Effective web-based clinical practice guidelines resources: recommendations from a mixed methods usability study

Abstract

Background Clinical practice guidelines (CPG) are an important knowledge translation resource to help clinicians stay up to date about relevant clinical knowledge. Effective communication of guidelines, including format, facilitates its implementation. Despite the digitalization of healthcare, there is little literature to guide CPG website creation for effective dissemination and implementation. Our aim was to assess the effectiveness of the content and format of the Diabetes Canada CPG website, and use our results to inform recommendations for other CPG websites. Methods Fourteen clinicians (family physicians, nurses, pharmacists, and dieticians) in diabetes care across Canada participated in this mixed-methods study (questionnaires, usability testing and interviews). Participants “thought-aloud” while completing eight usability tasks on the CPG website. Outcomes included task success rate, completion time, click per tasks, resource used, paths, search attempts and success rate, and error types. Participants were then interviewed. Results The Diabetes Canada CPG website was found to be usable. Participants had a high task success rate of 79% for all tasks and used 144 (standard deviation (SD) = 152) seconds and 4.6 (SD = 3.9) clicks per task. Interactive tools were most frequently used compared to full guidelines and static tools. Misinterpretation accounted for 48% of usability errors. Participants overall found the website intuitive, with effective content and design elements. Conclusion Different versions of CPG information (e.g. interactive tools, quick reference guide, static tools) can help answer clinical questions more quickly. Effective web design should be assessed during CPG website creation for effective guideline dissemination and implementation.

Exploring the Role of Guidelines in Contributing to Medication Errors: A Descriptive Analysis of National Patient Safety Incident Data

“…The exception is a study of simulated rather than actual practice, which identified 21 guidelines-use discrepancies contributing to a medication error, of which 14 discrepancies related to finding the guideline and seven discrepancies related to reading it [ 14 ]. Similarly, previous user testing studies have identified problems finding and understanding information in guidelines, but were not designed to investigate a subsequent contribution to medication errors [ 19 , 20 , 27 , 28 ].…”

“…While iterative user testing and subsequent modification has been shown to make it easier for health professionals to find and understand information within one specific guideline [ 19 , 20 , 27 ], it does not address the process of finding the correct guideline to use, which contributed to many of incidents reported in the present study. Future research should therefore investigate whether techniques such as iterative usability testing of wider guideline information systems [ 28 ] are able to prevent further medication errors. Given the limitations of research based on voluntary reporting of medication incidents, future studies utilising prospective qualitative or quantitative data collection from staff involved in incidents would give greater certainty about the characteristics and prevalence of guideline-related medication errors.…”

A Web-Based Dyadic Intervention to Manage Psychoneurological Symptoms for Patients With Colorectal Cancer and Their Caregivers: Protocol for a Mixed Methods Study

“…After the CRCweb prototype is developed, we will ask 4 patient-caregiver dyads to use the CRCweb prototype and provide feedback about the usability of the program [ 34 ]. Semistructured interviews (30-45 minutes) will probe for participants’ experiences with using CRCweb (eg, design, navigation, structure, and language).…”

The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects—A Family Doctor Perspective

“…Despite the proven benefits, implementation rates remain below 50% historically across clinical disciplines [ 4 , 34 ]. Many attempts have been made to identify barriers that limit the implementation of clinical guidelines in daily medical practice [ 35 , 36 ]. It has been found that many guideline manuals are too long and complicated, making it difficult to implement them effectively.…”

“…Given the abundance of guidelines available, there is a growing need for continuous quality assessment and the improvement of the development process [ 8 , 34 , 35 ]. In today’s era of healthcare system digitalization, online tools such as websites, alerting systems, interactive platforms and clinical decision support systems are being used to aid in the access and implementation of clinical guidelines [ 36 , 37 , 38 ]. However, the effects on practice and clinical outcomes from these tools are still unknown.…”