Tasks

Usability Testing: Patient Fall Submission Form

Presenter: Stewart Hutchison

1

User testing of nursing staff and physicians for their online incident reporting system.

If a patient fall is witnessed in the hospital, staff is required to log-in to the RL Solutions webpage and fill out an extensive form detailing the event.1

Summer InternshipUX / Usability in Healthcare

This was part of my summer internship in 2014, working with MedStars Human Factors in Healthcare within the hospital environment.

The project was to better understand patient falls that were increasingly occurring at MedStar hospital. I began by interviewing nurses, asking them to show me2

Contextual inquiryWhy are patients falling?What is nursing staff seeing?

Some common contributing factors nursing staff was seeing in the patient rooms:

Call bells out of reach, unwillingness to use portable urinals, non-slip socks left at the bottom of the bed, and phones/emergency pullstrings not being used

The yellow bracelet is also an indication of a patient at high risk for falling4

Bed alarms are sometimes not audible during busy times.

Some non-slip socks are not yellow in color and not as recognizable.

Setting the wheelchair locking mechanism is often forgotten by nursing and tech staff.

Spilled liquid on the light-colored floors is difficult to see and is another common contributor.6

7Scope:

A usability test of MedStars patient fall submission form (https://rl6.rlsolutions.com/Medstar_Prod).

The submission process will be tested for quality of reports given by various staff members.

Purpose:

An extensive review of fall report descriptions has indicated a disposition for staff to view the patient as solely responsible for their fall incidents.

Informed by the SEIPS model (environment, tasks, tools, organization, person), a re-design of the fall submission form will be recommended to encourage staff to consider these additional influences, discouraging patient-blaming, and producing balanced and informed incident reports.

8Goal:

Reduce the time required for staff to complete the online form

Increase the number of identifiable factors

Become a more user-friendly experience

I wanted to use this feedback to create common scenarios experienced by staff when witnessing patient falls.

These common contributing factors should be readily available and easily identifiable on the online incident reporting form.8

Procedure:

Recruit four staff members from 3NW (Orthopedic)Read scenarioFill in formRecorded with CamtasiaPost analysisTime on taskFields skipped or answered incorrectly9

9

Current Form (RL Solutions)10

Heres the online incident reporting form10

Testing Form (Axure Wireframe)11

Heres a wireframe I created with Axure for user testing.

The order of questions and drop-down menu options have been preserved.

When finished, users select Submit and are directed to a satisfaction survey (SUS)11

12

(http://www.measuringusability.com/sus.php)SUS - System Usability Scale (Sauro, 2011)

The SUS yields a satisfaction score, a common usability measure12

13Fall ScenarioDuring hourly rounding, you discover a patient on the floorPatient is post-op, recovering from a hip replacementPatient fell at home 2 weeks ago and Morse Fall Score was 50In the room you see the bed alarm is off, non-slip socks are on the bed

Re-Design #1Contributing Factors14

Re-Design #2

Contributing Factors Incorporating the SEIPS Model 15

(Carayon et al., 2006)

16

Re-Design #3Collapse Person Affected Details to reduce fatigue

17Test #3Targeted Fields:

4/4 2/4 4/4 4/4 3/4 3/4 2/4

18

Test #3Targeted Fields:

3/4 2/4 3/4 3/4 2/4

Test #3Targeted Fields:19

2/4 2/4 4/4 4/4 4/4 0/4 2/4 2/4

20Fall Event Details

Fall Safety Precautions In Place

Staff / Patient Affected

2:00 Highlight Video

21Test #1% Fields CorrectTimeSUSUser 1 - RN11/17 = 65%8:15--User 2 - Tech7/17 = 41%13:00--User 3 - Tech9/17 = 53%10:30--User 4 - RN8/17 = 47%19:00--

Test #2% Fields CorrectTimeSUSUser 5 - Tech12/17 = 71%12:0082.5User 6 - Tech12/17 = 71%7:3060User 7 - Tech10/17 = 59%7:3080User 8 - Physician11/17 = 65%8:0050

Test #3% Fields CorrectTimeSUSUser 09 - RN16/20 = 80%10:0067.5User 10 - RN12/20 = 60%8:3070User 11 - RN17/20 = 85%18:0055User 12 - RN10/20 = 50%4:1577.5

22More time required Less perceived usability (SUS)More accurate forms More required timeSolutionCollapse groups of fields which may be unused

Provide checklist options prior to brief descriptionsProblem

Summary23Contributing Factors / Immediate Actions: Required and placed before Brief DescriptionFall PhysiologicalIntrinsic vs. Extrinsic factorsEvent Date (of fall) / Time or Approximate Time (of fall)Other Location InfoCombine with Specific Location to obtain room #Person Affected DetailsCollapse fields into add/modify option to reduce fatigueGeneral AreaInclude Patient Room

Thank you!24