Bryan Gibson1, Jorie Butler2, Kumiko Schnock3, David Bates3, David Classen4. 1. University of Utah, Department of Biomedical Informatics, 421 Wakara Way, Salt Lake City, UT, 84132, USA. Electronic address: Bryan.Gibson@utah.edu. 2. University of Utah, Department of Geriatrics, Salt Lake City, USA. 3. Harvard University, Division of General Internal Medicine and Primary Care, Boston, USA. 4. University of Utah, Division of Clinical Epidemiology, Salt Lake City, USA.
Abstract
BACKGROUND: Nearly one third of hospitalized patients suffer harm from medical errors in U.S. hospitals each year. OBJECTIVE: Our goal was to design a patient-facing application that is intended to engage patients and their caregivers in reviewing and responding to clinical issues that may have safety implications. PATIENT INVOLVEMENT: We conducted user-centered design sessions with recently hospitalized individuals and /or informal caregivers. METHODS: We conducted five user-centered design sessions with total of 37 individuals. Sessions began with individuals sharing personal stories of recent hospitalizations and any experienced safety events. We then solicited feedback on the current iteration of the patient-facing safety application. The design of the app was updated between sessions. RESULTS: The design of our app centers around three key findings. First, involving patients in safety promotion is novel to most patients and their caregivers: therefore the framing of the tool's purpose and appropriate use is critical to engage potential users and manage expectations, this messaging was carefully crafted with patient input. Second, since most patients do not associate specific safety issues with appropriate remedial or preventative actions, the centerpiece of the application is a table that connects safety issues with related "Questions you should ask" and "Things you can do". Third, patients need understandable explanations of medical terms and concepts as well as explanation of changes in risk; the tool includes plain language "translations" of all medical terms used, links to curated patient education materials, and simplified graphics to visualize changes in risk. DISCUSSION: Our findings may generalize to other efforts to engage patients in their care. PRACTICE VALUE: Designing for patient engagement requires patients' perspective both on their current role and their ideal role; framing for expectations, action-oriented design, and clarity of presented information may address that gap in patient engagement.
BACKGROUND: Nearly one third of hospitalized patients suffer harm from medical errors in U.S. hospitals each year. OBJECTIVE: Our goal was to design a patient-facing application that is intended to engage patients and their caregivers in reviewing and responding to clinical issues that may have safety implications. PATIENT INVOLVEMENT: We conducted user-centered design sessions with recently hospitalized individuals and /or informal caregivers. METHODS: We conducted five user-centered design sessions with total of 37 individuals. Sessions began with individuals sharing personal stories of recent hospitalizations and any experienced safety events. We then solicited feedback on the current iteration of the patient-facing safety application. The design of the app was updated between sessions. RESULTS: The design of our app centers around three key findings. First, involving patients in safety promotion is novel to most patients and their caregivers: therefore the framing of the tool's purpose and appropriate use is critical to engage potential users and manage expectations, this messaging was carefully crafted with patient input. Second, since most patients do not associate specific safety issues with appropriate remedial or preventative actions, the centerpiece of the application is a table that connects safety issues with related "Questions you should ask" and "Things you can do". Third, patients need understandable explanations of medical terms and concepts as well as explanation of changes in risk; the tool includes plain language "translations" of all medical terms used, links to curated patient education materials, and simplified graphics to visualize changes in risk. DISCUSSION: Our findings may generalize to other efforts to engage patients in their care. PRACTICE VALUE: Designing for patient engagement requires patients' perspective both on their current role and their ideal role; framing for expectations, action-oriented design, and clarity of presented information may address that gap in patient engagement.
Authors: David A Dorr; Christopher D'Autremont; Christie Pizzimenti; Nicole Weiskopf; Robert Rope; Steven Kassakian; Joshua E Richardson; Rob McClure; Floyd Eisenberg Journal: Appl Clin Inform Date: 2021-08-04 Impact factor: 2.762