Information Services and Technology, Children's Healthcare of Atlanta, Atlanta, Georgia, United States.
Emory University School of Medicine, Atlanta, Georgia, United States.
Appl Clin Inform. 2024 Aug;15(4):763-770. doi: 10.1055/a-2351-9642. Epub 2024 Jun 25.
Blood product ordering is a complex process and mistakes can harm patients and lead to poor outcomes. Orders and order sets can be designed to help mitigate errors, but major changes in design can unintentionally cause new errors.
Our objective was as follows: (1) utilize formative in situ usability testing to iteratively improve the design of a redesigned blood product order set prior to go-live, (2) implement changes based on feedback derived from this testing, and (3) compare the error rate, system usability scale (SUS) score, time to task completion, and click counts between the prior order set in use at the time and the revised redesigned order set.
A multidisciplinary project team convened to redesign blood product orders and order sets from scratch based on a review of the literature and benchmarking against four pediatric academic institutions with the goal of addressing prior ordering errors. The newly redesigned blood product order set was iteratively updated via in situ formative usability testing performed with available clinical users using a concurrent think-aloud protocol in real clinical environments. Errors, SUS scores, time to task completion, and click counts were assessed for the revised redesigned order set using summative testing.
Formative usability testing with 20 participants led to seven design changes in the redesigned order set which reduced the error rate at go-live. Summative usability testing showed that even though the usability scores were only slightly improved for the revised redesigned order set, the error rates in blood orders were significantly decreased.
Usability testing can identify design errors early in the process which can be rectified prior to implementation, thus avoiding unintended consequences of changes.
血液制品的订购是一个复杂的过程，错误可能会危害患者并导致不良后果。订单和订单集可以设计为帮助减轻错误，但设计的重大变化可能会无意中导致新的错误。
我们的目的如下：（1）利用形成性现场可用性测试在重新设计血液制品订单集上线之前迭代改进设计，（2）根据从测试中得出的反馈实施更改，以及（3）比较在使用中之前的订单集和重新设计的重新设计的订单集的错误率、系统可用性量表（SUS）得分、完成任务的时间和点击次数。
一个多学科项目团队开会重新设计血液制品订单和订单集，从头开始，对文献进行审查，并以四家儿科学术机构为基准，目标是解决之前的订购错误。新设计的血液制品订单集通过在实际临床环境中使用现有临床用户使用并发思维大声协议进行现场形成性可用性测试进行迭代更新。使用总结性测试评估修订后的重新设计的订单集中的错误、SUS 分数、完成任务的时间和点击次数。
对 20 名参与者进行的形成性可用性测试导致重新设计的订单集中进行了七项设计更改，从而降低了上线时的错误率。总结性可用性测试表明，尽管重新设计的重新设计的订单集的可用性得分仅略有提高，但血液订单中的错误率显着降低。
可用性测试可以在实施之前尽早发现设计错误，从而避免更改的意外后果。
