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A Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management: Results of the User-Centered Design Process
- Source :
- JMIR mHealth and uHealth, JMIR mHealth and uHealth, Vol 7, Iss 4, p e13226 (2019)
- Publication Year :
- 2018
-
Abstract
- BackgroundStressful situations during intraoperative emergencies have negative impact on human cognitive functions. Consequently, task performance may decrease and patient safety may be compromised. Cognitive aids can counteract these effects and support anesthesiologists in their crisis management. The Professional Association of German Anesthesiologists set up a project to develop a comprehensive set of digital cognitive aids for intraoperative emergencies. A parallel development for several software platforms and stationary and mobile devices will accommodate the inhomogeneity of the information technology infrastructure within German anesthesia departments. ObjectiveThis paper aimed to provide a detailed overview of how the task of developing a digital cognitive aid for intraoperative crisis management in anesthesia was addressed that meets user requirements and is highly user-friendly. MethodsA user-centered design (UCD) process was conducted to identify, specify, and supplement the requirements for a digital cognitive aid. The study covered 4 aspects: analysis of the context of use, specification of user requirements, development of design solutions, and evaluation of design solutions. Three prototypes were developed and evaluated by end users of the application. Following each evaluation, the new requirements were prioritized and used for redesign. For the first and third prototype, the System Usability Scale (SUS) score was determined. The second prototype was evaluated with an extensive Web-based questionnaire. The evaluation of the third prototype included a think-aloud protocol. ResultsThe chosen methods enabled a comprehensive collection of requirements and helped to improve the design of the application. The first prototype achieved an average SUS score of 74 (SD 12), indicating good usability. The second prototype included the following main revisions: 2-column layout, initial selection of patient type (infant, adult, or parturient), 4 offered search options, and the option to check off completed action steps. Its evaluation identified the following major revision points: add quick selection for resuscitation checklists, design the top bar and tabs slightly larger, and add more pictograms to the text. The third prototype achieved an average SUS score of 77 (SD 15). The evaluation of the think-aloud protocol revealed a good intuitiveness of the application and identified a missing home button as the main issue. ConclusionsAnesthesiology—as an acute medical field—is particularly characterized by its high demands on decision making and action in dynamic, or time-critical situations. The integration of usability aspects is essential for everyday and emergency suitability. The UCD process allowed us to develop a prototypical digital cognitive aid, exhibiting high usability and user satisfaction in the demanding environment of anesthesiological emergencies. Both aspects are essential to increase the acceptance of the application in later stages. The study approach, combining different methods for determining user requirements, may be useful for other implementation projects in a highly demanding environment.
- Subjects :
- 020205 medical informatics
Computer science
resuscitation
Health Informatics
Context (language use)
Information technology
02 engineering and technology
crew resource management, healthcare
User requirements document
Task (project management)
03 medical and health sciences
Patient safety
User-Computer Interface
0302 clinical medicine
Software Design
Surveys and Questionnaires
0202 electrical engineering, electronic engineering, information engineering
Humans
030212 general & internal medicine
Intraoperative Complications
User-centered design
Internet
Original Paper
business.industry
End user
System usability scale
practice guideline
Usability
reference books, medical
T58.5-58.64
Mobile Applications
anesthesiology
Crisis Intervention
ergonomics
Anesthesia
emergency treatment
Public aspects of medicine
RA1-1270
business
Anesthesia Department, Hospital
checklist
human factors
Subjects
Details
- ISSN :
- 22915222
- Volume :
- 7
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- JMIR mHealth and uHealth
- Accession number :
- edsair.doi.dedup.....5b77c270d32764d76f2f5fa4356f962f