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Developing the VA Geriatric Scholars Programs' Clinical Dashboards Using the PDSA Framework for Quality Improvement.

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Iterative development of clinical dashboards using Plan-Do-Study-Act cycles improves user adoption and usability. This approach ensures that health IT innovations meet evolving clinician needs over time.

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Area of Science:

  • Health Information Technology
  • Clinical Informatics
  • Usability Engineering

Background:

  • Clinician end-user involvement is crucial for effective clinical dashboard development.
  • Clinician turnover presents a challenge to maintaining user-centered design throughout a dashboard's lifecycle.

Purpose of the Study:

  • To summarize a Plan-Do-Study-Act (PDSA)-guided iterative development process for clinical dashboards within the VA Geriatric Scholars Program (GSP).
  • To evaluate the adaptations and performance of a potentially inappropriate medication dashboard (PIMD) through continuous improvement cycles.

Main Methods:

  • The potentially inappropriate medication dashboard (PIMD) underwent iterative development guided by two PDSA cycles.
  • System Usability Scale (SUS) and user interaction logs were used to evaluate PIMD performance.
  • Routine users (Geriatric Scholars with ≥5 dashboard views) completed the 10-item SUS survey.

Main Results:

  • The proportion of Geriatric Scholars using the PIMD increased from 31.0% in 2017 to 60.2% in 2019.
  • The PIMD demonstrated above-average usability with a SUS score of 75.2 (95% CI 70.5-79.8), exceeding the acceptability standard of 68.
  • Iterative adaptations based on user feedback broadened the dashboard's utility.

Conclusions:

  • Continuous, iterative development using PDSA cycles enhances clinical dashboard adoption and usability.
  • The described PDSA-guided framework offers a valuable model for developing well-adopted and usable health IT innovations.
  • Soliciting user feedback during dashboard orientation is key to successful iterative adaptations.