAKWELL

BreakWell provides a highly customizable and accessible way for healthcare workers to utilize their precious break times to improve their wellbeing while at work. This 3 month design project was the culmination of my MSc in Digital Design & Development, and done in collaboration with Wenhui Liang, Jeremiah Almaraj, and Erica Figueiredo. All deliverables shown are my own work and contributions to the project.

SUMMARY

Working closely with four members of a renowned healthcare organization, the design and development of BreakWell was informed by data from over 120 healthcare staff. Unlike other healthcare applications, BreakWell does not simply monitor vitals, exercise, or diet. Instead, the application utilizes the accessibility and functionality offered by mobile devices to make taking breaks desirable and highly rewarding for shift workers. By tailoring mindfulness exercises, workout and meal recommendations around healthcare workers schedules, BreakWell offers holistic support that automatically suits their lifestyle, rather than leaving it up to healthcare workers to determine how to blend healthy habits into their daily lives. Over time this results in healthier, happier employees, less human error, better job performance, and healthier, happier patients.

DESIGN QUESTION

How can

we encourage healthcare staff to take their breaks and utilize that time to build positive wellbeing

In a way that

connects them with their colleagues and works in harmony with their schedules

so that

they feel supported in their wellbeing and cared about by their organization and peers while at work

RESULTS

End User Survey & Interview Insights

Prototype Progressive Web App

Technical Specification Report

Business Plan & Proposal

CONTEXT

BACKGROUND

Employee health and wellness has been a hot topic for companies and employees across the world for many years. Not only do employers now use gym memberships, recreation rooms, and flexible working hours as a selling point to potential employees, but they choose to invest in these resources because of the well known business benefits of healthier, happier employees. According to Ireland’s Health Service Executive (HSE), “Workplace health and wellbeing programmes have been identified by the WHO as one of the “best buy” options for prevention and control of non-communicable diseases and mental health and wellbeing. Some of the benefits to focusing on staff health and wellbeing include reduced absenteeism, increased productivity and improved staff morale”. The global outbreak of COVID-19 in early 2020 added further pressure on organizations and businesses to prioritize and support the physical and mental health of their employees.

SELLING THE AMBIGUITY OF THE DESIGN PROCESS

Originally, our client came to the team asking for a health application for their employees. Their list of desired features was based on the wellbeing habits they recommend as professionals, including: step counter, sleep tracker, healthy recipes, and workout videos. The first step in the project was selling the design process. As a team, we emphasized that, in conducting our initial research, we would be removing any assumptions from what features the final product may include. In fact, we were removing the assumption that the best solution would necessarily be an app at all! We reassured them that by diving into their staff's daily experiences, we would be able to determine not only what resources they want and need, but ensure we were investing in resources they would actually use.

WHAT IS "WELLBEING" ANYWAYS?

We couldn't possibly design a wellbeing application without first understanding what it is. According to Ireland's Healthcare Executive's Wellbeing at Work Initiative, wellbeing can be broken down into various aspects of health:

PHYSICAL

Being aware of your body and of what it needs to remain fit and healthy throughout your lifetime.  It is about taking care of your physical body so that you are able to carry out your daily activities as well as possible.

EMOTIONAL

Being aware of thoughts and feelings and how they affect our behavior.  By being aware of our emotions and how they impact us we are better able to respond rather than react to daily challenges and demands.

OCCUPATIONAL

Feeling sufficiently skilled and capable of fulfilling your day to day employment with the opportunity for learning, progression and growth, in a safe, healthy and supportive work environment.

SOCIAL & CULTURAL

Your ability to interact with people around you and to create connections that support you in your daily life. Having and maintaining social/community links of support  are very important for maintaining positive health and wellbeing.

INTELLECTUAL

getting personal and professional fulfillment in work while still maintaining balance in our lives outside of work. It is also about expanding your knowledge and skills and engaging in creative and mentally stimulating activities.

