JMIR Publications

ABSTRACT

Background:

Typical solutions for improving discharge planning often rely on one-way communication mechanisms, static data entry into the electronic health record (EHR), or in-person meetings. Applying robust user-centered design, we have created a dynamic EHR discharge readiness tool, allowing the care team to communicate the status of patient discharge readiness and patient discharge needs in real-time across hospital settings.

Objective:

Applying robust user-centered design strategies, design an innovative EHR-based discharge communication tool.

Methods:

We employed multiple user-centered design strategies, including exploring the current state for documenting discharge readiness and directing discharge planning, iterative low-fidelity prototypes, multi-disciplinary stakeholder meetings, Brainwriting Premortem exercise, and pre-production user testing. We iteratively collected feedback from users via meetings and surveys.

Results:

We conducted 28 meetings with 20 different stakeholder groups. From these stakeholder meetings, we developed 14 low fidelity prototypes prior to deploying the Discharge Today tool for our pilot study. During the pilot study, stakeholders requested 46 modifications, 54% successfully executed. We found most providers who responded to the survey reported that the tool either saved time or did not change the amount time required to complete their discharge workflow (21, 87.5%). Responses to open-ended questions offered both positive feedback and opportunities for improvement in the domains of efficiency, integration into workflow, redundancies avoided, expedited communication, and patient-centeredness.

Conclusions:

Survey data suggest that this electronic discharge readiness tool has been successfully adopted by providers and clinical staff. Frequent stakeholder engagement and iterative user-centered design was critical to the successful implementation of this tool. Clinical Trial: Not applicable