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UBC Theses and Dissertations

Design principles for homecare documentation based on classifying and modeling workarounds Al-Masslawi, Dawood


Computer systems are being used in healthcare at an increasing rate, especially in homecare nursing. However, mismatch between the technology and the clinical work has been a concern for clinicians and system designers. This mismatch is a barrier to nurses’ work and results in the need to work around the technology. The purpose of this dissertation is to identify design principles for interactive computer systems that reduce the mismatch. This study had four phases: 1) identification and classification of workarounds; 2) modeling and mapping of workarounds to design features; 3) creation of the mapped design features; and 4) refining and evaluation of the design features. An ethnographic study of homecare nurses who provide care for patients with wounds in Vancouver (n=33, 120 hours), indicated that they create and use workarounds. It is possible that this is a manifestation of unsuccessful adoption of an implemented wound documentation system. A user-centred design process was created to identify design principles for such interactive systems. A model from the literature was adapted, the work situation model, to identify and describe the most common workaround situations and their attributes such as tasks, and resources. The results were validated using a questionnaire (n=58). Furthermore, the identified workarounds were mapped to design principles from the literature, with the use of the workaround situation model attributes. This mapping used measures developed for applications of the technology acceptance model in healthcare, to identify a mapping fit for the workaround situations to a dimension of usefulness or ease of use. These dimensions include items such as increased productivity, and lowered mental/physical effort. The mapped design principles were evaluated and refined in iterations of exploratory prototyping (n=15), and experimental prototyping (n=12). A set of 9 design principles were used to create features for a prototype. This prototype used features such as speech recognition, wearable technology, and smart mobile devices. Results of qualitative data analysis (n=27) and questionnaires (n=11) indicated that the prototype was perceived to be useful, easy to use, and a good task-technology fit. This showed that the design informed by homecare nurses workarounds addresses key aspects of technology acceptance.

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Attribution-NonCommercial-NoDerivatives 4.0 International