Aanand D Naik1,2,3, Molly J Horstman1,2,3, Linda T Li4,5, Michael K Paasche-Orlow6, Bryan Campbell1, Whitney L Mills1,2, Levi I Herman1,7, Daniel A Anaya4,8, Barbara W Trautner1,2,4, David H Berger1,4. 1. Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, TX, USA. 2. Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 3. VA Quality Scholars Coordinating Center, Michael E. DeBakey VA Medical Center. 4. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. 5. Department of Medicine, Boston University School of Medicine, Boston, MA, USA. 6. Jesse H. Jones Graduate School of Business, Rice University, Houston, TX, USA. 7. Department of Gastrointestinal Oncology, Section of Hepatobiliary Tumors and Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. 8. Department of General Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Abstract
OBJECTIVES: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery. MATERIALS AND METHODS: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability. RESULTS: Literacy evaluation of the prototype suggested >12th-grade reading level. Subsequent revisions reduced reading level to 8th grade or below. Contents were formatted during heuristic evaluation into 3 action-oriented zones (green, yellow, and red) with relevant warning lexicons. Usability testing demonstrated comprehension of this 3-level lexicon and recognition of appropriate patient actions to take for each level. DISCUSSION: We developed a discharge warnings tool for colorectal surgery using staged user-centered design. The lexicon of surgical discharge warnings could structure communication among patients, caregivers, and clinicians to improve post-discharge care. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.
OBJECTIVES: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery. MATERIALS AND METHODS: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability. RESULTS: Literacy evaluation of the prototype suggested >12th-grade reading level. Subsequent revisions reduced reading level to 8th grade or below. Contents were formatted during heuristic evaluation into 3 action-oriented zones (green, yellow, and red) with relevant warning lexicons. Usability testing demonstrated comprehension of this 3-level lexicon and recognition of appropriate patient actions to take for each level. DISCUSSION: We developed a discharge warnings tool for colorectal surgery using staged user-centered design. The lexicon of surgical discharge warnings could structure communication among patients, caregivers, and clinicians to improve post-discharge care. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the United States.
Entities:
Keywords:
colorectal surgery; discharge instructions; health literacy; readmissions; usability testing
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