Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 19, 2024
Open Peer Review Period: Nov 20, 2024 - Jan 15, 2025
Date Accepted: Feb 19, 2025
(closed for review but you can still tweet)
Exploratory Co-Design on Electronic Health Record Nursing Summary: A Case-Study
ABSTRACT
Background:
Although electronic health record nursing summaries aim to provide a concise overview of patient data, they often fall short of meeting nurses’ information needs, leading to underutilization. This gap arises from a lack of involvement of nurses in the design of health information technologies.
Objective:
The purpose of this co-design study was to solicit insights from nurses regarding nursing summary design considerations, including key information types and the preferred design prototype.
Methods:
We recruited clinical nurses (N = 33) practicing in inpatient units at a university hospital in the Midwest. We used images from a simulated nursing summary to generate visual card versions of the 46 information types currently included in an electronic health record nursing summary. Participants evaluated the relevance of each information type card to the nursing summary and indicated their preferred arrangement of the information type on a summary layout. After participants evaluated the information type cards, debriefing interviews were conducted to explore their rationales for the desired content and its arrangement.
Results:
The participants demonstrated a high level of engagement in the co-design process. On average, all 33 participants included 61% (n = 28) of the total information types (n = 46). The most frequently included cards were unit specimen (lab), activity, diet, and hospital problems. Participants most frequently preferred adjacency of the following pairs: activity and diet (paired by 26 participants; 79%) and notes to physicians and notes to treatment team (paired by 25 participants; 76%). Participants preferred arranging the cards to improve information accessibility, focusing on key information types.
Conclusions:
Involving nurses in the co-design process may result in more useful and usable designs, thereby reducing the time required to navigate nursing summaries. Future work should include refining and evaluating prototypes based on the designs created by the nurses. Clinical Trial: NA
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