Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States.
Division of Hospital Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio, United States.
Appl Clin Inform. 2024 Mar;15(2):327-334. doi: 10.1055/a-2272-6184. Epub 2024 Feb 20.
Our objective was to evaluate the usability of an automated clinical decision support (CDS) tool previously implemented in the pediatric intensive care unit (PICU) to promote shared situation awareness among the medical team to prevent serious safety events within children's hospitals.
We conducted a mixed-methods usability evaluation of a CDS tool in a PICU at a large, urban, quaternary, free-standing children's hospital in the Midwest. Quantitative assessment was done using the system usability scale (SUS), while qualitative assessment involved think-aloud usability testing. The SUS was scored according to survey guidelines. For think-aloud testing, task times were calculated, and means and standard deviations were determined, stratified by role. Qualitative feedback from participants and moderator observations were summarized.
Fifty-one PICU staff members, including physicians, advanced practice providers, nurses, and respiratory therapists, completed the SUS, while ten participants underwent think-aloud usability testing. The overall median usability score was 87.5 (interquartile range: 80-95), with over 96% rating the tool's usability as "good" or "excellent." Task completion times ranged from 2 to 92 seconds, with the quickest completion for reviewing high-risk criteria and the slowest for adding to high-risk criteria. Observations and participant responses from think-aloud testing highlighted positive aspects of learnability and clear display of complex information that is easily accessed, as well as opportunities for improvement in tool integration into clinical workflows.
The PICU Warning Tool demonstrates good usability in the critical care setting. This study demonstrates the value of postimplementation usability testing in identifying opportunities for continued improvement of CDS tools.
我们的目的是评估先前在儿科重症监护病房（PICU）实施的自动化临床决策支持（CDS）工具的可用性，以促进医疗团队之间的共同态势感知，从而预防儿童医院内的严重安全事件。
我们在中西部地区一家大型城市四级独立儿童医院的 PICU 中对 CDS 工具进行了混合方法的可用性评估。使用系统可用性量表（SUS）进行定量评估，而使用出声思维可用性测试进行定性评估。根据调查指南对 SUS 进行评分。对于出声思维测试，计算了任务时间，并按角色分层确定了平均值和标准差。总结了参与者的定性反馈和主持人的观察结果。
51 名 PICU 工作人员，包括医生、高级执业医师、护士和呼吸治疗师，完成了 SUS 评估，而 10 名参与者进行了出声思维可用性测试。总体中位数可用性评分为 87.5（四分位距：80-95），超过 96%的人将工具的可用性评为“好”或“优秀”。任务完成时间范围从 2 秒到 92 秒，审查高风险标准的完成时间最快，添加高风险标准的完成时间最慢。出声思维测试的观察结果和参与者的反应强调了该工具易于学习和清晰显示复杂信息的优点，以及在将工具集成到临床工作流程方面进行改进的机会。
PICU 警告工具在重症监护环境中具有良好的可用性。本研究证明了在实施后进行可用性测试对于确定继续改进 CDS 工具的机会具有价值。
