Designing New Clinical Systems: Innovative Approaches to Support Practice
by Pat McDonell & Carol Warren
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ABSTRACT
In order to effectively influence patient outcomes, it is important to build and provide Clinical Informatics systems that reflect and enhance current practices. At the Hospital for Sick Children, we successfully moved from paper based records to an electronic permanent patient record in the early 90s. We are now transitioning from this DOS-based text interface, to a system with a Graphical User Interface (GUI). We have developed valuable insights into the design and development of the new GUI system through the use of the following three tools: practice review, staff engagement and the findings of a quantitative research project.
First, a variety of methods, including questionnaires, were used to review current clinical practices and processes, with clinical and other staff. Secondly, to ensure that all hospital staff were aware of the upcoming transition and engaged in the process, a number of activities to profile the project, including user group meetings, were developed. Finally, we also employed the findings from an ongoing research project involving data collection through non-participant observation, interviews with staff, and textual and visual rhetorical analysis of the current system. This research indicates that the visual and textual design of an electronic record system impacts on the daily practices of the health care professionals.
In using these three tools, we strive to achieve a specific goal: ensuring that the design of the new system supports healthcare providers in decision-making and care provision across the hospital.
ABOUT THE AUTHOR
Pat McDonell
Pat is a Senior Nurse Analyst in the Information Services Department and a member of the Nursing Informatics and Technology Program at the Hospital for Sick Children in Toronto, Canada. She has held various positions in nursing and informatics at HSC since 1982. She continues to support the current clinical system, in place since the early ‘90s, as well as sharing her expertise in the design, development and implementation of the hospital’s new Clinical Information System.
Carol Warren
Carol is a Senior Nurse Analyst in the Information Services Department and a member of the Nursing Informatics and Technology Program at the Hospital for Sick Children in Toronto, Canada. She has been employed at HSC for 18 years in various roles, both in nursing and informatics. She is currently working on the design, development and implementation of the hospital’s new Clinical Information System.
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