Towards Dynamic Checklists: Understanding Contexts of Use and Deriving Requirements for Context-Driven Adaptation

Abstract

The goal of this in-the-wild study was to understand how different patient, provider, and environment contexts affected the use of a tablet-based checklist in a dynamic medical setting. Fifteen team leaders used the digital checklist in 187 actual trauma resuscitations. The measures of checklist interactions included the number of unchecked items and the number of notes written on the checklist. Of the 10 contexts we studied, team leaders' arrival after the patient and patients with penetrating injuries were both associated with more unchecked items. We also found that the care of patients with external injuries contributed to more notes written on the checklist. Finally, our results showed that more experienced leaders took significantly more notes overall and more numerical notes than less experienced leaders. We conclude by discussing design implications and steps that can be achieved with context-aware computing towards adaptive checklists that meet the needs of dynamic use contexts.