Application of clinical workstations: functionality and usability

Clinical workstations are software systems that support physicians and nurses in all their specific activities concerned with the medical care of inpatients. In the university hospital of Saarland, we are testing several commercial systems so as to whether they can give such comprehensive support. For their evaluation, we developed a list of criteria grouped in functions to support the physicians, functions to support the nurses, and general functions, together with a grading schema. Besides scope and quality of functions, the acceptance of clinical workstations strongly depends on organizational environment and human factors. To evaluate these conditions, we interviewed all people concerned with the system, using a checklist. The following are examples of problems that we detected: "Facts" (new design of work flow, eg, for examination or nursing procedures); some tasks have to be performed twice; reaction to emergencies; frequent changes of staff. Technical deficiencies (response times too long; mobile data collection was insufficient due to width of display and lack of data consistency, eg, during the doctor's visit). Psychological factors (fear of using computers; statements such as "Medical work cannot be planned" or "Too few benefits from the system"; in view of increasing "transparency," no use for electronic scheduling; insufficient understanding of work flow of automated tasks). The consequences of this study are the introduction of clinical workstations in hospital needs, as well as reengineering the business processes of the ward as a careful and intensive training of staff. This article will present and discuss methods and results of this evaluation study.