Defining User Needs for a New Sepsis Risk Decision Support System in Neonatal ICU Settings Through Ethnography: User Interviews and Participatory Design

Harte, Richard; Quinlan, Leo R.; Andrade, Evismar; Fallon, Enda; Kelly, Martina; O’Connor, Paul; O’Hora, Denis; Pladys, Patrick; Beuchée, Alain; ÓLaighin, Gearóid

doi:10.1007/978-3-030-02053-8_34

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…20 In 2019, Harte et al described ethnographic approaches combined with interviews and participatory design in developing requirements for NICU sepsis CDS. 21 Our sociotechnical approach produced information that encompassed findings from both studies. For example, interview questions and probes on experience with difficult cases resulted in findings on NICU nurse decision making and challenges to newer NICU nurses inexperienced with sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…19 Prior work has demonstrated the utility of human factors and user-centered methods in addressing neonatal intensive care unit (NICU) sepsis including the critical decision method in assessing nurse decision making and ethnographic approaches, though neither address clinical decision support (CDS) based on machine learning. 20 21 However, the work demonstrates that developing CDS for NICU sepsis recognition is an ideal setting for incorporating sociotechnical models into human-centered design methods and requirements processes that address sociotechnical factors. 20…”

Section: Introductionmentioning

confidence: 99%

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Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants

et al. 2022

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Objective The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit. Methods We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semi-structured interviews, (2) user profiles, and (3) system use cases. Results Thirty-one neonatal intensive care unit clinicians participated in semi-structured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing. Conclusion Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system. Applying the sociotechnical model resulted in discovering work system, process, and outcome requirements that would otherwise be difficult to capture, or missed entirely, using traditional requirements gathering methods or approaches to clinical decision support design.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants

et al. 2022

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…19 Prior work has demonstrated the utility of human factors and user-centered methods in addressing neonatal intensive care unit (NICU) sepsis including the critical decision method in assessing nurse decision making and ethnographic approaches, though neither address clinical decision support (CDS) based on machine learning. 20,21 However, the work demonstrates that developing CDS for NICU sepsis recognition is an ideal setting for incorporating sociotechnical models into human-centered design methods and requirements processes that address sociotechnical factors. 20…”

Section: Introductionmentioning

confidence: 99%

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2022

ACI open

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Objective The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit. Methods We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semistructured interviews, (2) user profiles, and (3) system use cases.Results Thirty-one neonatal intensive care unit clinicians participated in semistructured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing. Conclusion Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system.

show abstract

Defining User Needs for a New Sepsis Risk Decision Support System in Neonatal ICU Settings Through Ethnography: User Interviews and Participatory Design

Cited by 2 publications

References 8 publications

Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants

Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants

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