Lessons Learned from Implementing a Patient Prioritization Tool Designed with End-Users in a Pediatric Emergency Ward

Area of Science:

• Healthcare Management
• Human Factors Engineering
• Emergency Medicine

Background:

• Emergency departments face overcrowding, impacting care quality and finances.
• Optimum, an electronic tool for pediatric emergency department (PED) patient prioritization, was developed with staff involvement.
• Initial assessments indicated low staff adoption of Optimum despite its user-centered design.

Purpose of the Study:

• To investigate the reasons behind the low utilization of the Optimum system by PED staff.
• To understand the barriers to adopting a user-centered designed patient prioritization tool.

Main Methods:

• A mixed-methods approach involving surveys and semi-structured/unstructured interviews with PED staff.
• Grounded theory approach used by ergonomics experts to analyze interview transcripts.
• Data extraction and iterative organization of semantic units to identify usage patterns.

Main Results:

• Interviews with 12 PED staff (physicians, nurses) revealed mixed responses to the Optimum tool.
• Users reported issues with understanding and trusting the Optimum display.
• The tool was primarily used for estimating patient load rather than for actual patient prioritization.

Conclusions:

• Implementing new tools in clinical settings is challenging, even with user-centered development.
• Integration into existing daily patient management systems is crucial for successful tool adoption.
• Failure to integrate Optimum into daily workflows hindered its intended use for patient prioritization.