Iterative User Interface Design for Automated Sequential Organ Failure Assessment Score Calculator in Sepsis...

Area of Science:

• Medical Informatics
• Clinical Decision Support
• Healthcare Workflow Optimization

Background:

• The updated sepsis definition necessitates frequent Sequential Organ Failure Assessment (SOFA) score recalculations.
• Manual SOFA score calculation imposes a significant clerical burden due to extensive information retrieval.

Purpose of the Study:

• To quantify the clerical workload associated with manual SOFA score calculation using time-motion analysis.
• To develop and evaluate a user-centered design for an automated, electronic medical record (EMR)-integrated SOFA score calculator.

Main Methods:

• Time-motion analysis of manual SOFA score calculation by internal medicine residents.
• Agile development process for creating an automated SOFA score calculator user interface.
• Usability evaluation of the final user interface using the Computer Systems Usability Questionnaire.

Main Results:

• Manual SOFA score calculation averaged 61.6 seconds per instance.
• The user-centered design process yielded a highly favorable user interface (>75% favorability).
• Positive feedback was received across system usability, information quality, and interface quality domains.

Conclusions:

• Early stakeholder engagement in an agile design process led to an automated SOFA calculator that reduces clinician workload.
• The developed tool meets clinicians' needs at the point of care.
• User-centered design and usability evaluation are crucial for developing clinical score calculators and decision support tools.