Right Place, Right Time: Information Design to Support Decisions in Acute Care

 描述（由申请人提供）：改善电子医疗保健信息组织、优先级排序和呈现以支持患者护理是患者安全的关键优先事项。每年都有成千上万的患者因为重要信息被遗漏、误解或识别太晚而受到伤害。提供者抱怨说，他们很难快速找到所需的信息，关键信息可能会被遗漏。旨在帮助提供者检测重要患者变化或遵循循证护理活动的技术进步正在以智能监测和决策支持工具的形式进行。然而，这些工具往往被认为只是增加了更多的信息负荷。本项目的主要目标是实施以用户为中心的设计过程，以建立设计指南并评估设计概念，从而更好地组织、优先考虑和呈现急性护理电子患者信息。我们的方法首先进行知识启发活动，包括采访，卡片分类，并排名捕捉的方式急性护理信息的组织和优先级在重症监护提供者的头脑。为了说明背景和复杂性在医疗保健信息组织和优先级排序中的重要性，我们将在现实的患者用例背景下进行我们的活动。我们将使用这些活动的结果来通知一个迭代的以用户为中心的设计过程，以创建和评估更智能，更有效的患者信息显示的概念设计。在我们最近对重症监护环境中信息使用的定性研究中， 我们确定需要设计信息呈现以支持对患者和任务进行优先级排序， 监视患者的即将发生的危机或风险，跟踪患者状态和目标进展，以及动态患者数据的快速定向信息访问。因此，我们的概念设计将这些目标作为主要焦点。我们将进行访谈，实施启发式检查方法，并应用设计概念的可用性测试来开发功能性设计原型。最后，我们将使用这项工作的结果，以医疗保健信息呈现的设计指南的形式生成知识。我们希望我们的工作能够产生高效的重症监护患者信息呈现。特别是，我们希望我们的工作能够提供信息：动态患者数据的呈现，智能系统生成或解释的信息的呈现，以及识别和传达临床相关性和紧迫性的方法。我们的创新方法包括使用严格的以用户为中心的设计方法，以确定有意义的计划，组织患者数据。我们将把这些发现与传达有价值的数据特征的新技术相结合，例如紧急性和随时间变化。该项目的结果可应用于未来电子健康记录的设计，以便重要数据不会丢失，并可以轻松快速地访问。在重症监护病房以及其他护理环境中，我们预计这种效果的结果将显着减少临床医生的工作量和可预防的不良事件。

 DESCRIPTION (provided by applicant): Improving electronic health care information organization, prioritization, and presentation to support patient care is a crucial patient safety priority. Each year tens of thousands of patients are harmed because important information is missed, misunderstood, or identified too late. Providers complain that it is difficult for them to find the information they need quickly and that key information can be missed. Technological advances intended to help providers detect important patient changes or follow through with evidence-based care activities are underway in the form of intelligent surveillance and decision support tools. However, these tools are often perceived as simply adding more to the information load. The primary objective of this project is to implement a user-centered design process to establish design guidelines and evaluate design concepts to better organize, prioritize, and present acute care electronic patient information. Our approach begins by conducting knowledge elicitation activities including interviews, card sorting, and ranking to capture the way acute care information is organized and prioritized in the minds of critical care providers. To account for the importance of context and complexity in health care information organization and prioritization, we will conduct our activities in the context of realistic patientuse cases. We will use the findings from these activities to inform an iterative user-centered design process to create and evaluate conceptual designs for smarter, more effective patient information displays. In our recent qualitative study of information use in critical care settings, we identified a need to design information presentation to support prioritizing patients and tasks, monitoring patients for impending crises or risks, tracking patient status and progress toward goals, and rapid directed information access of dynamic patient data. Thus, our conceptual designs will have these goals as a primary focus. We will conduct interviews, implement heuristic inspection methods, and apply usability testing of design concepts to develop a functioning design prototype. Finally, we will use the findings of this effort to generate knowledge in the form of design guidelines for healthcare information presentation. We expect our work to result in highly effective critical care patient information presentation. In particula, we expect our work to inform: presentation of dynamic patient data, presentation of information generated or interpreted by intelligent systems, and means of identifying and conveying clinical relevance and urgency. Our innovative approach includes the use of rigorous user-centered design methods to identify meaningful schemes for organizing patient data. We will integrate these findings with novel techniques of conveying valuable data characteristics such as urgency and change over time. The results of this project can be applied to the design of future electronic health records so that important data are not missed and can be accessed easily and quickly. In intensive care units as well as other care settings, we expect the results of this effot to significantly reduce clinician workload and preventable adverse events.