Communication Design for Operating Rooms

Year : 2014  

Type: School project

Client: The University of Chicago Medicine

Role: Contextual research, Design Analysis, Concept Ideation, Wireframe & Information Flow, Clickable Prototype.

The operating room is a mysterious environment, it's like stage in the theater. There are multiple roles on the stage (doctor, scrub nurse, anesthesiologist, patient, etc.), each one has their own responsibility. They collaborate and adjust themselves together in order to achieve a great performance. How does the O.R. team work together before, during and after the surgery? This project focuses on analyzing the communication & information system among actors in an O.R. team, and how to improve the system.



How to understand a complex and unfamiliar environment like the operating room?

Our team started to build understanding around the topic through secondary research. Also, we conducted 15 expert interviews with surgeons, administrators, nurses, anesthesiologists and other stakeholders who are involved in a surgery. Afterwards, the team split into subgroups to visit the hospital, observing surgeries. 



1. A surgery is a flexible journey

We found that the length of a journey varies for different actors. For example, for a surgeon, the journey starts at the preparation meeting right before the surgery; for clinic nurse, the journey starts at checking and preparing the right tools one day before the surgery. For patients' family, they might be involved in the whole process, but not directly participate during the surgery. This finding helps us define the communication point for each role.

2. A quiet but high-tension world

The team was exposed to an O.R. environment through site visits. We found the O.R. is a quiet but high-tension world. The surgeon is the general in an O.R., staff couldn't speak loudly to affect the performance of the surgery. Everyone has to wear masks and scrubs, which means besides eyes, one person's whole body is covered by the scrubs. As a result, communication highly relies on experience, body languages and eye contacts. Furthermore, the staffs shown very territorial in the O.R. They are all aware of where to stand, the distance between each other, and continually keep an eye on what's going on in the surgery.

3. Multiple types of communication across teams inside & outside the O.R.

The O.R. information flow is a complex web. In order to perform a successful surgery, diverse teams in a hospital (or across hospitals) have to work together. From the first consulting to scheduling operating rooms & equipment, preparing tools to cleaning the O.R., and talking to families. The communication will influence the accuracy, efficiency, affordability, and efficacy of a surgery, or even further influence the operation of the hospital.




The research tools and frameworks we used:

- Concept map

- Interview debrief spreadsheet

- Actor & Action flow

- Observation field tools (data capture)

- Task flow

- Needs & opportunity map




What is a preference card?  

Every surgeon has his/her own preferences about the type of the tools and equipment, and how to position the tools, equipment, and patients. Preference cards record surgeons' special needs in order to facilitate the surgery. They are used for scheduling, tool preparation, supply arrangement and billing between different stakeholders involved in a surgery. 



User journey map

We define 4 stages of interactions around preference card, including created, activated, in use, and updated. This 4 stage works as a looping process.

  • Created : A new preference card is created by the specialty managers and surgeons.
  • Activated: Scheduler schedules a case and picks up a corresponding preference card in Hospital Epic system.
  • In Use: CSP and O.R. nurses check preference cards during work.
  • Updated : Preference card is updated by specialty manager according to suggestions from surgeons or O.R. nurses after procedures. 


The hospital found that staffs are not really using preference cards as they required, which result in inaccurate, redundant, and inefficient communication in the hospital. 

How we tackle the challenge?

- User Interview

- Communication flow map

- User journey & value map


Communication flow among users

  • The surgeons and O.R. nurses are supposed to communicate with each other regarding the use of preference cards. Specialty manager only involves in “Created” and “Updated” stages.
  • O.R. nurses need concrete communication when trying to customize preference cards according to surgeon’s need at “Activated” stage.
  • After a surgery, specialty manager need concrete feedback from the surgery team to update the card.


We collected interview quotes about the preference card from various stakeholders. The preference card is mainly related to three tasks: tool preparation, communication, and billing. We clustered interview quotes into problems and opportunities, came up with design themes of customization, efficiency, accuracy, update, consistency, informing and budgeting to further inform our design.