Designing Real-time Decision Support for Trauma Resuscitations

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This is a review of an article by Yadav et al, Designing Real-time Decision Support for Trauma Resuscitations [1]


Electronic Clinical Decision Support (eCDS) has been recommended for implementation of clinical decision rules. However, many eCDS tools are implemented and designed without taking into account clinical workflow in practice context. A eCDS specific to pediatric traumatic brain injury (TBI) is lacking. A human factors engineering approach could identify implementation barriers.


To design a pediatric TBI eCDS tool for trauma resuscitation using a human factors approach.


A mixed-methods approach adapting the Hix and Hartson star life cycle was used. Using standard trauma resuscitation protocols, a hierarchical task analysis of pediatric TBI evaluation was developed. Software team developed prototype eCDS based on the hierarchical task analysis and human factors engineers evaluated the prototype and gave feedback for improvement. eCDS then underwent iterative usability evaluations to ensure all concerns were identified and addressed.


After the prototype eCDS tool was developed, the new eCDS was rated better than existing tools for one of 10 standard user interface design heuristics and rated equivalent in the remainder. Clinical experts also rated barriers to use the eCDS tool was being low.


This study investigated CDS design and implementation in a special setting where existing CDS tools were out of context. This illustrated the importance of CDS to be able to adapt to different settings requiring high customizations.


  1. Yadav, K., Chamberlain, J. M., Lewis, V. R., Abts, N., Chawla, S., Hernandez, A., ... & Burd, R. S. (2015). Designing Real‐time Decision Support for Trauma Resuscitations. Academic Emergency Medicine, 22(9), 1076-1084.