Design and Development of a Mobile Decision Support System: Guiding Clinicians Regarding Law in the Practice of Psychiatry in Emergency Department

摘要

Decision-making in an emergency department needs to be efficient. It does not allow observation of the patient for a prolonged period of time, especially if the patients harm themselves or others, or refuses treatment. This includes suicidal, violent, intentional self-inflicted or non-consenting to treatments patient. Clinicians have to quickly decide whether to call the police, admit the patient to the psychiatric ward, according to recommended, predefined procedures. Since, for different situations different laws are applicable, clinicians need to follow certain procedures and consider specific legal issues while also handling challenging patients at the emergency department. Finding the right information quickly and following the recommended procedure is essential since the repercussions for a doctor acting incorrectly could be severe. This paper presents a mobile decision support system (DSS) prototype designed for healthcare providers to identify and follow the correct procedure based on applicable laws to mitigate the chance of incorrect actions being taken, along with the associated risks and preserve both the patients and their own rights. We explored healthcare providers requirements and alternatives for visualizing information by conducting observation, semi structured interviews and a total of four co-design workshops. The resulting mobile DSS enables clinicians to quickly access the correct information regarding their power and authority while also protecting the safety and welfare of the patient. Usability evaluation of the prototype showed that the average time spent to complete a given task was about 12 seconds by a total of six medical interns. Participants of the evaluation described the system easy to use, intuitive and highly useful for everyday use.