J Am Med Inform Assoc - Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation.

Tópicos

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Resumo

JECTIVE: To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors.MATERIALS AND METHODS: We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug-allergy, drug-drug interaction, and drug-disease alerts based upon human factors principles. We assessed usability (learnability of redesign, efficiency, satisfaction, and usability errors), perceived workload, and prescribing errors.RESULTS: Although prescribers received no training on the design changes, prescribers were able to resolve redesigned alerts more efficiently (median (IQR): 56 (47) s) compared to the original alerts (85 (71) s; p=0.015). In addition, prescribers rated redesigned alerts significantly higher than original alerts across several dimensions of satisfaction. Redesigned alerts led to a modest but significant reduction in workload (p=0.042) and significantly reduced the number of prescribing errors per prescriber (median (range): 2 (1-5) compared to original alerts: 4 (1-7); p=0.024).DISCUSSION: Aspects of the redesigned alerts that likely contributed to better prescribing include design modifications that reduced usability-related errors, providing clinical data closer to the point of decision, and displaying alert text in a tabular format. Displaying alert text in a tabular format may help prescribers extract information quickly and thereby increase responsiveness to alerts.CONCLUSIONS: This simulation study provides evidence that applying human factors design principles to medication alerts can improve usability and prescribing outcomes.

Resumo Limpo

jectiv appli human factor engin principl improv alert interfac design hypothes incorpor human factor principl alert improv usabl reduc workload prescrib reduc prescrib errorsmateri method perform scenariobas simul studi use counterbalanc crossov design veteran affair prescrib compar origin versus redesign alert redesign drugallergi drugdrug interact drugdiseas alert base upon human factor principl assess usabl learnabl redesign effici satisfact usabl error perceiv workload prescrib errorsresult although prescrib receiv train design chang prescrib abl resolv redesign alert effici median iqr s compar origin alert s p addit prescrib rate redesign alert signific higher origin alert across sever dimens satisfact redesign alert led modest signific reduct workload p signific reduc number prescrib error per prescrib median rang compar origin alert pdiscuss aspect redesign alert like contribut better prescrib includ design modif reduc usabilityrel error provid clinic data closer point decis display alert text tabular format display alert text tabular format may help prescrib extract inform quick therebi increas respons alertsconclus simul studi provid evid appli human factor design principl medic alert can improv usabl prescrib outcom

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