Patient information organization in the intensive care setting: expert knowledge elicitation with card sorting...

Area of Science:

• Medical Informatics
• Human-Computer Interaction
• Critical Care Medicine

Background:

• Electronic health records often hinder information uptake due to low-level organizational demands.
• Clinical concept-oriented views show promise for improving information processing, but their application in critical care is not well-defined.

Purpose of the Study:

• To identify high-level cognitive processes used by critical care clinicians.
• To determine patient information organization schemas relevant to critical care settings.

Main Methods:

• Conducted an open card sort with 29 patient data elements and a modified Delphi card sort with 65 elements.
• Included 39 critical care clinicians with diverse training and experience.
• Analyzed data using hierarchical cluster analysis (HCA) and factor analysis (FA), comparing results across methods and exercises.

Main Results:

• Common constructs identified include cardiovascular, infectious disease, medications, neurology, patient overview, respiratory, and vital signs.
• More comprehensive Delphi sort solutions additionally incorporated gastrointestinal, renal, and imaging constructs.
• System-based groupings were primary, with source-based groups emerging for longer concept lists.

Conclusions:

• Clinicians' mental models are best supported by a hybrid information organization approach.
• This hybrid model may integrate system, source, or problem-based groupings.
• Findings can inform the design of information displays to enhance critical care decision-making.