Clinical handover improvement in context: exploring tensions between user-centred approaches and standardisation

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Communication

Background:

• User-centered design is vital for optimizing health information systems.
• Standardization of clinical practices aims to enhance patient care quality and safety.
• Clinical handover is a critical process for patient care continuity.

Purpose of the Study:

• To explore tensions between user-centered approaches and standardization in health information systems for clinical handover.
• To identify unique departmental requirements for clinical handover information systems.
• To propose a resolution for integrating diverse user needs with standardization efforts.

Main Methods:

• A user-centered approach was employed in three hospital departments.
• Unique departmental requirements for clinical handover information systems were identified.
• The implications of accommodating diverse needs on standardization were analyzed.

Main Results:

• Distinct minimum data sets were developed for each department, challenging hospital-wide standardization.
• Accommodating unique user requirements highlighted potential organizational quality and safety risks.
• Tensions arose between user-centered needs and standardized clinical handover practices.

Conclusions:

• Flexible standardization emerged as a strategy to resolve tensions between user needs and standardization.
• This approach was embedded in Australia's national guidelines for clinical handover improvement.
• Integrating user-centered design with flexible standardization can enhance health information system quality and safety.