Emergency Department Status Boards: A Case Study in Information Systems Transition

Abstract

Patient status boards play an important role in coordinating and communicating about patient care in hospital emergency departments (EDs). Status boards are transitioning from dry-erase whiteboards to electronic systems. Although electronic systems may preserve some surface features of the manual artifacts, important affordances of the manual technology are not always maintained. We compared information on manual and electronic status boards in an ED. Photographs of the manual board and screen shots of the electronic system were obtained before and after a hospital transitioned between systems. Displayed information as well as detailed content regarding patient chief complaints, clinical plans, and dispositions were coded and analyzed to understand the type and function of information present, as well as the use of features such color. Results indicated that although categories of information found were similar, the frequency with which some types of information appeared on the two system displays was substantially different. In particular, information used to coordinate aspects of patient treatment was more frequently found in the manual system. Results suggest that in the design of new information technologies, simply matching the format or information fields available on an existing system may not be sufficient to sustain current work practices or to prevent unanticipated shifts in use.