Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

Pascale Carayon; Peter Hoonakker; Ann Schoofs Hundt; Megan Salwei; Douglas A. Wiegmann; Roger L. Brown; Peter Kleinschmidt; Clair Novak; Michael Pulia; Yudi Wang; Emily Wirkus; Brian Patterson

Study

Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

January 8, 2020

Carayon P, Hoonakker P, Hundt AS, et al. BMJ Qual Saf. 2020;29(4):329-340.

View more articles from the same authors.

This simulation study assessed whether integrating human factors engineering into a clinical decision support system can improve the diagnosis of pulmonary embolism (PE) in the ED. Authors found that this approach can improve the PE diagnostic process by saving time, reducing perceived workload and improving physician satisfaction with the technology.

PubMed citation

Available at

Related Resources From the Same Author(s)

Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.

May 11, 2022

SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients.

October 3, 2013

Team cognition in handoffs: relating system factors, team cognition functions and outcomes in two handoff processes.

June 22, 2022

A mixed methods study examining teamwork shared mental models of interprofessional teams during hospital discharge.

January 8, 2020

Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey.

February 12, 2020

ICU nurses' acceptance of electronic health records.

July 13, 2011

Care transition of trauma patients: processes with articulation work before and after handoff.

February 16, 2022

Impact of staff turnover during cardiac surgical procedures.

February 12, 2020

Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.

December 2, 2020

Lessons learned from a systems approach to engaging patients and families in patient safety transformation.

February 12, 2020

Effect of cognitive aids on adherence to best practice in the treatment of deteriorating surgical patients: a randomized clinical trial in a simulation setting.

January 8, 2020

Evaluating the safety of mental health-related prescribing in UK primary care: a cross-sectional study using the Clinical Practice Research Datalink (CPRD).

September 15, 2021

User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study.

July 29, 2020

Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study.

September 16, 2020

SEIPS 101 and seven simple SEIPS tools.

June 9, 2021

A professional development course improves unprofessional physician behavior.

February 12, 2020

Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility.

July 21, 2021

Human factors systems approach to healthcare quality and patient safety.

August 14, 2013

SEIPS 3.0: human-centered design of the patient journey for patient safety.

February 19, 2020

Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.

May 19, 2021

Nursing implications of an early warning system implemented to reduce adverse events: a qualitative study.

May 11, 2022

Conducting an efficient proactive risk assessment prior to CPOE implementation in an intensive care unit.

June 13, 2012

Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel.

October 27, 2021

Incidence, duration and risk factors associated with delayed and missed diagnostic opportunities related to tuberculosis: a population-based longitudinal study.

March 24, 2021

Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.

March 15, 2017

CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.

September 1, 2021

The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: a cross-sectional study of US hospitals.

March 4, 2015

Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study.

December 23, 2020

Application of electronic trigger tools to identify targets for improving diagnostic safety.

October 17, 2018

Effect of contextual factors on the prevalence of diagnostic errors among patients managed by physicians of the same specialty: a single-centre retrospective observational study.

February 8, 2023

Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.

March 23, 2022

Changing hospital organisational culture for improved patient outcomes: developing and implementing the Leadership Saves Lives intervention.

August 12, 2020

Diagnostic error experiences of patients and families with limited English-language health literacy or disadvantaged socioeconomic position in a cross-sectional US population-based survey.

February 16, 2022

The MedSafer study-electronic decision support for deprescribing in hospitalized older adults: a cluster randomized clinical trial.

February 2, 2022

Impact of pharmacist-led multidisciplinary medication review on the safety and medication cost of the elderly people living in a nursing home: a before-after study.

February 12, 2020

Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events.

November 11, 2020

Fall prevention implementation strategies in use at 60 United States hospitals: a descriptive study.

December 9, 2020

Real-world virtual patient simulation to improve diagnostic performance through deliberate practice: a prospective quasi-experimental study.

December 15, 2021

Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care.

