One of the factors that can contribute both to poor recording of observations and failure to interpret them correctly is the way in which observation charts are designed and used.
The purpose of this initiative is to develop a general adult observation chart that will be designed according to human factors and other relevant principles to support accurate recording of information, identification of deterioration and prompt action based on observed physiological abnormalities.
In undertaking this initiative the Commission wants to build on current approaches with an explicit focus on the application of evidence to the development and use of observation charts to improve the care of patients who deteriorate.
A background paper summarising the use of observation charts to identify clinical deterioration (PDF 977 KB) is available for download.
Human Factors and Observation Chart Research Project
The Commission is working in partnership with Queensland Health and University of Queensland to undertake a research project to provide new knowledge about the design and use of observation charts that will assist staff to better identify clinical deterioration.
This project will have a national focus and will:
- Compare a range of existing patient observation charts in order to identify which existing charts are best in terms of recording vital signs, detecting deterioration and responding appropriately to deterioration.
- Examine performance in using the different charts under different situations
- Create and evaluate a new chart that takes into account the best features of existing charts.
- provide recommendations for the best patient observation chart for clinical use based on empirical evidence.
The outputs of the project will be disseminated nationally and will contribute to the development of a national observation chart.
Phase 1 Report
The first phase of the project, a heuristic analysis of 25 existing observation charts, has been completed and a report on the outcomes of this analysis, Heuristic Analysis of 25 Australian and New Zealand Adult General Observation Charts (PDF 3,028 KB) is now available to download.In the heuristic analysis 1189 usability problems were identified in the 25 charts. Problems were identified in the layout of the page and the information in the chart, the way in which vital signs were recorded, the way in which track and trigger systems were integrated, labelling of information and use of language, cognitive and memory load required to use the chart, use of fonts and colour, and photocopying and low light legibility.
The second phase of the study will involve a survey of clinicians about observation charts and a comparison of performance of a small number of charts in a simulation centre.
