“CATCH-IT Reports” are Critically Appraised Topics in Communication, Health Informatics, and Technology, discussing recently published ehealth research. We hope these reports will draw attention to important work published in journals, provide a platform for discussion around results and methodological issues in eHealth research, and help to develop a framework for evidence-based eHealth. CATCH-IT Reports arise from “journal club” - like sessions founded in February 2003 by Gunther Eysenbach.
Monday, November 2, 2009
Nov 9: User-designed information tools to support communication and care coordination in a trauma hospital
Full-Text · Abstract Only · Slideshow · Draft CATCH-IT
BACKGROUND: In response to inherent inadequacies in health information technologies, clinicians create their own tools for managing their information needs. Little is known about these clinician-designed information tools. With greater appreciation for why clinicians resort to these tools, health information technology designers can develop systems that better meet clinicians' needs and that can also support clinicians in design and use of their own information tools.
OBJECTIVE: To describe the design characteristics and use of a clinician-designed information tool in supporting information transfer and care coordination
DESIGN: Observations, semi-structured interviews, and photographing were used to collect data. Participants were six nurse coordinators in a high-volume trauma hospital. Content analysis was carried out and interactions with information tools were analyzed.
RESULTS: Nurse coordinators used a paper-based information tool (a nurse coordinator's clipboard) that consisted of the compilation of essential data from disparate information sources. The tool was assembled twice daily through (1) selecting and formatting key data from multiple information systems (such as the unit census and the EHR), (2) data reduction (e.g., by cutting and whitening out non-essential items from the print-outs of computerized information systems), (3) bundling (e.g., organizing pieces of information and taping them to each other), and (4) annotating (e.g., through the use of colored highlighters and shorthand symbols). It took nurse coordinators an average of 41min to assemble the clipboard. The design goals articulated by nurse coordinators to fit the tool into their tasks included (1) making information compatible with the mobile nature of their work, (2) enabling rapid information access and note-taking under time pressure, and (3) supporting rapid information processing and attention management through the effective use of layout design, shorthand symbols, and color-coding.
CONCLUSIONS: Clinicians design their own information tools based on the existing health information technologies to meet their information needs. The characteristics of these clinician-designed tools provide insights into the "realities" of how clinicians work with health information technologies. The findings suggest an often overlooked role for health information technologies: facilitating user creation of information tools that will best meet their needs.