QuickGrip

An app which aims to help Occupational and Physical therapists improve efficiency and accuracy in documenting grip strength.

UX Case Study - Personal Project

OVERVIEW

Problem

Completing manual calculations for grip strength is tedious and can be inaccurate in a clinical setting due to human error.

My Role

UX Designer
UX Researcher

Solution

An app that allows you to enter each grip strength measurement as they is taken, then completes the calculation necessary and displays each individual measurement for both hands. These measurements are stored in app and organized by date/time to prevent HIPAA violations.

Timeline
February 2022 - April 2022

Tools
Figma

UX Design Process

01. Empathize

Literature Review
User Interview
User Persona
User Story
User Journey

02. Define

Problem Statement
Hypothesis
Value Proposition

03. Ideate

Competitive Analysis
Sketches
User Flow
Wireframe
Usability Testing

04. Prototype

High Fidelity
Iterations
Style Guide

05. Test

Usability Testing
Next Steps
Final Thoughts

EMPATHIZE

Background

Occupational and Physical Therapists often measure grip strength as a screening tool for upper body strength and functional use of the upper extremities. The most commonly used tool is the JAMAR hydraulic Dynamometer. The protocol for this tool involves taking a measurement from one hand and then switching to the other hand for a total of three measurements per side. The average of these measurements provides the grip strength for that hand. It can be time consuming to keep track of each measurement and take the averages with each patient. From my own experience as an OT, ensuring accuracy of these measurements when doing them with a calculator was prone to errors because I was always in a rush to finish documentation. I might press the wrong button or divide by 4 rather than 3. I would typically hand write each measurement and then do the calculation at the end of the day, once all treatment was finished. I would occasionally lose my measurements since they were written on paper or lose track of which patient was associated with which measurement.

A JAMAR hydraulic Dynamometer. Image retrieved from PhysioSupplies

Literature Review

To ensure accuracy and correct order of tasks, I conducted a limited literature review regarding the establish protocol for use of the dynamometer. The American Society for Hand Therapists released an official protocol for the Hand Grip Strength test. It recommended use of the Jamar Dynamometer for three measurements of each hand with a minimum of 15 seconds rest between gripping of each hand. The average of the three measurements was documented as the patient's grip strength.

User Interviews

I interviewed five occupational and two physical therapists who are currently working in patient care. Interviews were completed via video chat. My goal was the gather qualitative data and figure out if other therapists were having the same difficulties as I was with maintaining accurate records of grip strength. Users were asked the following questions:

What is the most frustrating thing you have to do at work?
Describe your documentation process.
How is your time management is at work?
Describe how you document and calculate grip strength.

Demographics

User Persona

Following user interviews, I completed the following user personas to guide my design.

User Story

Persona: Rady
Setting: Inpatient Rehabilitation Hospital

Story:
As an occupational therapist, I want to enter, calculate, and save grip strength measurements in an app, so that I can keep track of which measurements belong to which patients.

Acceptance Criteria
Scenario 1:
Measurements should be calculated accurately (the average of three numbers). Given that the numbers 20, 30, and 25 are entered into the app, the number 25 should be returned.

Scenario 2:
The measurements and calculated average should be saved by time they were entered. Given that Rady entered the numbers 20, 30, and 25 in at 9:30AM, she should be able to pull up her measurements taken at 9:30 AM at a later time and see both the individual measurements and the calculated average

User Journey

DEFINE

Problem Statement

Completing manual calculations for grip strength is tedious and can be inaccurate in a clinical setting due to human error. Increased time spent calculating and documenting worsens ability to meet productivity standards.

Hypothesis

We believe having a focused app for calculating and storing grip strength results for occupational and physical therapists will achieve improved productivity rates by decreasing the amount of time required to document and organize these findings.

Value Proposition

QuickGrip calculates, stores, and organizes your patient's Dynamometer grip strength measurements for you, allowing you to spend less time documenting and more time providing excellent care.

IDEATE

Competitive Analysis

To my knowledge, there are no apps which provide this service that are not connected with a specific type of Dynamometer. Dynamometers which connect via cord or bluetooth to a computer program and automatically collect these numbers do exist, however, most OT and PT clinics will not have access to these types of expensive devices due to cost and ever decreasing reimbursement rates.

