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How to build an App – Lesson 2
Stuart Nuttall Wednesday 13 October 2021

The process – user stories

In lesson one we discussed the process for getting your idea on paper and trying to describe the problem your solution solves.  With Lesson 2 we move on to the process of building user stories that describe how individuals will use the product.

The key starting point for what you are about to build doesn’t necessarily start with you.  It starts with your end users.  It is the what and the how of using the product.  

In lesson one we discussed the requirement to think about the “need”  and what problem the app solves. You now need to think about the people it solves this for and how they will interact with it.

Start by creating profiles of the different users who will use the app. What is their job, what will they use the app for, how will they use the app, what specific problem or pain point will the app solve for them.  It may be useful to send out surveys at this point or to bring your users together to form a user group to help brainstorm ideas.  If you already have a prototype, have they used it, do they have any feedback.  What do they think of your idea and the way it will work for them. 

It’s a great way to get the information that will be useful later when writing your spec as you can envisage the individuals using the product and what they will be trying to get done with each function.  It may also allow you to prioritise features that need to be included on your MVP and which features could go on the backlog.

Write all these user profiles and user stories down.  This is what will give you the key outline to what you’re trying to achieve.  Think big picture at this point.  We’re still on the “what’ not the ‘how’ at this stage.

Here’s an example of some of the user stories we collected for CEMBooks V2

Junior doctor – “my patient has a PE that needs thrombolysing – how do I do that, who do I need to tell and where do I need to refer them, there’s bits of information all over the place, is this laminate in date?”

Nurse in charge – “I’m down 2 nurses, on a background of a heavy hour of attendances. How serious is that at this time of day / night, how do I record this, do I need to let someone know, who, and how do I contact them, and what should I expect them to do?”

Consultant: “I remember a discussion about a patient like this in an email trail a few months ago with a pan specialty agreement, where is that?”

To explore the first user story in more detail we need;

Resources; – a repository of guidelines with “How to treat PE” that is easy to find and quickly give advice, as opposed to a regional A-Z of PE. This should be up to date and have a clear author/reference.  We should be able to point to advice about where and how to refer the patient to and this should be easily searchable.

Phone book – should provide the phone and contact information for all of the teams referred to in the guideline.  You should be able to call or message these directly from your phone through the product.

This outlines a specific use case for our App.  Yours will have similar – start to write them down and work them through to this level.

Once completed, start to go through these and prioritise them 

1/ core functions

2/ nice to have

3/ if money was no object…

At this point it’s worth considering what other systems are out there and do any of these do those individual use cases really well – it’s worth knowing what is out there and how you will create a differentiation between your product and the competition but also if something is being done well, there’s no point reinventing the wheel 

This brings you to a point where you should have a list of key functions that your product will perform. 

The next stage will be to describe in much more detail the ‘how’ underlying each function.  How will it work, what steps are involved in the workflow for each function and where each function will take the user.

And that is the point we’ll leave it at today. Head back in two weeks, where we consider building a functional specification from your user stories.

As usual we welcome any comments about these tutorials – more info, more examples, too long, too short, too boring whatever you have to say please drop a comment in the section below or on our Twitter feed and we’ll get back to you.

Thanks

SN

Roles – who are they and what do they do?
Stuart Nuttall Thursday 7 October 2021

Who is in charge of the shift in your ED?  Who makes decisions regarding site operations out of hours? Who is “on call for ICU”?

EPIC, NiC, CIC, CSM, ADOP, Reg on call, Doc in the box, Matron for escalation, Bronze command etc etc

Every hospital has them and they are key to how hospitals and departments run.  Often they are a different person on a different day too – even different people at different times of the same day.  How do you keep track of who is working in each Role at a specific time of day?  What are the expectations for individuals when working in those Roles?  How do you minimise variation in interpretation of a departmental status and variation in responses between those situations while allowing people autonomy from day to day and individual to individual?  How can you ping a notification to a Role to notify them of an operational event e.g. surge in attendance, block to flow, lack of pods to send samples to the lab for instance in real time!  

