Usability Testing of Situation Awareness Clinical Decision Support in the ICU.

OBJECTIVE:Our objective was to evaluate the usability of an automated clinical decision support (CDS) tool previously implemented in the pediatric intensive care unit (PICU) to promote shared situation awareness among the medical team to prevent serious safety events within children's hospitals. METHODS:We conducted a mixed-methods usability evaluation of a CDS tool in a PICU at a large, urban, quaternary, free-standing children's hospital in the Midwest. Quantitative assessment was done using the System Usability Scale, while qualitative assessment involved think-aloud usability testing. The System Usability Scale was scored according to survey guidelines. For think-aloud testing, task times were calculated, and means and standard deviations were determined, stratified by role. Qualitative feedback from participants and moderator observations were summarized. RESULTS:Fifty-one PICU staff members, including physicians, advanced practice providers, nurses, and respiratory therapists, completed the System Usability Scale, while ten participants underwent think-aloud usability testing. The overall median usability score was 87.5 (IQR: 80-95), with over 96% rating the tool's usability as "good" or "excellent". Task completion times ranged from 2 to 92 seconds, with the quickest completion for reviewing high-risk criteria and the slowest for adding to high-risk criteria. Observations and participant responses from think-aloud testing highlighted positive aspects of learnability and clear display of complex information that is easily accessed, as well as opportunities for improvement in tool integration into clinical workflows.