| High usage, outcomes not improving | Content or format is wrong for the moment | Observe 3 practitioners using the tool in the workflow moment; identify where the guidance fails to enable correct action |
| Low usage, outcomes not improving | Access mechanism is failing | Shadow practitioners during the critical moment; identify whether they know the resource exists and whether they can access it in time |
| High usage initially, declining over time | Tool content becoming outdated OR practitioners internalizing the content | Compare error rates: if declining with usage, practitioners are internalizing (positive). If error rates stable, content is outdated — trigger maintenance review |
| Tool never accessed after launch | Discovery failure — practitioners don't know it exists | Survey 5 practitioners: do they know this resource exists? If not, redesign the discovery mechanism and access path |