FINANCIAL

being aware of your money and being able to manage and plan your finances by balancing, saving and spending efficiently and within one’s means. 

ENVIRONMENTAL

Your surroundings and how you interact with them impact on your health and wellbeing, therefore having a safe and healthy work environment is essential.  

WELLBEING CHALLENGES FOR SHIFT WORKERS

Over 20% of workers in Europe are shift workers, with a large percentage being employees of healthcare organizations. Working within a shift system involves periods of 6–12 hours work at a time with employees alternating on two, three, or four shifts within any 24 hour period. (Harrington, 2001)

 

Even the healthiest workers who engage in shift work are likely to experience symptoms which not only damage their health but their performance at work, such as:

 

  • disrupted metabolism and circadian rhythms
  • poor diet
  • chronic disease
  • anxiety and depression

EXPLORE & EMPATHIZE

STAFF SURVEY

After conducting research to understand what wellbeing is and the general challenges shift workers face, we wanted to explore the specific experiences of Irish healthcare workers. Our anonymous user survey was created as a quantitative way to gauge what type of wellbeing intervention would most benefit the staff. The questions were crafted to assess staff members’ current wellbeing habits and strategies, technology and app usage, barriers to wellbeing, and openness/ interest in a wellbeing app created by their employer. The survey was distributed via members of the healthcare organization to other staff via their official work email addresses. 143 staff participated in the survey. Wellbeing this was defined to participants as “overall sense of physical, emotional, financial, social, and occupational health and happiness”.

Doctor's Appointment

53% of staff find it difficult to maintain positive wellbeing.

83% of staff already use apps as part of their wellbeing and self care routine.

64% of staff feel apps are useful for maintaining their wellbeing.

58% of staff would be happy to use a wellbeing app offered by their employer.

Most Useful Qualities of Favourite

Health Apps

 

1.

Accessibility & Convenience

2.

Target Setting & Tracking

3.

Reminders

4.

Positive Feedback for Healthy Behaviors

Biggest Wellbeing Motivators

 

 

61%

Fun, engaging ways to stay healthy

46%

Being part of a community support system for healthy living

43%

Easy access to factual, in-depth information

Most Desired

In-App Resources

61%

Healthy recipes

58%

Stand and stretch reminders

48%

Short guided meditations

45%

Workout videos

42%

Step Counter

Hesitations to Use Employers' App Due To

 

1.

Lack of Personalization

2.

Desire for Less Screen Time

3.

Privacy Concerns

4.

Satisfaction with Existing Routines & Resources

INSIGHTS & IMPACTS - AS IS NARRATIVE

The rich user data from our survey was summarized into As-Is use cases which captured the daily experience of our users. These were used to highlight the precise touchpoints available for our app to intervene and change staffs' wellbeing challenges throughout their day. The following use case highlights the insights gained into a typical staff member's work experience and the impact it is has on their wellbeing.

IMPLICATIONS

Based on our research and design empathy activities, the following implications were derived from our user research and design empathy activities. These were used to guide ideation and creation of BreakWell.

Using the app should make staff feel supported, cared about, and listened to by their employer.
Since staff already successfully incorporate wellbeing activities and apps into their lives outside of work, the app must primarily help them implement wellbeing supports during their work day.
Accessibility, ease of use, and privacy must be prioritized throughout all features in order to encourage usage during hectic, busy, and stressful daily schedules.
Stethoscope on the Cardiogram

IDEATE

We conducted an initial ideation phase using mind maps, group brainstorming, and rapid prototyping to address the pain points gleaned from the survey. Our application design sought to combine what staff enjoy about the wellbeing apps they already use while addressing their concerns about a potential app offered by their employer. Since stress and morale were the primary challenges staff faced, in addition to providing easy access to a variety of wellbeing resources, our goal was to provide a positive, safe space where staff feel they are connected to each other, cared about, and listened to. Since the app would be provided free to employees, our hope was that this would emphasize their employers’ investment in their wellbeing and help staff feel their employer cares about them.

