SEND: a system for electronic notification and documentation of vital sign observations.
BACKGROUND
Recognising the limitations of a paper-based approach to documenting vital sign observations and responding to national clinical guidelines, we have explored the use of an electronic solution that could improve the quality and safety of patient care. We have developed a system for recording vital sign observations at the bedside, automatically calculating an Early Warning Score, and saving data such that it is accessible to all relevant clinicians within a hospital trust. We have studied current clinical practice of using paper observation charts, and attempted to streamline the process. We describe our user-focussed design process, and present the key design decisions prior to describing the system in greater detail.


RESULTS
The system has been deployed in three pilot clinical areas over a period of 9 months. During this time, vital sign observations were recorded electronically using our system. Analysis of the number of observations recorded (21,316 observations) and the number of active users (111 users) confirmed that the system is being used for routine clinical observations. Feedback from clinical end-users was collected to assess user acceptance of the system. This resulted in a System Usability Scale score of 77.8, indicating high user acceptability.


CONCLUSIONS
Our system has been successfully piloted, and is in the process of full implementation throughout adult inpatient clinical areas in the Oxford University Hospitals. Whilst our results demonstrate qualitative acceptance of the system, its quantitative effect on clinical care is yet to be evaluated.
Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford, OX3 7DQ, UK. wong@robots.ox.ac.uk.
David
D
Wong
Kadoorie Centre for Critical Care Research and Education, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Timothy
T
Bonnici
Kadoorie Centre for Critical Care Research and Education, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Julia
J
Knight
Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford, OX3 7LD, UK.
Lauren
L
Morgan
IM&T, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Paul
P
Coombes
Kadoorie Centre for Critical Care Research and Education, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Peter
P
Watkinson
D004282:Documentation / Q000379:methods; D006801:Humans; D008491:Medical Informatics Applications; D009313:National Health Programs / Q000458:organization & administration*; D010865:Pilot Projects; D012720:Severity of Illness Index; D006113:United Kingdom; D055986:Vital Signs / Q000502:physiology*