JMIR Publications

ABSTRACT

Background:

Early rehabilitation in neurocritical care is frequently underutilized due to fragmented workflows, interdisciplinary coordination challenges, and a lack of structured digital decision support. Traditional clinical decision support systems (CDSS) often address single domains and do not accommodate the dynamic and multi-professional nature of ICU environments.

Objective:

This study aimed to design and evaluate the usability of the ERATbi App, a modular, tablet-based CDSS developed to support early rehabilitation planning for patients with moderate-to-severe traumatic brain injury (TBI) in intensive care settings.

Methods:

The ERATbi App integrates four functional modules—delirium risk management, precision nutrition, stepwise early mobilization, and respiratory care for rib fractures—into a unified interface. A simulation-based usability study was conducted with 18 ICU clinicians. Metrics included System Usability Scale (SUS) scores, task completion rates, error rates, and task durations. Additional feedback was gathered via a 5-point Likert satisfaction scale and open-ended responses.

Results:

The app demonstrated high usability (mean SUS = 83.6 ± 7.4), 100% task completion, and a low error rate (4.2%). Average module completion time was 6.5 minutes, and participants reported strong satisfaction (mean = 4.7 ± 0.5). Users highlighted the value of the app’s visual logic, real-time alerts, adaptive thresholds, and modular workflow integration for enhancing team coordination and decision consistency.

Conclusions:

The ERATbi App exhibited strong usability, high user satisfaction, and clinical relevance in simulated ICU workflows. Its logic-driven, workflow-embedded design may support scalable, interdisciplinary implementation of early rehabilitation in neurocritical care environments. Clinical Trial: Not applicable (this study does not meet the WHO definition of a clinical trial)