Assessing the information environment in intensive care units

This paper describes the development and application of a methodology for evaluating how physicians and nurses view the usefulness of various sources of patient information available within a hospital intensive care unit (ICU). The methodology encompasses semi-structured interviews, task analysis, a simulated case study of a critically ill patient, verbal protocol analysis, questionnaire responses based on both past experiences in the ICU and performance on the simulated task, and a post-task interview. Eleven nurses and six physicians participated in the study. Analysis of the questionnaires revealed significant differences in the rankings of the information sources by both the nurses and the physicians on each of seven evaluation criteria. Significant differences were also found among both the physicians and the nurses in rankings of the relative importance of the individual information sources for meeting task requirements. A framework for describing information gathering applicable to critical care environments was proposed as a means for better understanding how information sources are used. Overall, the methodology was found to be useful in terms of providing valuable data regarding the utility and usability of information sources. The importance of using a systematic approach for assessing the usefulness of information sources, particularly from the perspectives of performing design interventions and predicting the effectiveness of new information technologies, as well as the limitations in adopting this type of approach, are also discussed.