October 27, 2021

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.

November 16, 2022

Repurposing clinical decision support system data to measure dosing errors and clinician-level quality of care.

November 11, 2020

The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour and improve safety.

May 5, 2021

Core competencies for patient safety research: a cornerstone for global capacity strengthening.

February 2, 2011

Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews.

July 8, 2020

Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study.

January 9, 2019

How safe are paediatric emergency departments? A national prospective cohort study.

August 3, 2022

Work effort, readability and quality of pharmacy transcription of patient directions from electronic prescriptions: a retrospective observational cohort analysis.

March 31, 2021

Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial.

March 17, 2021

How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory.

October 19, 2022

Prevalence of Errors in Anaphylaxis in Kids (PEAK): a multicenter simulation-based study.

July 22, 2020

From tasks to processes: the case for changing health information technology to improve health care.

April 1, 2009

The effects of computerized provider order entry implementation on communication in intensive care units.

February 20, 2013

Changes in end-user satisfaction with computerized provider order entry over time among nurses and providers in intensive care units.

November 28, 2012

National cross-sectional cohort study of the relationship between quality of mental healthcare and death by suicide.

June 1, 2022

Adverse events during intrahospital transport of critically ill children: a systematic review.

February 12, 2020

July 20, 2022

Systematic review and meta-analysis of interventions for operating room to intensive care unit handoffs.

March 10, 2021

Association of default electronic medical record settings with health care professional patterns of opioid prescribing in emergency departments: A randomized quality improvement study

February 12, 2020

Effects of tall man lettering on the visual behaviour of critical care nurses while identifying syringe drug labels: a randomised in situ simulation.

April 20, 2022

How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience.

February 5, 2020

Diagnostic errors in the intensive care unit: a systematic review of autopsy studies.

August 8, 2012

Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review.

December 16, 2020

Use of e-triggers to identify diagnostic errors in the paediatric ED.

April 6, 2022

Using failure mode and effects analysis to plan implementation of smart i.v. pump technology.

August 23, 2006

Optimizing Pediatric Patient Safety in the Emergency Care Setting.

October 19, 2022

Improving peripherally inserted central catheter appropriateness and reducing device-related complications: a quasiexperimental study in 52 Michigan hospitals.

April 14, 2021

Delayed diagnosis of serious paediatric conditions in 13 regional emergency departments.

October 26, 2022

Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients.

August 26, 2020

Harnessing the power of medical malpractice data to improve patient care.

January 8, 2020

Impact of structured interdisciplinary bedside rounding on patient outcomes at a large academic health centre.

July 22, 2020

A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: what works for whom and why?

December 2, 2020

Timeout procedure in paediatric surgery: effective tool or lip service? A randomised prospective observational study.

March 24, 2021

Checklists to reduce diagnostic error: a systematic review of the literature using a human factors framework.

June 1, 2022

Applying human factors engineering to address the telemetry alarm problem in a large medical center.

August 11, 2021

'Immunising' physicians against availability bias in diagnostic reasoning: a randomised controlled experiment.

March 18, 2020

Associations between internet-based patient ratings and conventional surveys of patient experience in the English NHS: an observational study.

July 11, 2012

2019 update on medical overuse: a review.

September 25, 2019

A scoping review of real-time automated clinical deterioration alerts and evidence of impacts on hospitalised patient outcomes.

August 3, 2022

Safe clinical practice for patients hospitalised in mental health wards during a suicidal crisis: qualitative study of patient experiences.

December 23, 2020

A survey of outpatient internal medicine clinician perceptions of diagnostic error.

February 5, 2020

Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.

June 30, 2021

Integrating adverse event reporting into a free-text mobile application used in daily workflow increases adverse event reporting by physicians.

January 8, 2020

Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme.

June 22, 2022

Assessing quality of older persons' emergency transitions between long-term and acute care settings: a proof-of-concept study.