We have seen a variety of options – whiteboards, excel sheets printed out and stuck on boards in offices, rota’s emailed out weekly etc. We see operational escalation plans that always reference Roles rather than individuals and so it became clear when designing a hospital “operating system” like CEMBooks V2 that we needed to focus on these Roles and their associated activity. This includes “Sign In” processes, accessibility and visibility 24/7 alongside direct contact information.  

During implementation we work with teams to ensure that their escalation plans are directed to the correct Role at the correct time of day.  Roles can be tagged in Sit reps and Logs and these will all result in push notifications going to the device or desktop of the individual signed into that Role. It even pops up directly on your watch face if you have a smart watch!! 

Within the Phone book you can clearly see who is currently signed into a Role and how to contact them (see below – real numbers redacted).  

In a future blog we’ll talk about behaviours around signing into Roles and some of the experience we’ve had around that, but we’d love to hear from you in the comments below about what are the key roles in your organisation and how do you know who is doing that Role today and how and when you should contact them.

Till next time!

SN 7/10/21  

How to build an App – Lesson 1
Stuart Nuttall Wednesday 29 September 2021

So, you want to build an App. To solve a problem, to make your life easier or to perhaps make some money. How hard can it be? But what are the first steps to take, what do I need, what software do I need and how do I go about it??

To start with, as always, a disclaimer.  There is always more than one way to get something done.  The same is true with web and app design.  I don’t intend to give you the definitive way, or the only way, simply a way. The CEMBooks way that we used when we decided that we needed to build on CEMBooks V1 to produce CEMBooks V2.

At the time I was new to the company and as such hadn’t been involved with the development of V1, my colleagues who’d built V1 had some idea but the make up of the company had changed and the scale of what we now wanted to build was different.  The key processes remained the same however.

Before you begin, you need to be pragmatic.  Do you have all the skills yourself to complete the project or are you going to need help. You maybe able to develop the use cases but can’t go any further at which point you need a team to build your product and turn it into reality.  In which case you need funding and it’s important you think about that at an early stage.  Do you plan on self funding it? if yes, that’s fine, you only have to answer to yourself in terms of project costs.  If not, how do you propose to fund it? Research grants and funding, bank loans, innovation awards? Can you design and code your way to a functioning prototype or are you going to be applying for funding based on an idea??

As much as your idea might be the best idea ever and you may hear that having the idea gets you 90% of the way there, in reality you won’t get anywhere without the practical skills or funding to make your idea a reality.

Therefore the key starting point is to explain your idea. Tell stories. Develop the dream. Explain how your idea will make a difference and who it makes a difference to.

Explain the why behind your idea – usually it will be to solve a problem so….

1/ describe the problem 

2/ describe the scale of the problem (your market)

3/ what is the current process 

4/ why does that create a problem

5/ What is the impact of that problem

6/ who does it affect – (your user group)

7/ do they see it as a problem in the same way you do

8/ do they suggest any other ideas to use alongside yours

What is out there already as a solution? Describe the pros and cons of the current situation and solution.  If this is a new market you may need to convince others that the problem you can see is one that affects them too. Are there solutions available that partially solve the solution. Can you work with that supplier to make it better rather than starting from scratch?

Start writing – however you want to progress your idea one of the key steps is to begin to commit it to paper.  It starts to become real, it becomes something that can be discussed, reviewed and improved and it will become the backbone of your project proposal. 

At that point your need to ask yourself some more questions:

Can you code

Can you draw and design

Do you know about User interface design (UX)

Do you know about the differences between App’s and reactive mobile web design

If you do, then that’s brilliant you can start building as your time allows.  If not then you should consider how your proposal will allow you to pitch your idea to obtain funding to find a team who can build your idea. Remember though that it’s your idea and you want to retain any Intellectual Property that may be available.  At this point you may not know how much your project will cost – we’ll come to this when we build the product spec in a later lesson – but it’s the right time to think about where your funding will come from and what is available so this may limit your spec in just how adventurous you can be.

