Sarah Mitrano




Led visual design in partnership with a multinational technology company to create an early warning system for skilled nursing.

Product Strategy / Service Design / UX Design / UI Design 

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Our client was an established leader within the hospital healthtech space.

With the passage of the Affordable Care Act, which created unprecedented incentives for the healthcare industry to reduce rehospitalizations, they saw an opportunity to improve care outcomes by introducing new technology solutions into the historically tech-starved nursing facility environment.

Our client had developed a biometric sensor for use outside of hospitals, but needed guidance in creating a system that would make the data actionable and impactful. They came to us for help conducting user research, honing and validating the value proposition, and designing the service and UI of the new system for pilot.


Defining a shared vision 

We began by testing early hypotheses with nursing staff at all levels.


Initial research

Our team shadowed nurses and staff onsite throughout their work day, conducted in context interviews with generative activities, and worked with our clients to synthesize findings and map the patient's journey.  

💬 Ask me in person

How did you learn what it meant to make data that was “actionable” for nursing staff?


Patient deterioration journey

Using findings from our initial research, we developed a deterioration journey that tracks the critical path from a patient's initial admission through the development of a complication and ultimate re-hospitalization. We used this map to identify ten opportunity areas for intervention.


Concepting & testing

We conducted a total of 36 user testing sessions at 17 different nursing homes.



Following the discovery phase, we sketched on concept areas, using paper prototypes to test ideas. We then conducted iterative user testing sessions with nurses to further hone the functionality.

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Design principles

We developed six user-centered design principles and refined them through iterative rounds of research.


Designing THE experience



We worked with in-house clinicians to develop an initial notification algorithm for pilot.


Notification logic

We created an initial algorithm for when, why, how often, and which types of notifications should be sent to nurses. 

Flow diagrams

We created detailed flow diagrams to help the engineering team understand the designed functionality.

💬 Ask me in person

Why was it important to develop a logic algorithm for the notification system?


Final solution

Winston is a connected sensing solution for skilled nursing.

Rather than interrupting existing verbal and manual workflows that work well for nurses today, it adds an additional layer of connectedness and peace of mind.

The system gives nurses with a tap on the shoulder to inform them of signs of deterioration that go unnoticed today. Winston’s MVP feature set is small and focused to ensure that it effectively delivers on its core value proposition and minimizes impact to nurse workflows. Together, a watch worn by nurses and desktop portal keep nursing staff informed throughout their shift. 


I designed the UI of the watch app, and created a prototype to demonstrate key flows. 

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Me demoing the prototype at presentation to the engineering team.


I created the following storyboard for a book that was shared with senior stakeholders to showcase the project.  


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