First Advisor

Wimett, Lynn

Second Advisor

Cullen, Patricia

College

Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice

School

Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Abstract

Problem. The electronic form used by lactation consultants to document assessment findings, interventions, plans and recommendations, did not meet user’s requirements. Purpose: The purpose of this project was to evaluate the effect of optimization through a User Centered Design (UCD) process on information quality, use and user satisfaction. Goals. The goals were to provide information technology (IT) support for the organization’s Baby Friendly initiative and to support collaborative, consistent messaging for breastfeeding families which could, in turn, support exclusive breast milk feeding. Exclusive breast milk feeding is a population health initiative that could positively impact the triple aim of better care, lower costs and better health. Objectives. Information quality, use and user satisfaction affect user adoption and acceptance of IT solutions. The objective of this project was to test the effectiveness of UCD on optimization by measuring the increase in information quality, use and user satisfaction after implementation of an optimized electronic lactation assessment. Plan. Stakeholders were identified and the electronic form was optimized through UCD. A pre-test/post-test quasi-experimental design was chosen to measure the effect of optimization. Instruments included a modified version of the System and Use Assessment Survey (AHRQ, n.d.), a chart audit tool and an electronic data warehouse use query. IRB approval was obtained from COMIRB and Regis University. The pre and post data collection periods were each six weeks in length, allowing for a two week chart audit period and four week survey. The intervention was implemented after the close of the pre-test period. Clinical users were educated following the organization’s usual methods for EHR changes. Five months after the intervention, the study timeline was repeated for the post-test period. After the post-test period, a use query was run to collect data for both pre-test and post-test periods. Data were collected, coded, and entered into electronic spreadsheets for storage and analysis. Outcomes and Results. Although the sample as a whole showed no statistically significant increases in any parameter of information quality, use, or user satisfaction, when survey participants were divided by role, nurses and providers, there was a statistically significant increase in the post-test nursing group for two measures of information quality and one measure of information use. A Mann Whitney U test found a significantly higher perception of completeness of the lactation assessment, U = 200, z = -2.11, p = .035, r = .29 and reported frequency of accessing the lactation assessment from the EHR, U= 233, z = -2.01, p = .044, r = 0.26. A Fishers exact test found a statistically significant increase in the presence of lactation assessments in the post-test chart audit [1, N = 39] = 11.8, p =.001, φ= .39). The outcomes may be explained by differences in how each role uses the EHR. Additional education for providers may be necessary to overcome these differences.

Date of Award

Fall 2015

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

All content in this Collection is owned by and subject to the exclusive control of Regis University and the authors of the materials. It is available only for research purposes and may not be used in violation of copyright laws or for unlawful purposes. The materials may not be downloaded in whole or in part without permission of the copyright holder or as otherwise authorized in the “fair use” standards of the U.S. copyright laws and regulations.

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