Transforming Design at Loyal Health:
A Four-Year Journey

Leading product design operations and building a healthy, collaborative culture.

Context and challenge

When I joined Loyal Health in March 2020, the world was entering an unprecedented global pandemic. The company was an emerging startup with fewer than thirty employees and three product designers. I faced the unique challenge of building and scaling a design team entirely remotely—a concept that was novel at the time.

My primary goal was clear: establish a strong, culturally healthy design team that could support our rapidly growing business. What seemed like an impossible task during a period of complete uncertainty became a transformative journey over the next four years. I am truly proud and grateful to have been a part of this team.

Role

Director, Design and UX Research

Timeline

March 2020 - September 2024

Creating a design organization

By the time I completed my tenure, our design team had grown from two to fourteen people. We weren't just growing in numbers but building a comprehensive design function that would become integral to the company's success. I hired and led a world-class product team, responsible for a clean, consistent, and accessible experience across web and mobile. Select the links to jump to specific initiatives:

Establish an Efficient Hiring Process

As a new organization, we lacked a hiring process. As I started hiring to support Loyal’s new initiatives, I realized I needed to create an efficient process that matched our emerging company’s needs. Since we lacked a recruiting team, I ensured designers’ time was split wisely between working on their products and interviewing. One of the benefits of working at Thoughtworks is that I have conducted a lot of interviews. I used my experience to create a streamlined process, enabling us to hire the correct people with minimal time.

In addition, our nascent status required us to hire designers who could handle high ambiguity, 0 to 1 design, and be adaptable and proactive. The traditional hiring process often focuses solely on technical skills. I knew I needed to take a fundamentally different approach: hiring people, not just skills. Here is the process I created:

  • Manager Interview: This interview centers around behavioral questions and getting to know more about the candidate, their past work, and what they are looking for in their future team.

  • At-home exercise: Although controversial, I believe this is the quickest and most comprehensive way to discern a candidate’s individual abilities. To make this task as focused as possible for candidates, I provided a brief that clearly stated what they were being evaluated on. It also provided UX research materials that had been “previously conducted” to support their decision-making.

  • Group panel homework presentation: Candidates walk through their at-home exercise and answer questions about their decision-making and process from a panel of designers. This reduces the number of interviews needed as well as the potential overlap of questions.

  • Cross-Collab Peer Interview: Representatives from across the product function (PM and Engineering) participate in the interview. Designers are asked about their approach and experience in the product design and development process.

These interviews built on themselves, allowing us to dive deeper into the candidate’s abilities, collaborative nature, and outlook toward design. They focused on problem-solving, core design skills, and strategic thinking. At its largest, I scaled my team to 14, including product designers from associate to senior, Design Managers, a UX Researcher, and a Design System Designer. This group was responsible for all experiences across Web and mobile.

Set up Onboarding Processes: Creating Intentional Knowledge Transfer

The Hidden Cost of Rapid Growth

In fast-scaling organizations, hiring speed often comes at a critical price: fragmented knowledge and isolated teams. I've seen how quickly information can become siloed, leaving new team members struggling to understand the complex ecosystem of their work.

Creating A Systematic Approach

To proactively tackle this, I created a comprehensive onboarding process that transformed how new designers not only learned their roles but became integrated members of our organizational ecosystem. Each designer was given a centralized board with key activities, which included interactive presentations, educational videos, cross-functional introductions, and shadowing, and had targets for 30, 60, and 90 days. New candidates shadowed a peer to understand our development process. Understanding that designers at different career stages required more tailored onboarding experiences, I developed stage-specific strategies, e.g. associate designers started with smaller, focused features.

After each onboarding, I met with the new designer to rate their experience and identify gaps. Their feedback was used to iterate on our process. Two notable results from this were Bhakti’s living onboarding document and Val’s team playing cards.

The Multiplier Effect

What might seem like extensive upfront work became our advantage. By closing knowledge gaps and encouraging cross-functional understanding, I accelerated team integration, reduced learning curve duration, and created a culture of continuous learning.

Create a Clear Career Growth Path: Breaking the 89% Barrier

People do their best work when they have clear expectations and understand how they will be evaluated. Compelled by a Nielsen Norman study revealing that 89% of design teams lack a documented progression path, and having seen firsthand the impact a career ladder has on a designer’s overall experience, I made this my first major initiative as Director of Product Design.

I created a career lattice that provided clear, detailed expectations for each role and level of seniority on my team. It covered craft, leadership, and professional skills and gave examples within each competency. This framework was used to measure a candidate’s aptitude during the hiring process, by managers during the annual review process, and by team members to set goals and measure their progress toward their next career milestone.

As our organization scaled, this career lattice underwent four major iterations. It was so well received that cross-functional directors, including those in Engineering and AI, adopted it.

Define Design Team Processes and Culture

Rituals are important to drive our product work and craft forward, as well as nurture a bond between team members. One of my learnings as a design leader is that practices that work during one phase of life in your org may not work in another. This is not to say you are throwing out important rituals every quarter; it’s just that you just can’t set it and forget it when it comes to your team activities.

When our team experienced a " shift,” I conducted retrospective-like sessions to identify which rituals still provided value, which parts no longer worked, and which we needed to change. This ensured that we were not holding activities for their sake and that team members got the intended value from our practices.