May 18, 2022

February 2, 2022

Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care.

March 23, 2022

Association of clinician diagnostic performance with machine learning–based decision support systems: a systematic review.

April 14, 2021

Peers without fears? Barriers to effective communication among primary care physicians and oncologists about diagnostic delays in cancer.

November 1, 2017

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis.

July 8, 2020

Concordance with urgent referral guidelines in patients presenting with any of six ‘alarm’ features of possible cancer: a retrospective cohort study using linked primary care records.

August 10, 2022

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

October 21, 2020

Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis.

January 25, 2023

Vulnerability of the medical product supply chain: the wake-up call of COVID-19.

November 25, 2020

Publication of inspection frameworks: a qualitative study exploring the impact on quality improvement and regulation in three healthcare settings.

October 6, 2021

Understanding the "Swiss cheese model" and its application to patient safety.

July 21, 2021

FMEA team performance in health care: a qualitative analysis of team member perceptions.

June 24, 2009

Evaluation of nurse interaction with bar code medication administration technology in the work environment.

March 28, 2007

Care transitions in the outpatient surgery preoperative process: facilitators and obstacles to information flow and their consequences.

November 14, 2007

A system-wide approach to explaining variation in potentially avoidable emergency admissions: national ecological study.

January 8, 2014

Research to improve diagnosis: time to study the real world.

January 26, 2022

Related Resources

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

July 31, 2023

Patient Safety Innovations

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

May 31, 2023

Using sociotechnical theory to understand medication safety work in primary care and prescribers' use of clinical decision support: a qualitative study.

May 24, 2023

Human factors and safety analysis methods used in the design and redesign of electronic medication management systems: a systematic review.

May 17, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

Electronic health record use issues and diagnostic error: a scoping review and framework.

January 25, 2023

Electronic diagnostic support in emergency physician triage: qualitative study with thematic analysis of interviews.

November 16, 2022

Journal Article

Study

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

November 16, 2022

Allergic adverse drug events after alert overrides in hospitalized patients.

September 21, 2022

Impact of an electronic health record alert on inappropriate prescribing of high-risk medications to patients with concurrent "do not give" orders.

August 3, 2022

Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.

May 11, 2022

Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.

April 13, 2022

Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel.

October 27, 2021

Prescribing errors with low-molecular-weight heparins.

October 13, 2021

WebM&M Cases

Coming up for Err – Missed Diagnosis in a Patient with Recurrent Pneumothorax

August 25, 2021

Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.

August 25, 2021

Emergency physician perceptions of electronic health record usability and safety.

May 12, 2021

Can decision support combat incompleteness and bias in routine primary care data?

April 7, 2021

Patient Safety Innovations

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

March 3, 2021

Renal medication-related clinical decision support (CDS) alerts and overrides in the inpatient setting following implementation of a commercial electronic health record: implications for designing more effective alerts.

February 17, 2021

Associations of physicians’ prescribing experience, work hours, and workload with prescription errors.

November 18, 2020

Streamlining care in crisis: rapid creation and implementation of a digital support tool for COVID-19.

October 21, 2020

Patient safety and quality improvement: ethical principles for a regulatory approach to bias in healthcare machine learning.

July 22, 2020

Systemic defenses to prevent intravenous medication errors in hospitals: a systematic review.

July 1, 2020

Identifying safety hazards associated with intravenous vancomycin through the analysis of patient safety event reports.

April 15, 2020

Conspicuous by its absence: diagnostic expert testing under uncertainty.

March 25, 2020

Using a machine learning system to identify and prevent medication prescribing errors: a clinical and cost analysis evaluation.

December 18, 2019

Unscheduled return visits to the emergency department with ICU admission: a trigger tool for diagnostic error.

December 4, 2019

The computer will see you now.

August 28, 2019

See More About The Topic

Emergency Departments

Information Professionals

Medicine

Diagnostic Errors

Human Factors Engineering

Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site