Record
01
Company One
Rebuilt clinical scheduling for 4,000 staff
A rota tool nurses actively avoided. Eleven hospitals still running a 2011 system, with the real source of truth living in four thousand private spreadsheets.
Sector
Healthcare
Role
Design lead
Years
2025–26
Constraint
Patient-adjacent. Nothing publishable.
The brief was wrong. Northvale asked for a redesign of an interface. What they had was a process that no longer matched how the work is done, and an interface faithfully reflecting it.
The first six weeks went to the people doing the job, not the software. Twenty-two shadowing sessions across four wards, transcribed and coded into one question: what decision is this person trying to make, and what stands in the way of it?
The shift queue, after
Decision log
Four that mattered
Stopped designing the calendar
Six weeks of grid layouts existed before anyone questioned the unit of work. Nurses described their week as a list of holes, so the interface became a queue. That cost the entire first design phase, and a grid view still ships for the wards that refused to let it go.
Kept the spreadsheet
Leadership wanted the four thousand private spreadsheets gone. They were the actual system of record, so a spreadsheet view shipped as a first-class mode instead. Adoption stopped being a training problem, at the price of two export formats to maintain and a single-source-of-truth promise we had to walk back.
Ward managers before nurses
Nurses gave us the research and held the loudest complaints. Ward managers held the publishing action, so rollout was sequenced around them first. Support tickets halved — and the nurses who sat through twenty-two shadowing sessions waited two more quarters to see anything change, and said so.
Refused the mobile app
An app was already promised in the board deck. Shift data was checked on shared ward terminals, not phones, so the budget went to the terminals. I defended that twice at board level and it holds, except for community nurses working off-site, who needed the phone and still do.
Outcome
Measured twelve weeks after launch
74%
Shifts filled without a call
11
Hospitals live at rollout
3.1m
To publish a rota, from 26
What I would do differently
The part most portfolios leave out
I let the calendar metaphor run six weeks longer than it deserved. The signal was in the first three interviews — people described their week as a list of holes, never as a grid. I would now test the object model before any layout work at all.