My customer experience as an emergency appendicitis patient

Last month (June 2015), our Head of UX, Amir Ansari found himself in the back of an Ambulance with what he thought was extreme stomach cramps (or as we were referring to it, man flu) and 24 hours later, he ended up in surgery. But the most important part of this tale is that in true Amir form, and with his UX hat on, he decided that he would write about his experiences as a patient in the emergency department–and the importance of always having the ‘customer’ at the forefront of any design (product or service).


Would you believe, my spaghetti looks better than this one

I have always thought that my spaghetti bolognese sauce was good, in fact, better than good. But as I was tucking into dinner with my family on Tuesday night (26 May) , I started to get a slight stomach cramp. I thought maybe I have simply put too much garlic and onion in it (or perhaps I was eating too fast). I went to bed with a stomach cramp (I gave it a 5/10 for pain), woke up the next morning, had breakfast and went to work. Around 11am, after a small handful of cashews the pain increased to 6/10, so I decided after my 12.30 meeting with a client I would head home. At this point, I was thinking food poisoning or the like (I had gastro a few weeks back so thought that the virus was just resurfacing itself). I decided not to have lunch while the client tucked into a nice gourmet pie and chips.

Straight after the meeting I decided to catch the train home but soon started to feel nauseous. I thought I wouldn’t make the train ride home so jumped into a taxi hoping to get there quick enough before my nausea got worse. After 2 to 3 hours of rolling around in bed in absolute agony with pains reaching 9/10, I moaned for my wife to call the ambulance thinking that this gastro is nasty.

A UXer’s mind is always evaluating

It was at this point that I decided I would start to assess my customer (patient) journey and experience of the emergency medical system (I know, even in this state I couldn’t let go of what I love doing most; user and customer experience).

The ambulance arrived after 40mins and Luke the paramedic was a very nice man; he had a gentle sense of humour and was very caring and empathetic to my situation. He made an initial diagnosis that my pain was most likely not gastro, but appendicitis! I thought, nah it couldn’t be, surely it’s just a stomach bug (I’m not just a UX expert you know!).

The ride to the hospital via the ambulance was ok – lots of different drugs and painkillers which really didn’t reduce my pain, but made me groggy and dizzy. The ride, otherwise was still comfortable (partly because of having Luke to keep me distracted) although at the time my pain was 9/10 (where ten is equivalent to my arm being ripped off – the example given by Luke) and becoming unbearable.

Emergency room

Emergency, emergency. Turns out, it was serious!

I was then admitted to casualty to be seen by a number of doctors and nurses who were determining my condition. A surgeon quickly popped in to say that I have appendicitis (Luke was indeed correct) which would most likely mean that my appendix would need to be removed. At this stage it was 5pm, and the surgeon mentioned (but did not promise) that I may have surgery that night. I thought, there is no way that is going to happen!

Between 5pm on Tuesday and just before being told I was going into surgery at noon the following day, I came across a number of nurses. To be honest, I don’t remember many of their names, as for me, most of them lacked empathy. Julia however, was one nurse who was simply the most empathetic and understanding nurse I came across throughout this ordeal; appreciating the lack of transparency in knowing when I’d have surgery and doing all she could to make me feel comfortable. Many other nurses were either grumpy, stern, non-observant or simply treated me as just another entity that was adding work to their busy jobs.

Now, I appreciate that these nurses must come across a whole range of different personalities and situations on a day to day basis, and on top of this, these nurses are overworked at hospitals which are often understaffed; making the jobs of these medical professionals that much harder. Along with this is the sheer volume of paperwork that they are expected to complete.

Now talking about paperwork, there is so much of it, but ironically it doesn’t seem to work. There are two experiences I would like to share with you; the first was when I was admitted to casualty. The nurse offered to give me a pain killer (let’s label it painkiller X). I mentioned that this painkiller was not working on me and I’d prefer the one I had been given earlier (painkiller Y). She rudely replied that I was never given painkiller Y and continued to ask if I wanted painkiller X. Knowing I was in pain but didn’t have memory loss, I sternly replied (with my 9/10 pain) that this was incorrect and indeed I was given painkiller Y at some point that day. The nurse then turned rolled her eyes, turned to my patient folder, browsed through five pages and then said casually “Oh yes, here it is, looks like they did give you painkiller Y”.

My second experience was when I was about to be taken to the operating room. The nurses asked me who my next of kin was. I said that I had mentioned it twice to two different nurses and that they had written it down (I saw them), yet this nurse couldn’t find it as she flipped through the many pages in my patient folder. I also found it amazing that in the 20 hours since I arrived in hospital I had a patient folder almost the size of a Yellow Pages paper directory!

Woman with ipad

Imagine what we could build

Now looking at the above two experiences, I can easily imagine a world where instead of a big fat folder of paper hanging at the end of my bed, there is a single digital tablet, and both nurses could have browsed the well-designed health management app (hopefully I’ll get a chance to design such a system) and searched or browsed for my ‘next of kin’ or a specific medication instead of ineffectively browsing through sheets and sheets of paper to find this information.

So I’m sitting here a day after my operation, recovering (yes, I know, I’m writing this while still in hospital) and looking back at the last 36 hours. The first point I take away is that technology needs to play a bigger part in the administration of patient management. In its current state (i.e. the lack of technology or poor implementation of one), it’s simply not efficient, effective, and surely not sustainable (think about the hospital having to store my folder and the thousand of other folders like mine for patients who come to the hospital so infrequently).

And the second, and more important point that has been reiterated to me is the importance of empathy and it’s impact on customer experience. Empathetic carers and nurses have made my hospital customer experience memorable. Thanks to Luke the parametric, Julia the nurse in casualty, the nurses in the operation prep area, Natallie, Des, Georgina and Regi – the nurses who cared for me post operation, during my recovery. As tough as nurses have it, these people seem to just get it; they get the importance of empathising with the end user/customer in order to provide the best experience possible.

As customer and user experience practitioners, understanding the journey of the end user/customer – how they feel, their pain points and opportunities for improvement are essential to designing the right experience for them. This is why at DiUS and as part of our user experience methodology, we employ this exact philosophy to ensure we’re not just designing and building solutions right, but designing and building the right solutions for our client’s customers and end users.


 So I don’t miss my appendix too much, my colleague and fellow UXer Le gave me a plush version!

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