User-designed information tools to support communication and care coordination in a trauma hospital Gurses et al. J Biomed Inform. 2009 Aug;42(4):667-77

 does not evaluate an electronic information tool or system  offers insight on how clinicians manage info in spite of tools to make their job easier Why This Paper? Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 does not evaluate an electronic information tool or system

 offers insight on how clinicians manage info in spite of tools to make their job easier

 information technology introduced into many sectors =  efficiency, quality  some advances in health care related to admin IT systems, not clinical IT systems Why This Paper? Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 information technology introduced into many sectors =  efficiency, quality

 some advances in health care related to admin IT systems, not clinical IT systems

 qualitative methods provide a glimpse of what is ideal v. what is actually done in practice  provide information for designing systems What Makes It Interesting? Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 qualitative methods provide a glimpse of what is ideal v. what is actually done in practice

 provide information for designing systems

Ayse P. Gurses Johns Hopkins, School of Medicine  junior researcher (2005)  body of work centres on qualitative methods, interviews, observations  clinical settings, nurses, information The Authors Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Ayse P. Gurses

Johns Hopkins, School of Medicine

 junior researcher (2005)

 body of work centres on qualitative methods, interviews, observations

 clinical settings, nurses, information

Yan Xiao University of Maryland, School of Medicine  engineer – human factors  body of work centres on qualitative methods, observations  clinical settings, information The Authors Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Yan Xiao

University of Maryland, School of Medicine

 engineer – human factors

 body of work centres on qualitative methods, observations

 clinical settings, information

 information technology professionals  health administrators  health decision-makers Who Should Be Interested? Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 information technology professionals

 health administrators

 health decision-makers

 clinicians create their own tools  understanding why tools are built allows for development of systems to meet clinicians’ needs Background Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 clinicians create their own tools

 understanding why tools are built allows for development of systems to meet clinicians’ needs

To describe the design characteristics and use of a clinician-designed information tool in supporting information transfer and care coordination Objective Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

To describe the design

characteristics and use of a

clinician-designed information

tool in supporting information

transfer and care coordination

The researchers used:  shadowing  photographs  interviews  clipboards to qualitatively examine the use of a clinician-designed information tool that was meant to support information transfer and care coordination Methods Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

The researchers used:

 shadowing  photographs

 interviews  clipboards

to qualitatively examine the use of a clinician-designed information tool

that was meant to support information transfer and care coordination

Trauma care hospital Setting Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Trauma care hospital

A – EMR B - Access C - Census D – Attending E - Team F – Nurses G – Nurse Assts H - Float I – Beds J,K – Next Shift

Analysis of shadowing, interviews, photographs, and samples of the clipboards Outcome Measures Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Analysis of shadowing, interviews, photographs, and samples of the clipboards

Nurse coordinators use a paper-based information tool designed internally that compiled essential data from disparate information sources Results Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Nurse coordinators use a paper-based information tool designed internally that compiled essential data from disparate information sources

Information tools will be designed by users to meet their needs Conclusions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Information tools will be designed by users to meet their needs

The characteristics of these tools and systems provide valuable insight into the needs of the users in relation to information health technologies Conclusions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

The characteristics of these tools and systems provide valuable insight into the needs of the users in relation to information health technologies

There is a role for users in helping to design their own information systems Conclusions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

There is a role for users in helping to design their own information systems

Equator Network 1. COREQ – interviews and focus groups (2007) 2. Evolving Guidelines – psychology and related fields (1999) Assessment Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Equator Network

1. COREQ – interviews and focus groups (2007)

2. Evolving Guidelines – psychology and related fields (1999)

Essential: 1 nurse coordinator not interviewed Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Essential:

1 nurse coordinator not interviewed

Essential: data saturation not discussed Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Essential:

data saturation not discussed

Essential: limited information about interviews: length, audio-taping, field notes, etc. Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Essential:

limited information about interviews: length, audio-taping, field notes, etc.

Essential: no declaration of a paradigm framework or philosophic assumption Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Essential:

no declaration of a paradigm framework or philosophic assumption

Essential: mixing of analytic approaches: ethnographic methods, grounded theory Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Essential:

mixing of analytic approaches: ethnographic methods, grounded theory

Helpful: full interview guide offered online Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Helpful:

full interview guide offered online

Helpful: member checks Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Helpful:

member checks

Less Essential: software not mentioned (perhaps it was not used?) Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Less Essential:

software not mentioned (perhaps it was not used?)

Less Essential: more narrative Limitations Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

Less Essential:

more narrative

 pre-test used with observation instrument  shadowing described more thoroughly than other activities  triangulation Done Well Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 pre-test used with observation instrument

 shadowing described more thoroughly than other activities

 triangulation

 interview with 1 nurse coordinator  paradigm framework  mixing of analytic approaches  more info about interviews, other activities Questions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 interview with 1 nurse coordinator

 paradigm framework

 mixing of analytic approaches

 more info about interviews, other activities

 interview with 1 nurse coordinator  paradigm framework  mixing of analytic approaches more info about interviews, other activities Questions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 interview with 1 nurse coordinator

 paradigm framework

 mixing of analytic approaches

more info about interviews, other activities

 interview with 1 nurse coordinator  paradigm framework  mixing of analytic approaches  more info about interviews, other activities Questions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 interview with 1 nurse coordinator

 paradigm framework

 mixing of analytic approaches

 more info about interviews, other activities

 interview with 1 nurse coordinator  paradigm framework  mixing of analytic approaches  more info about interviews, other activities Questions Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 interview with 1 nurse coordinator

 paradigm framework

 mixing of analytic approaches

 more info about interviews, other activities

 the Clipboard is used more often than other information sources available  essential factors are portability, rapid accessibility, customizable, easy to add or change information Implications Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 the Clipboard is used more often than other information sources available

 essential factors are portability, rapid accessibility, customizable, easy to add or change information

 these features out-weight accuracy Implications Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 these features out-weight accuracy

 need for adaptable, flexible systems  no concrete beginning point or end point in creating systems  accept a hybrid system, ‘paperless’ may not be possible Implications Material in support of a verbal presentation, not for interpretation as a stand-alone document 09 November 2009

 need for adaptable, flexible systems

 no concrete beginning point or end point in creating systems

 accept a hybrid system, ‘paperless’ may not be possible