CUA of the Month – March, 2014

"I love working through a problem and figuring out how to fix it, but I think I probably enjoy discovering what the pain points are even more."
Alyce Green
User Experience Manager

Championing UX in the Operating Room

by Jim Garrett

There is much in the news these days about the healthcare system and all the changes going on. There is another change going on right inside the hospitals which isn’t making headlines, but is critical to the lives of the people being cared for, and those who care for them.

Enter Alyce Green, our Certified Usability Analyst of the month. Alyce is the User Experience Manager at Stryker. Stryker is one of the world’s leading medical technology companies and is dedicated to helping healthcare professionals perform their jobs more efficiently while enhancing patient care. The company offers a diverse array of innovative medical technologies, including reconstructive, medical and surgical, and neurotechnology and spine products to help people lead more active and more satisfying lives.

Alyce has been with Stryker since 2002 and received her CUA certification in early 2005. Over the years she has worked within the organization to bring user centered design (UCD) methodologies to Stryker’s broad range of products and services. Through her perseverance, she has helped Stryker enter the user centered design era. She employs various research techniques, both generative and formative, helping Stryker gain new insights about the OR and hospital ecosystems. With these inputs, and by incorporating more structured user feedback into designs, Alyce is helping Stryker support the changing demands on physicians, nurses and hospital staff.

What are your roles and responsibilities for user centered design?

I design and run User Research and Interaction Design programs for R&D units across the organization. Right now I am working on products that will be sold into hospitals, particularly Operating Rooms (ORs).

Tell us about UX and the medical device industry at Stryker.

Stryker is a very successful company in the medical device field. The changes in the last several years within the healthcare industry have given me traction to change the focus of how we talk about the value of our products. Remember, doctors and Nurses are “normal people” too. They use all sorts of consumer electronic devices in their day-to-day lives. This has also changed their expectations for how they interact with technology in the OR. Today, and into the future, I see that the increased focus on quantifying patient outcomes, increased hospital efficiency, and users’ general expectation of “delight” will bring UCD to the forefront of Stryker’s product design process.

We also see some changes in the sales cycle and the roles involved in the buying decision. This means innovating and providing valuable solutions to an expanded set of roles within the healthcare system. UCD is providing the roadmap for Stryker to navigate these changes. There is a real sea-change going on in our industry, and it has been very exciting to part of this!

You mentioned the change in the sales process. How are you interfacing with that from the user centered design perspective?

Historically the medical device industry has focused on physicians and surgeons as our “customers.” The buying decision used to be more directly influenced by individual preferences of these doctors. But that is changing. There are certain products within our offering which are specifically meant to be in the hands of surgeons and other physicians, but there are many products that are used by other types of healthcare practitioners.

They are used by nurses, scrub techs, by other people in the hospital. Yet, until recently the standard practice in our industry has basically been to ask surgeons what they think nurses might need or want. That is not a great way to design something that will truly meet the nurses’ needs. In addition, administrators at hospitals are now looking for ways to standardize and consolidate. They want to partner and buy complimentary product and service solutions from one company, instead of having multiple different brands of a particular product type.

Where do you enter into this with user centered design?

We now have had the opportunity to change the conversation. We are going in and doing observational research within the hospitals. By going into the OR, we can understand the ecosystem of all the players in the room, and be able to come back and better design for them.So, now we are designing for the user. We are able to then turn around and tout this approach as a strong differentiator in the market, a selling point to the “customer” (person/group making buying decision…but often not the user!).

Do you actually go to the hospitals, into the OR to evaluate this?

Absolutely! In fact we spent most of last October in hospitals across the country. I have a small team, and I augment it with contractors when I need to. We probably observed about thirty procedures and spoke one on one with fifty-plus healthcare providers and support staff.

Can you talk about what you went out there to see and what kind of changes you’ve made based on your observations?

Well, some of the outcomes from what we did this past fall will be design inputs for a particular project, which is still under development and I can’t share specifics about. But more generally, our observations and insights also helped us build reference materials for understanding the ecosystem within the OR, and the hospital in general. We now actually have huge printouts hanging on walls in R&D. These facilitate the conversation of who’s involved in what kind of activities, during what part of these workflows.

This is helpful on many levels, not the least of which is providing a common “language” or reference point to talk about these dynamic environments. This has been a big value to the R&D group, especially for engineers who haven’t gotten a chance to go and observe directly themselves.

What was the most significant thing you learned in your CUA training?

Gosh, that was a long time ago! I guess probably the course about identifying user needs. At that point in my career it was something I hadn’t had a lot of visibility into; how to go about collecting that information in a non-biased way. I still think Needs Gathering is the most challenging and interesting part of UCD. I love working through a problem and figuring out how to fix it, but I think I probably enjoy discovering what the pain points are even more.

Have you been able to make any carryover from your CUA training into your work now?

I still use some of the formats that I learned — some of the scoring formats, some of the protocols and tools that I got from that class. Of course, I have picked up many new ones along the way as well. Some of them I developed myself, some of them I have learned from colleagues. There are still many things that I go back to my roots for, particularly around test protocols — I tend to still lay them out and execute them very much how I learned from HFI.

Where do you find the passion, the satisfaction in your work?

At the end of the day I get a lot of satisfaction from knowing that doing my job well has a direct impact on somebody’s life and death situation or, at least, their quality of life. That has always been a meaningful part of why I like working at Stryker.

CUA of the Month

Each month we highlight the successes and achievements of a different member of our CUA community. If you are a Certified Usability Analyst and would like to be considered for CUA of the Month recognition, please send a brief professional bio to

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