So hopefully there is plenty to be getting started with there. I would emphasise the importance of getting started and committing something to paper.  In the same way as this blog it’s’ the first steps on a new adventure.

See you again in 2 weeks.

Sit Rep KPI’s
Stuart Nuttall Monday 20 September 2021

KPI’s – key performance indicators.  Not just the basic numbers that have to be reported to central agencies but the things that make your ward or department tick, that make it feel pressured, that you know if they’re sorted means that the department will run smoothly?

One of the first things we do when implementing CEMBooks V2 is to sit down with the local team and work out what needs to be reported on as daily work, what impacts how a department feels and what these numbers should be at different times of day.

A core emergency department KPI might be Attendance numbers.  If you have more patients attending/hour than can be seen and discharged in each hour the wait for clinician will rise.  The number that creates this imbalance is likely to be different at different times of the day. So 15 patients booking in per hour might be GREEN at 10 in the morning but if that were to happen at 4 am that would be PURPLE This would be a significant surge and would impact on how the department feels and the wait to see a clinician.  CEMBooks allows you to customise OPEL scoring of any KPI by  time of day. CEMBooks also allows you to add weightings to these to reflect exactly how each one impacts on the department function.

Some common  KPI’s catergopries that sites using CEMBooks have described to us for use in their ED sit reps include:

Demand – Attendance/hour

Acuity – Number in resus, overall NEWS score

Waiting times -Wait for clinician, wait for initial assessment

Staffing measures – Nurse staffing, CSW numbers, medical staffing

Admission issues –  Number of patients waiting to come in (TCI) Longest wait for TCI

We are starting to see the inclusion of the new RCEM quality indicators – 12 hour breaches, mean wait in department being included in department sit reps. too

What would you include as your KPI’s in your department or ward??  Would they be different for different times of day?? Let us know – reply here or on our Twitter thread!!

Thanks

SN 

#CEMBooksV2 #KPIs

Product Update – CEMBooks V2.18
Stuart Nuttall Tuesday 7 September 2021

Sprint 18 has now come to a close with the latest release pushed to live on the 3rd September 2021.

The following features have been added to the live production environment


Whats New:


Living wall search & download improvements: Search and download data from logs & sitreps
Phonebook search improvements: better unified results on default searches
Escalations pertaining to a sitrep can be accessed from a sitrep
Mention users / roles improvements: more quickly mention roles and users
Autofilled KPI’s data now show time source data was submitted to the system
Notification improvements: More specific notification alerts

You can’t see this but the native mobile app is nearing completion 😁….

www.cembooks.com landing page improvements.

Bugs Fixed:


Bug duplicating presentation of logs data when opening / closing logs
Bug not allowing closing of logs
Increased comment character allowance
Family tree not scrolling properl in reactive mobile
Fixed rendering issues for tables in reactive web app

We are always happy to hear feedback – leave comments below or email brad@cembooks.com

7/9/21

SN.

Introduction – our first blog!
Stuart Nuttall Saturday 4 September 2021

Hello and welcome to the CEMBooks blog site.

Looking for the latest Product info for CEMBOoks V2?

You’re in the right place.

Content on this blog will be:

1/ Product updates as each development sprint is pushed to the live environment,

2/ Updates on the current dev sprint,

3/ Sharing use cases and examples of best practice

Various members of the CEMBooks team will be contributing to the blog to bring you up to date product information as soon as it is released.

We will be publishing on the blog through our landing page at www.CEMBooks.com and distributing via @CEMBooks on Twitter to begin with so please give us a follow.  

Look forward to starting the conversation.

SN 

04/09/21

Bug Fixes
Giorgos K Thursday 5 August 2021

Bug duplicating presentation of logs data when opening / closing logs
Bug not allowing closing of logs
Increased comment character allowance
Family tree not scrolling properl in reactive mobile
Fixed rendering issues for tables in reactive web app

@StuartNuttall