Purpose: In this study, we leverage a user-centered design methodology of iterative cycles of user research to inform optimizations to the electronic health record (EHR) in order to best support nurses with timely documentation, data visualization (e.g. visualization of tasks due), and ease of navigation.
Description: Timely, accurate, accessible nursing documentation is critical to care quality and seamless continuity of patient care amongst the interdisciplinary care team. It also has important implications for accreditation, regulatory, research, legal, billing, and reimbursement. While EHR systems provide myriad positive impacts on healthcare delivery, perception of usability, and user-friendliness continues to remain an area with opportunity for improvement. High click counts and ease of navigation have been cited as major sources of dissatisfaction amongst clinicians.
Evaluation/outcome: At two-weeks post-go-live, preliminary end user feedback revealed themes of education, efficiency, and aesthetic. Semi-structured interviews further highlighted opportunities for optimizations and an improved communication strategy for socializing system changes. Some end users reported that the change in screen design was disorienting at first, but as they became acquainted with it, they found it to be more user-friendly. The theme of education was informed by an identified need amongst some staff for an improved socialization of changes to come prior to implementation. The theme of efficiency was evidenced by feedback that staff perceive fewer clicks and screen toggling to complete workflows. As an example, one registered nurse (RN) reported “I like that I’m able to view patient information and an overview of the patient’s upcoming procedures.” We will continue to capture qualitative data in addition to analysis of quantitative findings related to timeliness of task management.
Conclusions: Our preliminary findings suggest that when a system is optimized leveraging user-centered design methodologies with early and frequent end user feedback, both usability and adoption can be improved. Tracking staff completion of educational materials is one metric to consider for go-live readiness. A frequent cadence of communication that comes directly from leadership to their direct reports and from senior leadership to the front lines is critical for effective enterprise-wide information dissemination.
Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.