goal of EBP is improvement of systems and microsystems within healthcare, with these
improvements based on science
STEEEP principles The Institute of Medicine (IOM) expert panel issued recommendations for urgent
action to redesign healthcare so that it is safe, timely, effective, efficient, equitable,
and patient-centered
(S) in STEEEP Safe-Avoid injuries to patients from the care that is intended to help them.
(T) in STEEEP Timely-Reduce waits and sometimes harmful delays for both those who receive and
those who give care.
(E) in STEEEP Effective-Provide services based on scientific knowledge to all who could benefit,
and refrain from providing services to those not likely to benefit.
(E) in STEEEP Efficient-Avoid waste, including waste of equipment, supplies, ideas, and energy.
(E) in STEEEP Equitable-Provide care that does not vary in quality because of personal
characteristics such as gender, ethnicity, geographic location, and socioeconomic
status.
(P) in STEEEP Patient-centered Provide care that is respectful of and responsive to individual
patient preferences, needs, and values, and ensure that patient values guide all
clinical decisions.
ACE Star Model of Knowledge Transformation FOCUS: EBP, research use, and knowledge transformation processes
Advancing Research and Clinical Practice through Close
Collaboration (ARCC) DESCRIPTION: Direct a systematic approach to synthesizing knowledge and
Model of Evidence-Based Practice in Nursing and transforming research findings to improve patient outcomes and the quality of care
Healthcare Address both individual practitioners and healthcare organizations Focus on
Johns Hopkins Nursing Evidence-Based Practice Model increasing the meaningfulness and utility of research findings in clinical decision
and Guidelines making
Iowa Model of Evidence-Based Practice
Stetler Model of Research Utilization
Promoting Action on Research Implementation in Health FOCUS: Strategic and organizational change theory to promote uptake and
Services (PARiHS) adoption of new knowledge
Vratny and Shriver Model for Evidence-Based Practice
Pettigrew and Whipp Model of Strategic Change DESCRIPTION:Trace mechanisms by which individual, small group, and
Outcomes-Focused Knowledge Translation organizational contexts affect diffusion, uptake, and adoption of new knowledge and
Determinants of Effective Implementation of Complex innovation
Innovations in Organizations Premise is that interventions, outcomes evaluations, and feedback are important
Ottawa Model of Research Use methods to promote practice change
Collaborative Model for Knowledge Translation between FOCUS: Knowledge exchange and synthesis for application and inquiry
Research and Practice Settings
Framework for Translating Evidence into Action DESCRIPTION: Structure ongoing interactions among practitioners, researchers,
Knowledge Transfer and Exchange policy-makers, and consumers to facilitate the generation of clinically relevant
Canadian Institutes of Health Research Knowledge knowledge and the application of knowledge in practice
Translation within the Research Cycle Model or All parties are engaged in bidirectional collaboration across the translation
Knowledge Action Model continuum
Interactive Systems Framework for Dissemination and
Implementation
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Knowledge Transformation (Ace Star Model)
is defined as the conversion of research findings from discovery of primary research
results, through a series of stages and forms, to increase the relevance,
accessibility, and utility of evidence at the point of care to improve healthcare and
health outcomes by way of evidence-based care.
Ace Star Model These five points are discovery research, evidence summary, translation to
guidelines, practice integration, and evaluation of process and outcome
clinical practice guidelines (CPGs) The IOM defines clinical guidelines as "systematically developed statements to
assist practitioner and patient decisions about appropriate health care for specific
clinical circumstances.
usability 1.Increased user productivity and efficiency 2.Decreased user errors and increased
safety 3.Improved cognitive support
human factors is "the scientific discipline concerned with the understanding of interactions among
humans and other elements of a system, and the profession that applies theory,
principles, data and methods to design in order to optimize human well-being and
overall system performance."
In healthcare, human factors might concern the design of a new operating room to
better support teamwork and patient flow.
ergonomics used interchangeably with human factors by the HFES in Europe but in the U.S.
and other countries its focus is on human performance with physical characteristics
of tools, systems, and machines
i.e. power drill fitting in hand
Human-computer interaction (HCI) is the study of how people design, implement, and evaluate interactive computer
systems in the context of users' tasks and work
usability is often used interchangeably with HCI when the product is a computer but usability
also concerns products beyond computers. Usability is also more focused on
interactions within a specific context or environment for a specific product.
Formally, the ISO defines usability as the extent to which a product can be used by
specific users in a specific context to achieve specific goals with effectiveness,
efficiency, and satisfaction.
allows users to achieve goals
joint cognitive systems imply that information is shared or distributed among humans and technology. This
framework is useful for examining teamwork in healthcare where team members
work together on patient care
Health Human-Computer Interaction (HHCI) Framework Humans or products can initiate interactions. The information is processed through
either the product or the humans according to characteristics. The recipient then
reacts to the information; for example, a healthcare provider could read and
respond to email from a patient or a product might process interactions after the
"enter" key is pressed. Iterative cycles continue as humans behave and products
act according to defined characteristics. Goals and planning are implicit within the
tasks displayed in the framework.
discount usability methods reduce the number of required users in usability projects and to use early design
prototypes.
These methods offer economies of time, effort, and cost and can be completed at
any point in the systems life cycle.
Two common techniques are heuristic evaluation and think-aloud protocol.
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Heuristic evaluations compare products against accepted usability guidelines to reveal major and minor
usability issues.
think-aloud protocol also involves a small number of users and has them talk aloud while they interact
with a product. Users voice what they are trying to do, indicate where interactions
are confusing, and provide other thoughts about the product during interactions.
This allows a detailed examination of the specified tasks, in particular to uncover
major effectiveness issues.
used in conjunction with other techniques
task analysis generic term for a set of more than 100 techniques that range from a focus on
cognitive tasks and processes (called cognitive task analysis) to observable user
interactions with an application (e.g., a systematic mapping of team interactions
during a patient code).
Task analyses are systematic methods that are used to understand what users are
doing or required to do with a product by focusing on tasks and behavioral actions
of the users and products.
These methods provide a process for learning about and documenting how ordinary
users complete actions in a specific context.
Methods of task analysis include the following: •Interviews •Observations
•Shadowing users at their actual work sites •Observing users doing tasks
•Conducting ethnographic studies or interviews
focused ethnographies concentrate on individuals' points of view, their experiences and interactions in
social settings, rather than on just the actions of those individuals
During observations, detailed descriptions are generated with an emphasis on
social relationships and their impact on work.
Usability Questionnaires System Usability Scale (SUS)- industry standard, 10-scale
Questionnaire for User Interaction Satisfaction (QUIS)-computer system or
application assessed
Purdue Usability Testing Questionnaire-100 open ended questions
Software Usability Measurement Inventory (SUMI)-
Exploratory Test conducted early in the systems life cycle after requirements are determined. These
tests are conducted on very basic or preliminary designs or redesigns where few
resources have been committed to programming the product. The objective of an
exploratory test is to assess the effectiveness of emerging design concepts
informal
Assessment Test conducted early in or midway through the development of a product application.
After the organization and general design are determined, this kind of test assesses
lower-level operations of the application, stressing the efficiency goals of the
product (versus effectiveness) and how well the task is presented to users.
conducted whens system partially developed
validation test completed later in the systems life cycle using a more mature product. This type of
test assesses how this particular product compares to a predetermined standard,
benchmark, or performance measure.
Comparison Study can conduct comparison studies at any point in the systems life cycle but they are
more commonly done to compare an existing design with a redesign or an early
prototype with a more mature product.
The major objective of this usability test is to determine which application, design, or
product is more effective, efficient, and satisfying
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