Perceived usefulness of a usability issues reporting form to help understand "usability-induced use-errors": a preliminary study.

The Medical Device regulation requires manufacturers to anticipate and prevent risks of use errors of their medical device. However, manufacturers experience difficulties to understand the concept of "usability-induced use-errors". Based on a "usability framework" aiming at describing the relationship between usability design principles, usability flaws, usage problems, and outcomes, a usability evaluation reporting form had been designed to support understanding the use-error concept. This paper reports the preliminary evaluation of the perceived usefulness of this form. Results show that manufacturers found helpful the presentation of the results of a usability evaluation through this form for it supports the understanding of the usability origins and the consequences of use-errors. Even if the use of this reporting form should be made easier as usability experts experience difficulties to fill it, it seems a promising way to clearly present "usability-induced use-errors" to manufacturers.

Economic benefits of safety-engineered sharp devices in Belgium - a budget impact model.

BACKGROUND: Measures to protect healthcare workers where there is risk of injury or infection from medical sharps became mandatory in the European Union (EU) from May 2013. Our research objective was to estimate the net budget impact of introducing safety-engineered devices (SEDs) for prevention of needlestick injuries (NSIs) in a Belgian hospital. METHODS: A 5-year incidence-based budget impact model was developed from the hospital inpatient perspective, comparing costs and outcomes with SEDs and prior-used conventional (non-safety) devices. The model accounts for device acquisition costs and costs of NSI management in 4 areas of application where SEDs are currently used: blood collection, infusion, injection and diabetes insulin administration. Model input data were sourced from the Institut National d'Assurance Maladie-Invalidité, published studies, clinical guidelines and market research. Costs are discounted at 3%. RESULTS: For a 420-bed hospital, 100% substitution of conventional devices by SEDs is estimated to decrease the cumulative 5-year incidence of NSIs from 310 to 75, and those associated with exposure to blood-borne viral diseases from 60 to 15. Cost savings from managing fewer NSIs more than offset increased device acquisition costs, yielding estimated 5-year overall savings of €51,710. The direction of these results is robust to a range of sensitivity and model scenario analyses. The model was most sensitive to variation in the acquisition costs of SEDs, rates of NSI associated with conventional devices, and the acquisition costs of conventional devices. CONCLUSIONS: NSIs are a significant potential risk with the use of sharp devices. The incidence of NSIs and the costs associated with their management can be reduced through the adoption of safer work practices, including investment in SEDs. For a Belgian hospital, the budget impact model reports that the incremental acquisition costs of SEDs are offset by the savings from fewer NSIs. The availability of more robust data for NSI reduction rates, and broadening the scope of the model to include ancillary measures for hospital conversion to SED usage, outpatient and paramedic device use, and transmission of other blood-borne diseases, would strengthen the model.

Integrating the SE and HCI models in the human factors engineering cycle for re-engineering Computerized Physician Order Entry systems for medications: basic principles illustrated by a case study.

OBJECTIVES: The integration of Human Factors is still insufficient in the design and implementation phases of complex interactive systems such as Computerized Physician Order Entry (CPOE) systems. One of the problems is that human factors specialists have difficulties to communicate their data and to have them properly understood by the computer scientists in the design and implementation phases. This paper presents a solution to this problem based on the creation of common documentation supports using Software Engineering (SE) and Human-Computer Interaction (HCI) methods. METHOD: The integration of SE and HCI methods and models is an interesting means for modelling an organization's activities, with software applications being part of these activities. Integrating these SE and HCI methods and models allows case studies to be seen from the technical, organizational and ergonomic perspectives, and also makes it easier to compare current and future work situations. RESULTS: The exploitation of these techniques allows the creation of common work supports that can be easily understandable by computer scientists and relevant for re-engineering or design. In this paper, the basic principles behind such communication supports are described and illustrated by a real case study.

Human factors methods to support the experts' review of automatically detected adverse drug events.

The European project Patient Safety through Intelligent Procedures in Medication (PSIP) aims at semi-automatically identifying and preventing Adverse Drug Events (ADEs). Data mining of the structured hospital data bases provides a list of potential ADEs, along with their frequencies and probabilities. Once a set of ADEs has been detected by data mining techniques, it is necessary to have them validated by human experts. This paper presents the methods used to support the review by clinicians and pharmacologists of these automatically detected ADEs. We use think-aloud methods and portable labs to track and record the experts reasoning and their reviewing cognitive procedures. We present preliminary results obtained with this method, which allows identifying the key data and information used to characterize the ADEs.

Comparative assessment of two interfaces for delivering a multimedia medical course in the French-speaking Virtual Medical University (UMVF).

The UMVF aims at helping medical students during their normal curriculum via the facilities provided by Internet based techniques. This paper describes a comparative assessment of two interfaces delivering a multimedia course: a conventional web server (WS) and an integrated e-learning platform in the form of a Virtual Campus (VC). Eleven students were arbitrarily divided into two groups. We used a qualitative method for comparing their acceptance of the on line course provided by the two different interfaces. The two groups were globally satisfied. However, a decrease in satisfaction was noted at the end of the experimentation in the VC group. This may be explained by a more complex Graphical User Interface (GUI) of the VC and some constraints which do not exist with the WS. The current e-learning platforms are probably not optimised for working conditions where presential and virtual activities are mixed. We think that a new type of "light" platforms should be developed for these specific working conditions. Students of the two groups also had limitations about the multimedia environment. They may change their opinion if they get more accustomed with the multimedia environment and if their teachers make a more adequate use of the multimedia techniques.

Usability assessment study of a web site displaying medical resources on line: the CISMeF.

We present here the usability assessment study of a medical web site dedicated to the Cataloguing and Indexing of French speaking Medical web Sites (CISMeF). We performed a usability inspection using heuristic evaluation and an empirical usability test using a portable lab. The results of the heuristic evaluation show usability flaws along guidance, prompting and legibility ergonomic criteria. The usability test confirms this result and gives some more hints about the severity rating of the problems. From these results, we draw up a set of recommendations for the re-engineering of the Human Computer Interface (HCI). We conclude on the necessity to integrate usability engineering early enough in the projects lifecycle.