Applying User-Centered Design to Develop an Audit and Feedback Intervention for the Home Care Sector

Colquhoun, Heather; Sattler, Deborah; Chan, Christine M. S.; Walji, Taheera; Palumbo, Rachel; Chalmers, Ian; Jokhio, Iffat; Ivers, Noah

doi:10.1177/1084822317700883

Cited by 12 publications

(19 citation statements)

References 19 publications

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“…Best practice guidance recommends the use of UCD to develop reports, including testing the recommended best practices themselves [3]. Studies of UCD applied to feedback report development are limited, but have demonstrated the use of iterative prototyping and user observation [8,13]. We build on these studies to contribute a method that incorporates key feedback report components and their dependencies.…”

Section: Discussionmentioning

confidence: 99%

“…These methods can enable feedback report designers to recognize defects and improvement opportunities in both the form of the report (i.e., how information is displayed) and its content (i.e., what information is communicated). For example, UCD activities improved the design of feedback reports for home healthcare professionals regarding report colors (form) and regional performance comparisons (content) [13]. By repeatedly testing an artifact, a designer can further refine the design of a prototype until no significant problems are identified [14].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…UCD methods have been applied to feedback reports in home healthcare [13] and primary care settings [8,15]. Colquhoun et al [13] incorporated paper prototyping, interviews, focus groups, cognitive interviewing, and think-aloud methods across two design phases to optimize an audit and feedback intervention for home healthcare providers. Brown et al incorporated interviews, video-based content analysis, eye-tracking analysis, and questionnaires to improve the usability of an electronic audit and feedback system [8,15].…”

Section: Introductionmentioning

confidence: 99%

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Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

et al. 2020

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Background: User-centered design (UCD) methods are well-established techniques for creating useful artifacts, but few studies illustrate their application to clinical feedback reports. When used as an implementation strategy, the content of feedback reports depends on a foundational audit process involving performance measures and data, but these important relationships have not been adequately described. Better guidance on UCD methods for designing feedback reports is needed. Our objective is to describe the feedback report design method for refining the content of prototype reports. Methods: We propose a three-step feedback report design method (refinement of measures, data, and display). The three steps follow dependencies such that refinement of measures can require changes to data, which in turn may require changes to the display. We believe this method can be used effectively with a broad range of UCD techniques. Results: We illustrate the three-step method as used in implementation of goals of care conversations in long-term care settings in the U.S. Veterans Health Administration. Using iterative usability testing, feedback report content evolved over cycles of the three steps. Following the steps in the proposed method through 12 iterations with 13 participants, we improved the usability of the feedback reports. Conclusions: UCD methods can improve feedback report content through an iterative process. When designing feedback reports, refining measures, data, and display may enable report designers to improve the user centeredness of feedback reports.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

et al. 2020

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“…Informed by user-centred design methodology, usability testing is a technique to evaluate whether the intended users of a product or service can achieve desired tasks. In the context of the A&F literature, usability of the feedback report is an issue which is addressed infrequently, despite the proliferation of electronic feedback [29–32]. Participants were encouraged to “think out loud” as they attempted to complete two distinct tasks on the D2D website [33].…”

Section: Methodsmentioning

confidence: 99%

Measurement without management: qualitative evaluation of a voluntary audit & feedback intervention for primary care teams

Wagner

Durbin

Barnsley

et al. 2019

BMC Health Serv Res

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Background The use of clinical performance feedback to support quality improvement (QI) activities is based on the sound rationale that measurement is necessary to improve quality of care. However, concerns persist about the reliability of this strategy, known as Audit and Feedback (A&F) to support QI. If successfully implemented, A&F should reflect an iterative, self-regulating QI process. Whether and how real-world A&F initiatives result in this type of feedback loop are scarcely reported. This study aimed to identify barriers or facilitators to implementation in a team-based primary care context. Methods Semi-structured interviews were conducted with key informants from team-based primary care practices in Ontario, Canada. At the time of data collection, practices could have received up to three iterations of the voluntary A&F initiative. Interviews explored whether, how, and why practices used the feedback to guide their QI activities. The Consolidated Framework for Implementation Research was used to code transcripts and the resulting frameworks were analyzed inductively to generate key themes. Results Twenty-five individuals representing 18 primary care teams participated in the study. Analysis of how the A&F intervention was used revealed that implementation reflected an incomplete feedback loop. Participation was facilitated by the reliance on an external resource to facilitate the practice audit. The frequency of feedback, concerns with data validity, the design of the feedback report, the resource requirements to participate, and the team relationship were all identified as barriers to implementation of A&F. Conclusions The implementation of a real-world, voluntary A&F initiative did not lead to desired QI activities despite substantial investments in performance measurement. In small primary care teams, it may take long periods of time to develop capacity for QI and future evaluations may reveal shifts in the implementation state of the initiative. Findings from the present study demonstrate that the potential mechanism of action of A&F may be deceptively clear; in practice, moving from measurement to action can be complex. Electronic supplementary material The online version of this article (10.1186/s12913-019-4226-7) contains supplementary material, which is available to authorized users.

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Precision feedback: A conceptual model

Landis‐Lewis,

Janda,

Chung

et al. 2024

Learning Health Systems

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IntroductionWhen performance data are provided as feedback to healthcare professionals, they may use it to significantly improve care quality. However, the question of how to provide effective feedback remains unanswered, as decades of evidence have produced a consistent pattern of effects—with wide variation. From a coaching perspective, feedback is often based on a learner's objectives and goals. Furthermore, when coaches provide feedback, it is ideally informed by their understanding of the learner's needs and motivation. We anticipate that a “coaching”‐informed approach to feedback may improve its effectiveness in two ways. First, by aligning feedback with healthcare professionals' chosen goals and objectives, and second, by enabling large‐scale feedback systems to use new types of data to learn what kind of performance information is motivating in general. Our objective is to propose a conceptual model of precision feedback to support these anticipated enhancements to feedback interventions.MethodsWe iteratively represented models of feedback's influence from theories of motivation and behavior change, visualization, and human‐computer interaction. Through cycles of discussion and reflection, application to clinical examples, and software development, we implemented and refined the models in a software application to generate precision feedback messages from performance data for anesthesia providers.ResultsWe propose that precision feedback is feedback that is prioritized according to its motivational potential for a specific recipient. We identified three factors that influence motivational potential: (1) the motivating information in a recipient's performance data, (2) the surprisingness of the motivating information, and (3) a recipient's preferences for motivating information and its visual display.ConclusionsWe propose a model of precision feedback that is aligned with leading theories of feedback interventions to support learning about the success of feedback interventions. We plan to evaluate this model in a randomized controlled trial of a precision feedback system that enhances feedback emails to anesthesia providers.

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Applying User-Centered Design to Develop an Audit and Feedback Intervention for the Home Care Sector

Cited by 12 publications

References 19 publications

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

Measurement without management: qualitative evaluation of a voluntary audit & feedback intervention for primary care teams

Precision feedback: A conceptual model

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