Recently, my work in health informatics immersed me in the intricacies of information design, tackling a task that perfectly showcased the critical intersection of technology, communication and patient safety. My mission was to review the usability of the existing Electronic Health Record (EHR) build for peripheral IV line documentation and to design a new build for extravasation management – a potentially severe complication from IV infusions requiring immediate, precise intervention. Diving into the existing peripheral IV line documentation, I quickly encountered a familiar problem: it wasn’t necessarily wrong, but it was profoundly difficult to use effectively. The existing design was primarily structured to capture information, and little else.
Recognising the multifaceted nature of this challenge, we adopted a comprehensive, user-centred approach to redesigning the peripheral IV line documentation. This strategy integrated data analytics to pinpoint usability bottlenecks, the clinical expertise of Subject Matter Experts (SMEs) to ensure accuracy and relevance, and the principles of User Experience (UX) and Information Design to create an effective and user-friendly system for documenting.
A key improvement involved integrating readily accessible reference windows containing relevant protocols and best-practice guidelines directly within the peripheral IV line documentation workflow. This provided clinicians with immediate, context-specific support, reducing the need to search for information elsewhere. We also actively engaged the Nursing Informatics Council, ensuring that frontline clinicians had a voice in the redesign process and their valuable feedback was incorporated into the new build.
Crucially, we created a dedicated, structured section within the EHR specifically for documenting and recording actions related to infiltration and extravasation events. This replaced the previous reliance on unstructured progress notes with clear, step-by-step workflows and standardised data elements, ensuring comprehensive and consistent documentation of these potentially severe complications and facilitating timely and appropriate interventions.
Our redesign efforts were guided by core principles of UX and Information Design, focusing on:
- Structured Data Capture: Implementing clear, labeled fields with appropriate validation rules to ensure data consistency and accuracy.
- Intuitive Workflows: Designing logical, step-by-step processes for documentation that mirror clinical practice.
- Enhanced Visual Clarity: Utilizing standardized terminology, clear visual cues, and consistent layouts to improve scannability and reduce ambiguity.
- Task-Specific Pathways: Creating dedicated documentation routes for different aspects of IV line care (insertion, maintenance, complications, discontinuation).
- Integrated Support: Embedding relevant protocols and guidelines directly within the documentation workflow.
- User-Centered Iteration: Continuously seeking and incorporating feedback from end-users throughout the design and implementation process.
Conclusion: Designing for Clarity, Efficiency, and Enhanced Patient Safety
By embracing a data-informed, user-centred approach grounded in the principles of UX and Information Design, we moved beyond simply addressing surface-level usability issues within the EHR. Our goal was to create a peripheral IV line documentation system that truly supports clinical practice, enhances data quality, contributes to improved efficiency and, most importantly, patient safety. This iterative process of understanding user needs, analysing system limitations, and applying design principles is crucial for building EHRS that empower clinicians and prioritise patient well-being.
What are your experiences with EHR usability challenges, particularly around procedural documentation? Share your thoughts and insights in the comments below. Let’s continue the conversation on how we can collectively advocate for and implement user-centred design principles in our healthcare technologies.
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