{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T21:57:52Z","timestamp":1773871072684,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003To improve blood transfusion practices, we applied user-centered design (UCD) to evaluate potential changes to blood transfusion orders.<\/jats:p><jats:p>\n          Objectives\u2003The aim of the study is to build effective transfusion orders with different designs to improve guideline adherence.<\/jats:p><jats:p>\n          Methods\u2003We developed three different versions of transfusion orders that varied how information was presented to clinicians ordering blood transfusions. We engaged 14 clinicians (residents, advanced practice providers [APPs], and attending physicians) from different specialties. We used the think aloud technique and rapid qualitative analysis to generate themes to incorporate into our modified orders.<\/jats:p><jats:p>\n          Results\u2003Most end-users who participated in the semi-structured interviews preferred the interruptive alert design plus behavioral nudges (n\u2009=\u20098\/14, 57%). The predominant rationale was that the in-line alert was not visually effective in capturing the end-user's attention, while the interruptive alert forced a brief stop in the workflow to consider the guidelines. All users supported the general improvements, though for different reasons, and as a result, the general improvements remained in the designs for the forthcoming trial.<\/jats:p><jats:p>\n          Conclusion\u2003The user experience uncovered through the think aloud approach produced a clear and rich understanding of potentially confounding factors in the initial design of different intervention versions. Input from end-users guided the creation of all three designs so each was addressing human factors with parity, which ensured that the results of our study reflected differences in interruptive properties of the alerts and not differences in design.<\/jats:p>","DOI":"10.1055\/s-0042-1759866","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:03:50Z","timestamp":1673481830000},"page":"28-36","source":"Crossref","is-referenced-by-count":4,"title":["User-Centered Design to Reduce Inappropriate Blood Transfusion Orders"],"prefix":"10.1055","volume":"14","author":[{"given":"Brad","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Anstett","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelam","family":"Mistry","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Pincus","sequence":"additional","affiliation":[{"name":"Adult & Child Center for Outcomes Research & Delivery Science\/The NavLab, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Tan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvie","family":"Novins-Montague","sequence":"additional","affiliation":[{"name":"Adult & Child Center for Outcomes Research & Delivery Science\/The NavLab, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. Michael","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"e12469","DOI":"10.2196\/12469","article-title":"Interruptive versus noninterruptive clinical decision support: usability study","volume":"6","author":"S Blecker","year":"2019","journal-title":"JMIR Human Factors"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"e28102","DOI":"10.2196\/28102","article-title":"The application of human-centered design approaches in health research and innovation: a narrative review of current practices","volume":"9","author":"I G\u00f6ttgens","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ijmedinf.2017.05.004","article-title":"User-centered design to improve clinical decision support in primary care","volume":"104","author":"J Brunner","year":"2017","journal-title":"Int J Med Inform"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e427","DOI":"10.1097\/pq9.0000000000000427","article-title":"Simulation-based user-centered design: an approach to device development during COVID-19","volume":"6","author":"N Colman","year":"2021","journal-title":"Pediatr Qual Saf"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.tracli.2020.08.002","article-title":"Cost of red blood cell transfusion; evaluation in a French academic hospital","volume":"27","author":"J C Rigal","year":"2020","journal-title":"Transfus Clin Biol"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1111\/trf.12958","article-title":"Increased hospital costs associated with red blood cell transfusion","volume":"55","author":"K M Trentino","year":"2015","journal-title":"Transfusion"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1001\/jama.2019.0554","article-title":"Patient blood management: recommendations from the 2018 Frankfurt Consensus Conference","volume":"321","author":"M M Mueller","year":"2019","journal-title":"JAMA"},{"issue":"04","key":"ref12","first-page":"509","article-title":"Monitoring compliance with transfusion guidelines in hospital departments by electronic data capture","volume":"12","author":"A Norgaard","year":"2014","journal-title":"Blood Transfus"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1055\/s-0040-1721779","article-title":"Optimizing inpatient blood utilization using real-time clinical decision support","volume":"12","author":"S Ikoma","year":"2021","journal-title":"Appl Clin Inform"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1055\/s-0039-3402714","article-title":"Formative usability testing reduces severe blood product ordering errors","volume":"10","author":"E W Orenstein","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1055\/s-0039-1693123","article-title":"A quality improvement initiative to decrease platelet ordering errors and a proposed model for evaluating clinical decision support effectiveness","volume":"10","author":"J W Yarahuan","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1186\/s13063-021-05453-9","article-title":"The NUDGE trial pragmatic trial to enhance cardiovascular medication adherence: study protocol for a randomized controlled trial","volume":"22","author":"R E Glasgow","year":"2021","journal-title":"Trials"},{"key":"ref17","volume-title":"Qualitative Research and Evaluation Methods. 3rd ed","author":"M Q Patton","year":"2002"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"e019993","DOI":"10.1136\/bmjopen-2017-019993","article-title":"Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? 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