Design Challenges in Converting a Paper Checklist to Digital Format for Dynamic Medical Settings

Sarcevic, Aleksandra; Rosen, Brett J.; Kulp, Leah; Marsic, Ivan; Burd, Randall S.

doi:10.4108/eai.16-5-2016.2263335

Cited by 13 publications

(10 citation statements)

References 18 publications

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“…The QI team originally planned to convert the tool from paper to electronic format, but end users have consistently advocated for the continued use of the “index card” format due to its ease of use and portability. 16 …”

Section: Discussionmentioning

confidence: 99%

Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care

Venn

Sotomayor

Godambe

et al. 2021

Pediatric Quality &Amp; Safety

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Section: Discussionmentioning

confidence: 99%

Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care

Venn

Sotomayor

Godambe

et al. 2021

Pediatric Quality &Amp; Safety

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“…Checklists and other cognitive aids have also caught up with this digitization trend in healthcare [1,7,21,29,33,35]. Checklists are different from EHRs because they support compliance with standardized protocols rather than just documentation.…”

Section: Related Workmentioning

confidence: 99%

“…Checklists are different from EHRs because they support compliance with standardized protocols rather than just documentation. Prior studies have shown that replacing paper forms with electronic checklist systems in medical contexts has had positive effects on task performance and teamwork [1,7,21,29,33,35,37]. Agarwala et al [1], for example, found that an electronic checklist for anesthesia handoffs improved relay and retention of critical patient information.…”

Section: Related Workmentioning

confidence: 99%

Comparing the Effects of Paper and Digital Checklists on Team Performance in Time-Critical Work

Kulp

Sarcevic

Cheng

et al. 2019

Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems

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This mixed-methods study examines the effects of a tablet-based checklist system on team performance during a dynamic and safety-critical process of trauma resuscitation. We compared team performance from 47 resuscitations that used a paper checklist to that from 47 cases with a digital checklist to determine if digitizing a checklist led to improvements in task completion rates and in how fast the tasks were initiated for 18 most critical assessment and treatment tasks. We also compared if the checklist compliance increased with the digital design. We found that using the digital checklist led to more frequent completions of the initial airway assessment task but fewer completions of ear and lower extremities exams. We did not observe any significant differences in time to task performance, but found increased compliance with the checklist. Although improvements in team performance with the digital checklist were minor, our findings are important because they showed no adverse effects as a result of the digital checklist introduction. We conclude by discussing the takeaways and implications of these results for effective digitization of medical work.

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“…Certain hurdles may make them reluctant to adopt a digital system, such as prior investment and familiarity with a current system (known as baby duck syndrome ) [ 4 ] and availability, training, and the position of the system [ 3 ]. Although it is feasible to use digital forms in medicine, it has its design constraints, including limited display size and the challenge of replicating the user experience of paper forms or checklists [ 5 ]. These constraints can be handled; however, there are many conflicting guidelines available on appropriate user-centric designs.…”

Section: Introductionmentioning

confidence: 99%

Comparing Single-Page, Multipage, and Conversational Digital Forms in Health Care: Usability Study

Iftikhar¹,

Bond²,

McGilligan³

et al. 2021

JMIR Hum Factors

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Background Even in the era of digital technology, several hospitals still rely on paper-based forms for data entry for patient admission, triage, drug prescriptions, and procedures. Paper-based forms can be quick and convenient to complete but often at the expense of data quality, completeness, sustainability, and automated data analytics. Digital forms can improve data quality by assisting the user when deciding on the appropriate response to certain data inputs (eg, classifying symptoms). Greater data quality via digital form completion not only helps with auditing, service improvement, and patient record keeping but also helps with novel data science and machine learning research. Although digital forms are becoming more prevalent in health care, there is a lack of empirical best practices and guidelines for their design. The study-based hospital had a definite plan to abolish the paper form; hence, it was not necessary to compare the digital forms with the paper form. Objective This study aims to assess the usability of three different interactive forms: a single-page digital form (in which all data input is required on one web page), a multipage digital form, and a conversational digital form (a chatbot). Methods The three digital forms were developed as candidates to replace the current paper-based form used to record patient referrals to an interventional cardiology department (Cath-Lab) at Altnagelvin Hospital. We recorded usability data in a counterbalanced usability test (60 usability tests: 20 subjects×3 form usability tests). The usability data included task completion times, System Usability Scale (SUS) scores, User Experience Questionnaire data, and data from a postexperiment questionnaire. Results We found that the single-page form outperformed the other two digital forms in almost all usability metrics. The mean SUS score for the single-page form was 76 (SD 15.8; P=.01) when compared with the multipage form, which had a mean score of 67 (SD 17), and the conversational form attained the lowest scores in usability testing and was the least preferred choice of users, with a mean score of 57 (SD 24). An SUS score of >68 was considered above average. The single-page form achieved the least task completion time compared with the other two digital form styles. Conclusions In conclusion, the digital single-page form outperformed the other two forms in almost all usability metrics; it had the least task completion time compared with those of the other two digital forms. Moreover, on answering the open-ended question from the final customized postexperiment questionnaire, the single-page form was the preferred choice.

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Design Challenges in Converting a Paper Checklist to Digital Format for Dynamic Medical Settings

Cited by 13 publications

References 18 publications

Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care

Implementation of an Intrahospital Transport Checklist for Emergency Department Admissions to Intensive Care

Comparing the Effects of Paper and Digital Checklists on Team Performance in Time-Critical Work

Comparing Single-Page, Multipage, and Conversational Digital Forms in Health Care: Usability Study

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