Sketches

I began my brainstorm session with the Crazy Eights exercise. I wanted to create a design that was similar to a calculator, since this is what most therapists use for this calculation. The design should follow the steps therapists take when taking grip strength measurements per protocol.

Start with the right hand.
Tell the patient to squeeze as hard as they can.
Repeat with the left hand.
Complete on bilateral hands, alternating, for a total of 3 measurements.
Calculate the average grip strength for each hand and list the individual measurements.

My goal was to eliminate as much problem solving required by the user as possible with use of this app. The therapist should not have to figure out anything. It should tell which hand you are starting with and which repetition you are on. Ultimately, this app should decrease amount of time spent calculating and documenting grip strength during evaluations and improve accurate calculation of grip strength.

User Flow

Wireframe

PROTOTYPE

Iterations

The first iteration of this design featured a gradient background, squared laterality toggles, and rounded buttons.

The gradient background visually looked a bit too busy with all of the other items on the screen. I wanted the app to have few visual distractions apart from the functional portions of the app, therefore this gradient background was changed to a single color. Navy blue was chosen for two reasons.

Firstly, navy blue evokes feelings of confidence and authority. It is important that therapists feel confident in their skills and their authority within their position at the hospital. Secondly, many patients who have experienced stroke or traumatic brain injuries have light sensitivities. Since this app is designed to be used in real time with patients in front of the therapists, it would beneficial for the app to avoid causing unnecessary distractions or discomfort for the patient.

The squared buttons at the top of the screen indicating if the user is measuring the right or left hand and which iteration they were on felt clunky and required a bit of problem solving to figure out which hand you were measuring. These were changed to a toggle style button, which is present in many apps and within both iPhone and Android operating systems for improved familiarity. The coloring was also changed, with the inactive state background and text being much lighter to reinforce that it is not being used at that time.

The round buttons were inspired by the iPhone calculator, which I personally used to calculate these measurements in clinic. I wanted the app to feel familiar and require little to no thinking on the part of the therapist, so the rounded buttons were kept in the final design.

User Feedback

Based on user feedback, the following design changes were implemented to the final design:

A tool bar was added to the bottom of the app to navigate between pages
A new page was added to allow for saving of measurements. These were organized by date and time taken. This will allow identification of the patient by comparing the therapist's schedule to the time the measurement was taken and while avoiding HIPAA violations
A delete button was added to the measurements page, using an icon
A new page was added with the official JAMAR grip strength norms

High Fidelity Prototype

Style Guide

TEST

Usability Testing

To evaluate my design, I conducted a usability testing session with my target users. Five occupational therapists and two physical therapists participated. Each user was asked to complete the following tasks:

Take two new measurements of grip strength.
View all the results of the measurements you have taken so far.
Compare your results to the norms table.

Each user was then asked the answer the following questions:

Would you use this app?
What would you change about this app?
What do you like about this app?
How difficult was it for you to use this app?

In general, users liked our design. All of the seven users stated that the app was easy to use. Five of the secen stated that they would consider using this app at work. One user stated she wished the app could record and save more types of measurements like range of motion or sensation. One user stated he wished this was a website or computer app rather than a phone app as he felt it would be unprofessional to use his phone during a therapy session.

Next Steps & Final Thoughts

This app has the potential to help improve the productivity for therapists who routinely take grip strength measurements. Improved productivity is not only good for the facility, it is also good for therapists. If they are able to decrease the amount of time they spend documenting, they can leave work on time and have better work-life balance. At a time when healthcare workers are burning out and leaving in record numbers, more apps like this could help improve employee retention.

I have learned so much from this project. It was the first true case study that I have completed and the first case study I have completed for a problem that I have personally experienced. It was an excellent exercise in incorporating my OT skills of activity analysis into analyzing and understanding how people interact with a digital item. I hope to further develop my design skills, design with more clarity, and further develop my personal style. Overall, I thoroughly enjoyed working on this project.

FIN

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