Managing multiple perspectives in the collaborative design process of a team health information technology

Hose, Bat‐Zion; Carayon, Pascale; Hoonakker, Peter; Ross, Joshua; Eithun, Benjamin; Rusy, Deborah A.; Kohler, Jonathan E.; Brazelton, T. Berry; Dean, Shannon M.; Kelly, Michelle M.

doi:10.1016/j.apergo.2022.103846

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…The integration of AI-driven solutions in the form of wearable devices, for instance, could provide real-time feedback to bystanders performing CPR, or even alert nearby medical professionals or trained individuals to rush to the scene [32]. This convergence of technology and medical intervention could redefine the OHCA landscape in the coming years [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Bednarz,

Goniewicz,

Al-Wathinani

et al. 2023

JCM

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Introduction: Out-of-hospital cardiac arrests (OHCAs) represent critical medical emergencies in which timely interventions can make a significant difference in patient outcomes. Despite their importance, the role of on-scene witnesses during such events remains relatively unexplored. Aim of the Study: This research seeks to shed light on the influence of witnesses, especially family members, during OHCAs and the effect of their interventions, or the absence thereof, on outcomes. Drawing from existing literature, our working hypothesis suggests that the presence of a witness, particularly one who is knowledgeable about CPR, can increase the likelihood of obtaining the return of spontaneous circulation (ROSC), potentially enhancing overall survival rates. Methods: Using a retrospective analytical method, we thoroughly reviewed medical records from the Lublin Voivodeship between 2014–2017. Out of 5111 events identified using ICD-10 diagnosis codes and ICD-9 medical procedure codes, 4361 cases specifically related to sudden cardiac arrest were chosen. Concurrently, 750 events were excluded based on predefined criteria. Results: Both basic and advanced EMS teams showed higher rates of CPR initiation and an increased likelihood of obtaining ROSC. Notably, the presence of a trained EMS professional as a witness significantly increased the chances of CPR initiation. The presenting rhythms most often detected were ventricular tachycardia (VT) and ventricular fibrillation (VF). Different urgency codes were directly linked to varying ROSC outcomes. When witnesses, especially family members, began chest compressions, the use of amiodarone was notably higher. A significant finding was that 46.85% of OHCA patients died without witnesses, while family members were present in 23.87% of cases. Actions taken by witnesses, especially chest compressions, generally extended the overall duration of patient care. Conclusion: The crucial influence of witnesses, particularly family members, on OHCA outcomes is evident. Therefore, it is essential to increase public awareness of CPR techniques and rapid intervention strategies to improve outcomes in emergency situations.

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Section: Discussionmentioning

confidence: 99%

Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Bednarz,

Goniewicz,

Al-Wathinani

et al. 2023

JCM

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“…One way to address this is by clearly defining an aim, for example, design a patient-centered discharge process, that can guide the integration and prioritization of perspectives in a design team with representation from multiple stakeholders. HFE methods such as participatory design and co-design offer frameworks for doing this [21][22][23][24].…”

Section: Overviewmentioning

confidence: 99%

Evaluating the Usability of an Emergency Department After Visit Summary: Staged Heuristic Evaluation

Barton¹,

Salwei²,

Rutkowski³

et al. 2023

JMIR Hum Factors

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Background Heuristic evaluations, while commonly used, may inadequately capture the severity of identified usability issues. In the domain of health care, usability issues can pose different levels of risk to patients. Incorporating diverse expertise (eg, clinical and patient) in the heuristic evaluation process can help assess and address potential negative impacts on patient safety that may otherwise go unnoticed. One document that should be highly usable for patients—with the potential to prevent adverse outcomes—is the after visit summary (AVS). The AVS is the document given to a patient upon discharge from the emergency department (ED), which contains instructions on how to manage symptoms, medications, and follow-up care. Objective This study aims to assess a multistage method for integrating diverse expertise (ie, clinical, an older adult care partner, and health IT) with human factors engineering (HFE) expertise in the usability evaluation of the patient-facing ED AVS. Methods We conducted a three-staged heuristic evaluation of an ED AVS using heuristics developed for use in evaluating patient-facing documentation. In stage 1, HFE experts reviewed the AVS to identify usability issues. In stage 2, 6 experts of varying expertise (ie, emergency medicine physicians, ED nurses, geriatricians, transitional care nurses, and an older adult care partner) rated each previously identified usability issue on its potential impact on patient comprehension and patient safety. Finally, in stage 3, an IT expert reviewed each usability issue to identify the likelihood of successfully addressing the issue. Results In stage 1, we identified 60 usability issues that violated a total of 108 heuristics. In stage 2, 18 additional usability issues that violated 27 heuristics were identified by the study experts. Impact ratings ranged from all experts rating the issue as “no impact” to 5 out of 6 experts rating the issue as having a “large negative impact.” On average, the older adult care partner representative rated usability issues as being more significant more of the time. In stage 3, 31 usability issues were rated by an IT professional as “impossible to address,” 21 as “maybe,” and 24 as “can be addressed.” Conclusions Integrating diverse expertise when evaluating usability is important when patient safety is at stake. The non-HFE experts, included in stage 2 of our evaluation, identified 23% (18/78) of all the usability issues and, depending on their expertise, rated those issues as having differing impacts on patient comprehension and safety. Our findings suggest that, to conduct a comprehensive heuristic evaluation, expertise from all the contexts in which the AVS is used must be considered. Combining those findings with ratings from an IT expert, usability issues can be strategically addressed through redesign. Thus, a 3-staged heuristic evaluation method offers a framework for integrating context-specific expertise efficiently, while providing practical insights to guide human-centered design.

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Work system barriers and facilitators of a team health information technology

et al. 2023

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Managing multiple perspectives in the collaborative design process of a team health information technology

Cited by 6 publications

References 27 publications

Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Evaluating the Usability of an Emergency Department After Visit Summary: Staged Heuristic Evaluation

Work system barriers and facilitators of a team health information technology

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