TY - JOUR
T1 - User-designed information tools to support communication and care coordination in a trauma hospital
AU - Gurses, Ayse P.
AU - Xiao, Yan
AU - Hu, Peter
N1 - Funding Information:
This work was funded by the National Science Foundation (IIS-0534646). Opinions expressed here are those of the authors and do not necessarily reflect the official position of the sponsor. The study benefited from discussions with Paul Gorman and Brian Hazelhurst. We would like to thank Steve Seebode, Therese Trainum, Kathy Ross, Virginia Delauter, and Deana Holler for their time and support during the study.
PY - 2009/8
Y1 - 2009/8
N2 - 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 41 min 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.
AB - 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 41 min 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.
KW - Clinical information systems
KW - Computer supported cooperative work
KW - Computerized medical records system
KW - Coordination
KW - EHR
KW - Interdisciplinary communication
KW - Nurses
KW - Qualitative research
KW - User interfaces
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U2 - 10.1016/j.jbi.2009.03.007
DO - 10.1016/j.jbi.2009.03.007
M3 - Article
C2 - 19298868
AN - SCOPUS:67649383347
SN - 1532-0464
VL - 42
SP - 667
EP - 677
JO - Journal of Biomedical Informatics
JF - Journal of Biomedical Informatics
IS - 4
ER -