eHealth in the Emergency Department
Issue
The implementation of health information technology in hospital Emergency Departments (ED) is changing the way healthcare is delivered and is a key component to improving quality of care. However, the beneficial impact of ehealth technology depends highly upon proper design to ensure optimal user adoption, perceived credibility, satisfaction and ease of use. The Scarborough Hospital (TSH) is conducting a pilot project which aims to enhance the quality and efficiency of their ED service by implementing two technologies: 1) A kiosk that captures data directly from patients to help clinicians monitor their changing health status, and (2) An electronic triage application that assists nurses in the assignment of patient acuity.
Methods
Human factors methods contributed to the design and evaluation of the patient kiosk and the nurse triaging application. Field observations were conducted in TSH emergency waiting rooms to understand current triaging practices and workflow. Expert evaluations of kiosk and triaging software prototypes were performed to ensure conformance to established usability principles. Patients and nurses participated in low fidelity usability testing to evaluate the ease of use and satisfaction of the kiosk and the triage application. A laboratory simulation of the TSH Emergency Department Waiting Room with patient and nurse participants was conducted to examine the effects on workflow.
Results
The present findings highlight the importance of conducting usability tests with targeted users to overcome problems related to ease of use, efficiency, and effectiveness. By having actual users try out the product beforehand, the project team was able to streamline the triage application for nurses, address issues of patient privacy and information security for patients and collect both nurse and patient perceptions of the new workflow. The use of human factors methods in this project helped to identify and address problems in user-friendliness, design, and functionality prior to implementation.
Related Publications:
CBC.ca 03/07 - Emergency patients to update condition while they wait
Canadian Healthcare Technology 03/07 - Multi-lingual kiosks tested...