Our design rituals

  • Design Standup

  • Design Critiques

  • Weekly Design meeting ( sharing/ continuous learning)

  • Once a month bonding sessions

  • Weekly 1:1’s and monthly skip levels

  • Senior and Peer Mentorship meetings

  • Feedback channel

  • Friday Kudos (the brainchild of Hannah Koenig)

Develop our Guiding Principles

There is often skepticism around establishing design principles for your products. Design principles are often criticized for being too generic or not helpful with decision-making. We approached this challenge differently.

We crafted our design principles in a multi-day workshop guided by collaborative exercises and breakthrough insights from Senior Designer Erin McGlothlin, which resulted in principles that were: 1. Practical and actionable, 2. Rooted in real examples 3. Applicable at both macro and micro levels. These principles ensured that my team approached designing our products with a unified mindset and clear expectations.

Our Design Principles

  • In order to foster health equity, we try to meet people where they are and design for their context keeping in mind inclusivity, diversity, and accessibility.

  • At Loyal we strive to provide a helping hand whenever needed. As hospital organizations across the country began tackling Covid-19 testing we created and shared a solution for triaging patients for free. We sweat the small stuff and create thoughtful experiences to empower health systems with the information and tools they need to better engage with their patients.

  • We listen to patients and our partners in healthcare, so that we can build the right thing. By sharing our insights across our teams and with our customers we work to ensure that real data drives our decisions.

  • We work to earn trust and confidence in our patients and our customers by providing clear and transparent communication in our interfaces and by making product choices that reflect our stance that privacy is non negotiable.

  • At Loyal we look forward and seek out areas in the healthcare industry that lack definition. We do this by listening to experts and patients, examining emergent technology, and the shifts in our domain. Our goal is to proactively work towards closing the gaps we find and creating a more seamless, supportive healthcare experience.

  • Our teams hone in on the goals and tasks of our users in every aspect of our work, whether we are making strategic decisions, troubleshooting with customers, or designing features. We respect people's time and effort and work to ensure that users are able to focus on their task and not our tool.

  • We believe that it is important to be comfortable with defining ambiguity and managing the unknown. We pride ourselves on being able to navigate our wide array of users, their needs, and contexts across an ever evolving, complex healthcare journey.

Design System Designer
Tory Martin

Establish a Design System:
From Grassroots to Strategic Initiative

Our design system began as a grassroots collaboration between designers and front-end engineers. Seeing its potential impact, I evolved it into a company-wide strategic function.

I hired a dedicated designer and put a design system team in place. Tory, our design system designer and front-end engineers, regularly met to audit our existing patterns, create new patterns based on proposals from our teams and new trends, and publish documentation.

Our biggest challenge was creating a cohesive platform experience as we updated our mature products while developing new ones. I worked with Tory and our PMs to establish a process and schedule for methodically doing so.

We used Figma to create shared libraries of patterns, components, and styles that are all in sync and up-to-date. And Storybook, the frontend workshop, to build components. Both tools enabled easy collaboration between engineering, product, and design.

Lastly, to show the value of our design system to stakeholders, Tory regularly presented data about its impact on our efficiency, design and development quality, and overall platform experience to our company.

Make UX Research a Core Company Practice: Building a Research Function

When I joined Loyal, the organization cared about solving patient and customer needs. However, because it lacked the necessary systems to conduct user research, its understanding of user needs was based more on intuition and anecdotes. It was critical to me we had a data-driven mentality and be built on top of a strong UX Research function.

Cultivating a Research Driven Culture

My approach was holistic. I knew change wouldn't come from tools or processes alone but from shifting our collective mindset, so I set up company-wide education through talks, involving stakeholders from across the organization in our current research processes, and got the executive alignment. With this, I secured a dedicated budget for our research function and hired a dedicated UX researcher, AJ. Together, we:

  • Developed a flexible, repeatable UX research process and frameworks

  • Democratized research across teams and implemented cross-functional participation

  • Coached designers with varying research backgrounds

  • Regularly shared insights across our org through presentations and Slack

Using Technology and an Enabler to Scale Research

As our product portfolio expanded, research operations became increasingly complex. Our initial approach was manual and became time-consuming. To tackle this, I analyzed our existing process, calculated time and cost inefficiencies, prepared a comprehensive ROI analysis, and engaged our VP of Product as the initial champion. After selecting HIPAA-compliant Dscout as our research tool, we were able to achieve the following outcomes:

  • Doubled research initiatives per team

  • Created a pool of qualified participants from across the United States

  • Reduced recruiting, scheduling, and compensation time by 60%

  • Established a continuous, predictable research roadmap

User research is now a key component of every project at Loyal. We use it to validate new product ideas and design explorations, conduct usability and accessibility testing during development, and follow up with users after release to measure success and impact. What began as a tactical initiative became a fundamental shift in how we approach product development.

User Researcher
AJ Ayeni

Measuring impact

Looking back, I'm profoundly grateful for the opportunity to shape Loyal Health's design culture. We didn't just build a design team—we created a collaborative, growth-oriented ecosystem that will continue to evolve and innovate.

3 to 14

85%

Growth of team

Retention Rate

4.7/5

Team Satisfaction
Score

Let’s Talk

I enjoy grabbing coffee in person and virtually. Message me at apettus3 [at] gmail [dot] com or on LinkedIn.

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