JMIR Publications

ABSTRACT

Background:

Re-triage is the emergent inter-hospital transfer of severely injured patients from non/low-level to high-level trauma centers.

Objective:

The aim was to apply user-centered design to develop a robust, acceptable, and feasible solution to improve the re-triage process.

Methods:

The mixed methods, observational, cross-sectional study applied the 5 phases of a user-centered design approach, including Phase 1: Understanding the design needs, through site visit observations and virtual focus groups; Phase 2: Ideation of potential solutions through a second round of virtual focus groups; Phase 3: Rank Ordering solutions to identify the most robust, acceptable, and potentially feasible solutions; Phase 4: Prototyping by creating low-fidelity prototypes for the highest-ranked solutions; and Phase 5: Validation of the robustness of the prototypes through virtual focus groups. All virtual sessions were recorded, transcribed, and inductively coded to generate themes of robustness, acceptability, and feasibility of the re-triage solution. Thematic analysis was anchored on the Desirability, Viability, and Feasibility Design Thinking Methodology.

Results:

A total of 19 sessions were conducted across all 5 phases with 49 participants from 12 trauma centers across Illinois. Participants included front-line users and leadership. The key design requirement was resource transparency between centers. The ideation phase produced 70 solutions. A systemwide bed-tracker was ranked the highest by participants. Protoyping and validation resulted in a centralized, systemwide, bed-tracker with hourly updated bed availability being the final solution to improve the re-triage of trauma patients from non-trauma/low-level and high-level trauma centers.

Conclusions:

A 5 phase user-centered design approach resulted in a single solution consisting in a centralized bed-tracker of available beds at high-level trauma centers to improve re-triage.