Summary
Aim
To evaluate usability of a decision support system for telephone triage nurses.
Background
Telephone triage by nurses has become an internationally accepted form of health service
delivery to cope with increasing demands on primary and emergency care. Decision support
software systems are used by nurses to facilitate the telephone triage process, yet,
the usability of these systems is rarely assessed.
Method
We applied a multi-method human factors approach to evaluate the usability of decision
support software used by Healthdirect Australia nurses during telephone triage. Methods
included: (1) stakeholder discussions; (2) heurstic analysis by two independent experts
across ten usability heuristics; and (3) interviews with system end users (n = 9). A list of heuristic violations with their severity ratings was developed. Qualitative
content analysis of the interview transcripts was undertaken to validate the results
of the heuristic evaluation.
Findings
Forty one unique heuristic violations were identified in the interface design of the
decision support software with median severity of 2.25 (range 0–4, with 0 = no problem to 4 = catastrophic problem). The highest number of violations was observed for flexibility
and efficiency of use (n = 12, median severity = 2.5) and for aesthetic and minimalist design (n = 11, median severity = 2). Interviews with nurses verified many of the violations identified in the heuristic
analysis. Improving the navigational design of the system for flexibility and efficiency
of use was identified as necessary by both the experts and end users.
Conclusion
In adopting a multi-method human factors approach, we identified a number of system
design features which may be impacting on the safety and efficiency of the nurse telephone
triage process. Addressing the identified usability issues and using feedback from
end-users to modify the decision support system would optimise system use and so improve
the triage process.
Keywords
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Article info
Publication history
Published online: February 24, 2016
Accepted:
February 2,
2016
Received in revised form:
January 19,
2016
Received:
July 20,
2015
Identification
Copyright
© 2016 Australian College of Nursing Ltd. Published by Elsevier Ltd.
