Designing observation charts to optimize the detection of patient deterioriation: Reliance on the subjective preferences of healthcare professionals is not enough

Preece, Megan H. W., Hill, Andrew, Horswill, Mark S., Karamatic, Rozemary and Watson, Marcus O. (2012) Designing observation charts to optimize the detection of patient deterioriation: Reliance on the subjective preferences of healthcare professionals is not enough. Australian Critical Care, 25 4: 238-252. doi:10.1016/j.aucc.2012.01.003

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Author Preece, Megan H. W.
Hill, Andrew
Horswill, Mark S.
Karamatic, Rozemary
Watson, Marcus O.
Title Designing observation charts to optimize the detection of patient deterioriation: Reliance on the subjective preferences of healthcare professionals is not enough
Journal name Australian Critical Care   Check publisher's open access policy
ISSN 1036-7314
1878-1721
Publication date 2012-11
Sub-type Article (original research)
DOI 10.1016/j.aucc.2012.01.003
Volume 25
Issue 4
Start page 238
End page 252
Total pages 15
Place of publication Philadelphia, PA United States
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Aim: Observation charts are critical to detecting patient deterioration. Research suggests their design has a dramatic impact on user performance in terms of failure rates for detecting abnormal vital signs and how quickly users can interpret recorded observations. In this study, we examined the design preferences of professional chart users to assess their alignment with objective performance data. In addition, we tested the assumptions of prior knowledge that chart designers appear to have made about chart users.
Methods
: We conducted an online survey of health professionals (n = 347). Participants answered questions about their observation chart design preferences in general, and were randomly assigned to evaluate one of nine specific charts.
Results:
Chart users' preferences for design features were not always consistent with objective performance data. While some views concurred with empirical findings (e.g., participants preferred to plot observations on a graph with graded colouring, where the colours corresponded with degrees of abnormality), others did not (e.g., participants preferred plotting blood pressure and pulse together on the same chart area, which the objective data suggest is problematic). Additionally, a substantial proportion of respondents were unfamiliar with some of the assumed knowledge required to interpret many charts (e.g., particular abbreviations).
Conclusions:
It is dangerous to rely solely on subjective opinions - even those of experienced health professionals - when developing patient observation charts, as optimal design may be counterintuitive and some preferences may merely reflect familiarity. Objective performance data is also required. In addition, the level of assumed knowledge required to use a chart should be minimized
Keyword Patient assessment
Patient safety
Physiological deterioration
Vital signs
Medical Emergency Team
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
School of Psychology Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
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