paper: user-designed information tools
TRANSCRIPT
User-designed information tools to supportcommunication and care coordination in a trauma hospital
Gurses et al. J Biomed Inform. 2009 Aug;42(4):667-77
does not evaluate an electronic information tool or system
offers insight on how clinicians manage info in spite of tools to
make their job easier
Why This Paper?
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
information technology introduced into many sectors = efficiency, quality
some advances in health care related to admin IT systems, not clinical ITsystems
Why This Paper?
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
qualitative methods provide a glimpse of what is ideal v. what is actually done in practice
provide information for designing systems
What Makes It Interesting?
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Ayse P. GursesJohns Hopkins, School of Medicine
junior researcher (2005)
body of work centres on qualitative methods, interviews, observations
clinical settings, nurses, information
The Authors
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Yan XiaoUniversity of Maryland, School of Medicine
engineer – human factors
body of work centres on qualitative methods, observations
clinical settings, information
The Authors
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
information technology professionals health administrators health decision-makers
Who Should Be Interested?
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
clinicians create their own tools understanding why tools are built
allows for development of systems to meet clinicians’ needs
Background
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
To describe the design characteristics and use of a clinician-designed information tool in supporting information transfer and care coordination
Objective
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
The researchers used: shadowing photographs interviews clipboardsto qualitatively examine the use of a clinician-designed information tool that was meant to support information transfer and care coordination
Methods
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Trauma care hospital
Setting
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
A – EMR
B - Access
C - Census
D – Attending
E - Team
F – Nurses
G – Nurse Assts
H - Float
I – Beds
J,K – Next Shift
Analysis of shadowing, interviews, photographs, and samples of the
clipboards
Outcome Measures
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Nurse coordinators use a paper-based information tool designed internally that compiled essential data from
disparate information sources
Results
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Information tools will be designed by users to meet their needs
Conclusions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
The characteristics of these tools and systems provide valuable insight into the needs of the users in relation to
information health technologies
Conclusions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
There is a role for users in helping to design their own information
systems
Conclusions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Equator Network
1. COREQ – interviews and focus groups (2007)
2. Evolving Guidelines – psychology and related fields (1999)
Assessment
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Essential:
1 nurse coordinator not interviewed
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Essential:
data saturation not discussed
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Essential:
limited information about interviews: length, audio-taping,
field notes, etc.
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Essential:
no declaration of a paradigm framework or philosophic
assumption
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Essential:
mixing of analytic approaches: ethnographic methods,
grounded theory
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Helpful:
full interview guide offered online
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Helpful:
member checks
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Less Essential:
software not mentioned (perhaps it was not used?)
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
Less Essential:
more narrative
Limitations
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
pre-test used with observation instrument
shadowing described more thoroughly than other activities
triangulation
Done Well
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
interview with 1 nurse coordinator
paradigm framework
mixing of analytic approaches
more info about interviews, other activities
Questions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
interview with 1 nurse coordinator
paradigm framework
mixing of analytic approaches
more info about interviews, other activities
Questions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
interview with 1 nurse coordinator
paradigm framework
mixing of analytic approaches
more info about interviews, other activities
Questions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
interview with 1 nurse coordinator
paradigm framework
mixing of analytic approaches
more info about interviews, other activities
Questions
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
the Clipboard is used more often than other information sources available
essential factors are portability, rapid accessibility, customizable, easy to add or change information
Implications
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
these features out-weight accuracy
Implications
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
need for adaptable, flexible systems
no concrete beginning point or end point in creating systems
accept a hybrid system, ‘paperless’ may not be possible
Implications
Material in support of a verbal presentation, not for interpretation as a stand-alone document09 November 2009