FEATURES

Scheduler

Users will be asked to put in their schedule monthly or weekly. Once a user puts in their schedule, suggested break times and break activities will populate each day. A user can accept these pre-selected options or customize them.

Healthy Recipes

After setting their schedule, users will be shown suggested healthy recipes. They can assign these to particular days of the week or view them in the recipe library at any time. They can bypass selecting meals if they do not want to add any to their schedule.

Workouts

After setting their meals, users will be shown suggested workout videos. They can assign these to particular days of the week or view them in the workout library at any time. They can bypass selecting workouts if they do not want to add any to their schedule.

Break Activities

The app will include a variety of 10 minute mindfulness, stretching, de-stressing and relaxation exercises. Once a user puts in their schedule, suggested break times and activities will populate each day. A user can accept these pre-selected breaks or customize them to be at a different time or include a different activity.

Morning Message

Once a week, managers will be prompted to write an encouraging message to their team, which will appear at the top of their team members’ app the next time they log in.

Feedback Box 

An entirely anonymous feedback forum where staff members may write suggestions for wellbeing supports they’d like to see in their workplace. These will be specific to each department. All posts will be entirely anonymous (no names or usernames) and will be automatically screened for anti-social messages. 

Appreciation Board

An anonymous board where staff can post encouraging messages and positive shoutouts to their team members.

INTERVIEWS

I mean it's a cute idea...I just don't know if it fits Irish culture. When we want to give each other kudos we're more likely to just go say something nice to that person face to face.

Our interviews were performed after our first round of rapid prototyping so we could probe our interviewees about potential features. Our interviewees provided crucial qualitative information about their work day, particularly surrounding workplace culture. Initially, we intended to include an Appreciation Board, where staff members could put positive, encouraging, and thank you messages to their colleagues. However, when this idea was shared with our interviewees, it became clear this format of communication is not compatible with employee culture. Employees would rather share those positive sentiments face to face. The board would likely end up being a place for jokes and sarcastic comments, rather than its intended kudos.

In chatting more in-depth with healthcare staff, we were able to build a narrative flow for their daily routines, experiences, and habits. We formed our interview questions around understanding how they currently maintain their wellbeing during the workday, their stress coping mechanisms, and their digital habits. We gained the following key insighs:

It is common for staff to skip breaks during stressful, busy times in order to prioritize their work performance and opportunities for professional growth.
Staff greatly enjoy the socially-oriented wellbeing activities offered in their workplace (staff parties, self-care workshops).
Staff most frequently spend their breaks going for walks or using their phone.

CREATE

REMOTE DEVELOPMENT DURING COVID

Due to the COVID-19 Pandemic my team was unable to meet in person, so we got extra creative and communicative in order to develop a full working prototype collaboratively and remotely. Using Azure, VisualStudio, and Microsoft Teams we worked together to develop a Progressive Web Application that functioned exactly as the app would were it to be fully developed. We decided to build a Progressive Web Application because it would be easier for the healthcare organization to update over time, since they already hired web developers to maintain their current websites.

DUE TO CLIENT PRIVACY

Due to IP protections, I am unable to share images of the final prototype application. Please see the next sections for an in-depth look at the impact and significance of BreakWell's concept.

VALUE PROPOSITION: NOT "JUST ANOTHER HEALTHCARE APP"

Nationally Approved Health Resources

 

BreakWell is a truly innovative app that not only provides wellbeing resources from a national healthcare organization, but makes them accessible to the staff who need to be using them most. The high quality resources cannot be utilized if they are not accessible. BreakWell will act as a one-stop-shop for the organization to deliver their wellbeing resources directly to their staff.

 

Simple, Modern Interface

 

BreakWell offers users plenty of customization options while maintaining a clean appearance. Navigation is tailored to ease use via touch screen on a mobile device.

