Impact of clinical reminder redesign on learnability, efficiency, usability, and workload for ambulatory clinic nurses

Computerized clinical reminders (CRs) were designed to reduce clinicians' reliance on their memory and to present evidence-based guidelines at point of care. As CR adoption and effectiveness has been variable, we examined the impact of four design modifications on learnability, efficiency, usability, and workload for intake nursing personnel in an outpatient clinic setting. In a simulation experiment, 16 nurses used prototypes of the current and redesigned system. The redesign was found to significantly increase learnability for first-time users as measured by time to complete the first CR, efficiency as measured by task completion time for two of five patient scenarios, usability as determined by all three groupings of questions taken from a commonly used survey instrument, and two of six workload subscales of the NASA Task Load Index (TLX) survey: mental workload and frustration. Modest design modifications to existing CR software positively impacted variables that likely would increase the willingness for first-time nursing personnel to adopt and consistently use CRs.