Usability testing of two co-designed discharge communication tools for use in pediatric emergency departments: findings from the EDUCATE study

Abstract

Abstract Background Discharge communication is a key component of high-quality care. This practice is important in the pediatric emergency department (PED), where patients and families often leave without fully understanding important information shared during their visit. Co-designed discharge communication interventions may enhance information exchange in PEDs. The aim of this study was to assess the usability of two discharge communication tools, co-designed with youth, parents, and PED clinicians, for asthma or concussion presentations. Methods This was a mixed methods study with a concurrent validating quantitative triangulation design. Youth, parents, and clinicians recruited from two Canadian PEDs completed usability tests for either an asthma or concussion co-designed discharge communication intervention. Usability Testing Round 1 was remote, where participants provided quantitative and qualitative feedback on tool functionality. Feedback from Round 1 informed the revised tools for Round 2 testing. Remote Usability Testing Round 2 was self-administered by a new group of participants who provided feedback on user experience and satisfaction with the tool by completing 5-point Likert scale questions and open-text fields. Round 1 data were analyzed using the severity of usability problems (SUP) scoring. Quantitative data from Rounds 1 and 2 were analyzed descriptively. Deductive content analysis was applied to qualitative data from Rounds 1 and 2. One reviewer coded participant feedback and a second reviewer verified categories. Results Round 1 (n = 14) revealed primarily cosmetic and minor usability issues for each tool. Revised tools were used in Usability Testing Round 2 (n = 40), which identified additional, minor revisions to each tool. A key suggestion was offering the tools in multiple languages and formats to ensure they met the diverse needs of patients and families presenting to the PED. Site 1 participants consistently scored the tools more helpful or useful compared to Site 2. Conclusions Through two rounds of comprehensive usability testing, we refined each tool to meet the needs of youth, parents and PED clinicians. Enhanced recruitment strategies are needed to reach youth and diverse populations to ensure future tools meet a range of information needs during PED discharge.