 

Customization & Privacy

 

The application requires official credentials in order to log in. This ensures only staff members will have access to the application. BreakWell saves user information so staff only have to log in once, and any schedule information will be saved so users do not have to manually enter their shifts each time. The app does not encode any user information from the suggestion box, ensuring true anonymity. In this way BreakWell offers the best of both customization and privacy for staff.

 

True Accessibility As a PWA

 

In the modern age the most accessible way to access and spread information is via mobile devices. BreakWell is a Progressive Web Application, making it accessible to all operating systems and easily updatable. Its responsive design is easy to interact with and adjusts to all mobile screen sizes. Running BreakWell is as easy as managing a website and is not reliant on application stores like Google Play or Apple Store. This provides more competitive and flexible options for hosting, database management, storage, and development.

 

Not Just a Library, But an Assistant

 

Healthcare staff’s workdays are hectic enough without having to manage their wellbeing activities via several different apps. BreakWell ensures implementation of positive wellbeing exercises by putting proven effective healthcare resources into bite size pieces and demonstrating exactly when to use them. This eliminates the complexity of figuring out which activities would benefit staff most. They can simply open the app and select which 10 minute break they’re interested in doing that day. Their schedule, meals, exercises, and meditations are all in one place. By decreasing the time and steps necessary to take advantage of these resources, BreakWell makes it less daunting for employees to care for themselves, ultimately making them more likely to incorporate these activities on a daily basis.

IMPACT STATEMENT

By using BreakWell, employees will be supported in their challenging work environment, making them more likely to stay employed in their roles for longer. Healthier employees means less stress on Ireland’s healthcare system overall. Happier employees will result in happier patients. Better patient experiences mean an overall more positive public view of the organization, both internally and externally. This will ultimately drive support and funding nationally and via partnerships with other organizations.

Implementing BreakWell will provide the following positive impacts for healthcare workers:

 
  • decreased absenteeism
  • decreased stress levels
  • decreased feelings of exhaustion
  • increased alertness
  • increased opportunity to shape wellbeing resources
  • increased efficiency and accuracy
  • increased loyalty and enthusiasm for work
  • greater positive feelings about being in work
  • greater sense of belonging to a supportive community
  • greater personal connection to work and colleagues

REFLECTION

I could not have asked for a more relevant or rewarding problem space to tackle for my Master's project. BreakWell is a truly important solution that I'm excited to see growth and investment in over time. The significance of providing support for healthcare workers particularly in times of crisis cannot be emphasized enough. We have the technology to provide well-researched, carefully curated, empathetic interventions that allow them to care for themselves while they care for us. 

While these three months established that accessibility and empathy is pertinent for BreakWell to be effective, three months of development are necessary to add features which would greatly improve the user experience by allowing staff members to access the app’s resources as easily and enjoyably as possible. Our interactive prototype would allow further user testing to determine which features should be prioritized based on their impact. The data from these tests would then determine development of the back end resources necessary to support real-time use of the application.

WHEN YOU DESIGN FOR EVERYONE, YOU DESIGN FOR NO ONE

The research conducted unfortunately put each user under the umbrella of "healthcare staff member". Ideally, I would have loved to put further care into dividing research, feature list development, and usability testing amongst various types of healthcare staff and assessing how the app could accommodate their specific needs. Nurses working in ICUs have very different schedules and health support needs to general practitioners, or healthcare administrators, etc. Ideally, a different version of the app could be used for each department, with different pre-settings or recommended settings by role (for example, suggesting appropriate dietary and fitness advice based on how sedentary a role is, or by how long the average shift is). The best part of the app being supported by a healthcare organization is that as soon as the app's interface and back-end can support these types of customizations, they can update the wellbeing resources as relevant. There's truly endless opportunity for BreakWell to be a powerfully effective intervention for healthcare staff. I don't believe this type of solution will ever be irrelevant, and I look forward to working on similar projects in the future.