User-centered design of discharge warnings tool for colorectal surgery patients

J Am Med Inform Assoc. 2017 Sep 1;24(5):975-980. doi: 10.1093/jamia/ocx018.

Abstract

Objectives: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery.

Materials and methods: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability.

Results: Literacy evaluation of the prototype suggested >12th-grade reading level. Subsequent revisions reduced reading level to 8th grade or below. Contents were formatted during heuristic evaluation into 3 action-oriented zones (green, yellow, and red) with relevant warning lexicons. Usability testing demonstrated comprehension of this 3-level lexicon and recognition of appropriate patient actions to take for each level.

Discussion: We developed a discharge warnings tool for colorectal surgery using staged user-centered design. The lexicon of surgical discharge warnings could structure communication among patients, caregivers, and clinicians to improve post-discharge care.

Keywords: colorectal surgery; discharge instructions; health literacy; readmissions; usability testing.

MeSH terms

  • Audiovisual Aids*
  • Colectomy
  • Colorectal Surgery
  • Colostomy
  • Digestive System Surgical Procedures*
  • Health Literacy*
  • Humans
  • Patient Discharge*
  • Patient Education as Topic*
  • Patient Readmission