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Formative Usability Testing Reduces Severe Blood Product Ordering Errors.

Evan W Orenstein1,2, Jeanne Boudreaux1,3, Margo Rollins3,4

  • 1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States.

Applied Clinical Informatics
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Summary
This summary is machine-generated.

User-centered design (UCD) significantly reduced medical errors in pediatric blood product ordering. This improved patient safety by optimizing electronic ordering systems, making them more intuitive and less prone to mistakes.

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Area of Science:

  • Health Informatics
  • Patient Safety
  • Human-Computer Interaction

Background:

  • Medical errors in blood product ordering and administration are frequent, particularly in pediatric care.
  • Failure modes and effects analysis identified high-risk areas in electronic blood ordering processes.

Purpose of the Study:

  • To compare three blood product ordering system designs: original, expert committee-designed (DEC), and user-centered design (UCD).
  • To evaluate differences in ordering errors, task completion, time, and user preferences between original and UCD systems.

Main Methods:

  • A multidisciplinary committee developed the DEC order set, which underwent iterative refinement via formative usability testing with front-line users.
  • Summative testing involved randomizing participants to use either the original or UCD system in simulated scenarios.
  • Data collected included ordering errors, time on task, and user design preferences, analyzed using two-sample t-tests.

Main Results:

  • Formative testing led to 18 changes, resulting in the UCD system.
  • Error-free task completion rose from 36% with the original design to 66% with UCD (p=0.03).
  • No significant difference in time on task was observed between the two designs.

Conclusions:

  • User-centered design (UCD) created significantly different and improved blood product order sets compared to the expert committee design (DEC).
  • UCD implementation resulted in a marked reduction in ordering errors for pediatric blood products in simulated clinical settings.