JMIR Publications

ABSTRACT

Background:

Emergency departments (EDs) are high-pressure environments where a diagnosis is made in a resource-constrained context. These environments also require complicated interactions between patients, caregivers, and healthcare providers to make timely diagnoses. EDs, in consequence, predispose to suboptimal diagnostic outcomes, leading to potential errors and subsequent patient harm. Various interventions have been designed to improve the ED diagnostic process and patient safety. However, designing patient-centered interventions is challenging due to limited opportunities for engaging patients in intervention design processes.

Objective:

This study aims to invite ED patients to participatory design sessions, identify their challenges and needs during ED visits, and present design guidelines for patient-centered interventions.

Methods:

We conducted a participatory design study with ED patients to design patient-centered interventions to improve diagnostic safety. In total, 36 ED patients or caregivers participated in eight design sessions. We presented ten intervention ideas as storyboards to the participants. Through storyboards describing the use cases of each intervention idea, we assessed the participants’ needs and challenges during the ED care process. We also facilitated co-design activities with them to improve the intervention designs. We audio- and video-recorded the design sessions. We then analyzed session transcripts, field notes, and design sketches.

Results:

Based on ED patients’ feedback and evaluation of our intervention designs, we found the three most preferred intervention ideas that address the common challenges that ED patients experience. We also identified four themes of ED patients' needs: feeling of inclusion in the ED care process, access to sources for patient comprehension of medical information, need to address patient anxiety related to information overload and privacy concerns, and ensuring continuity in care and information. We interpreted them as insights for designing technological interventions for ED patients. Hence, based on the findings, we present five considerations for designing better patient-centered interventions in the ED care process: 1) technology-based interventions should address patients’ dynamic needs to promote continuity in care, 2) interventions should consider the amount and timing of information that patients receive, 3) interventions should empower patients to be more active for better patient safety and care quality, 4) interventions should optimize human resources, depending on patient’s needs, and 5) interventions should be designed with the consideration of patients’ perspectives on implementation.

Conclusions:

This study provides unique insights for designing technological interventions to support ED diagnostic processes. By inviting ED patients into the design process, we present unique insights into the diagnostic process and design considerations for designing novel technological interventions to enhance patient safety.