Information gaps in reporting patient falls: the challenges and technical solutions.

The emerging computerized system for patient safety event reporting eases the course of learning from medical errors and adverse events for a safer healthcare environment. To a medical event like patient falls, the course usually involves pre, during and post stages for the prediction, reporting and solution of the event. However, the reporting stage often separates from the other two stages for risk assessment and cause analysis. As this iterative flow of actions falls apart and becomes unintelligible or intangible due to information gaps, it is dubious for users to join and complete the task at all three stages in a high quality. Therefore, in this paper, by referencing studies in aspects of Norman' s task action theory and fall management programs, we proposed a gap-bridging model to describe the process of assisting users in proceeding along the stages by user-centered design approaches. Based upon the model, we also developed a series of interface artifacts served as gap-bridging features, which hold promise in improving the quality of reporting and reporter engagement of the system.