"You Have to Piece the Puzzle Together" – Implications for Designing Decision Support in Intensive Care

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DOI

Intensive Care Unit (ICU) professionals have to make lifesaving therapy decisions promptly under high stress and uncertainty. Clinical Decision Support Systems (CDSS) can improve the quality of healthcare by identifying complex statistical connections between patients' parameters and by rapidly presenting the statistically most promising treatment options to physicians. However, HCI aspects are rarely considered when developing CDSSs. This paper describes a field study conducted in three ICUs investigating how physicians and nurses form (volume) therapy decisions and monitor their success. Our findings reveal a continuous decision cycle in which nurses and physicians collaborate synchronously and asynchronously to provide optimal care. Furthermore, the desire to understand how a CDSS generated recommendations varies depending on the user's goals and other contextual factors such as workload. These findings show that CDSSs for ICUs need to (1) specifically facilitate collaboration and (2) support adaptation of the interface to both context and users.