Information displays for automated surveillance algorithms of in-hospital patient deterioration: a scoping review.

Objective: Surveillance algorithms that predict patient decompensation are increasingly integrated with clinical workflows to help identify patients at risk of in-hospital deterioration. This scoping review aimed to identify the design features of the information displays, the types of algorithm that drive the display, and the effect of these displays on process and patient outcomes.

Materials And Methods: The scoping review followed Arksey and O'Malley's framework.

Preventing patient violence in hospitals: Applying critical decision method interviews to understand how skilled staff think and act differently.

Aims: Our aims were to understand how hospital staff who are skilled at managing aggressive patients recognize and respond to patient aggression and to compare the approaches of skilled staff to the experiences of staff who were recently involved in incidents of patient violence.

Background: Violence from patients toward staff is prevalent and increasing. There is a need for greater understanding of effective approaches to managing patient aggression in a wide variety of hospital settings.

User interface approaches implemented with automated patient deterioration surveillance tools: protocol for a scoping review.

Introduction: Early identification of patients who may suffer from unexpected adverse events (eg, sepsis, sudden cardiac arrest) gives bedside staff valuable lead time to care for these patients appropriately. Consequently, many machine learning algorithms have been developed to predict adverse events. However, little research focuses on how these systems are implemented and how system design impacts clinicians' decisions or patient outcomes.

Effect of Remote Cardiac Monitoring System Design on Response Time to Critical Arrhythmias.

Introduction: In many hospitals across the country, electrocardiograms of multiple at-risk patients are monitored remotely by telemetry monitor watchers in a central location. However, there is limited evidence regarding best practices for designing these cardiac monitoring systems to ensure prompt detection and response to life-threatening events. To identify factors that may affect monitoring efficiency, we simulated critical arrhythmias in inpatient units with different monitoring systems and compared their efficiency in communicating the arrhythmias to a first responder.

Organizing Audible Alarm Sounds in the Hospital: A Card-Sorting Study.

In hospitals, clinicians are presented with varied and disorganized alarm sounds from disparate devices. While there has been attention to reducing inactionable alarms to address alarm overload, little effort has focused on organizing, simplifying, or improving the informativeness of alarms. We sought to elicit nurses' tacit interpretation of alarm events to create an organizational structure to inform the design of advanced alarm sounds or integrated alert systems.

Preliminary Validation of a Patient-Reported Measure of the Age-Friendliness of Health Care.

Background/objective: To evaluate the validity and reliability of a patient-reported measure of the "age-friendliness" of health care.

Design: Based on four essential domains of high-quality health care for older outpatients (Medications, Mobility, Mentation and "what Matters," i.e.

Iterative heuristic design of temporal graphic displays with clinical domain experts.

Conventional electronic health record information displays are not optimized for efficient information processing. Graphical displays that integrate patient information can improve information processing, especially in data-rich environments such as critical care. We propose an adaptable and reusable approach to patient information display with modular graphical components (widgets).

Impact of integrated graphical display on expert and novice diagnostic performance in critical care.

Objective: To determine the impact of a graphical information display on diagnosing circulatory shock.

Materials And Methods: This was an experimental study comparing integrated and conventional information displays. Participants were intensivists or critical care fellows (experts) and first-year medical residents (novices).

Critical care information display approaches and design frameworks: A systematic review and meta-analysis.

Objective: To systematically review original user evaluations of patient information displays relevant to critical care and understand the impact of design frameworks and information presentation approaches on decision-making, efficiency, workload, and preferences of clinicians.

Methods: We included studies that evaluated information displays designed to support real-time care decisions in critical care or anesthesiology using simulated tasks. We searched PubMed and IEEExplore from 1/1/1990 to 6/30/2018.

Novel displays of patient information in critical care settings: a systematic review.

Objective: Clinician information overload is prevalent in critical care settings. Improved visualization of patient information may help clinicians cope with information overload, increase efficiency, and improve quality. We compared the effect of information display interventions with usual care on patient care outcomes.

Critical care information display approaches and design frameworks: A systematic review and meta-analysis.

Objective: To systematically review original user evaluations of patient information displays relevant to critical care and understand the impact of design frameworks and information presentation approaches on decision-making, efficiency, workload, and preferences of clinicians.

Methods: We included studies that evaluated information displays designed to support real-time care decisions in critical care or anesthesiology using simulated tasks. We searched PubMed and IEEExplore from 1/1/1990 to 6/30/2018.

Patient information organization in the intensive care setting: expert knowledge elicitation with card sorting methods.

Introduction: Many electronic health records fail to support information uptake because they impose low-level information organization tasks on users. Clinical concept-oriented views have shown information processing improvements, but the specifics of this organization for critical care are unclear.

Objective: To determine high-level cognitive processes and patient information organization schema in critical care.

How Do Simulated Error Experiences Impact Attitudes Related to Error Prevention?

Introduction: The objective of this project was to determine whether simulated exposure to error situations changes attitudes in a way that may have a positive impact on error prevention behaviors.

Methods: Using a stratified quasi-randomized experiment design, we compared risk perception attitudes of a control group of nursing students who received standard error education (reviewed medication error content and watched movies about error experiences) to an experimental group of students who reviewed medication error content and participated in simulated error experiences. Dependent measures included perceived memorability of the educational experience, perceived frequency of errors, and perceived caution with respect to preventing errors.

Toward Designing Information Display to Support Critical Care. A Qualitative Contextual Evaluation and Visioning Effort.

Objectives: Electronic health information overload makes it difficult for providers to quickly find and interpret information to support care decisions. The purpose of this study was to better understand how clinicians use information in critical care to support the design of improved presentation of electronic health information.

Methods: We conducted a contextual analysis and visioning project.

Operating Room-to-ICU Patient Handovers: A Multidisciplinary Human-Centered Design Approach.

Background: Patient handovers (handoffs) following surgery have often been characterized by poor teamwork, unclear procedures, unstructured processes, and distractions. A study was conducted to apply a human-centered approach to the redesign of operating room (OR)-to-ICU patient handovers in a broad surgical ICU (SICU) population. This approach entailed (1) the study of existing practices, (2) the redesign of the handover on the basis of the input of hand over participants and evidence in the medical literature, and (3) the study of the effects of this change on processes and communication.

Patient load effects on response time to critical arrhythmias in cardiac telemetry: a randomized trial.

Objectives: Remotely monitored patients may be at risk for a delayed response to critical arrhythmias if the telemetry watchers who monitor them are subject to an excessive patient load. There are no guidelines or studies regarding the appropriate number of patients that a single watcher may safely and effectively monitor. Our objective was to determine the impact of increasing the number of patients monitored on response time to simulated cardiac arrest.

Standardized assessment for evaluation of team skills: validity and feasibility.

Introduction: The authors developed a Standardized Assessment for Evaluation of Team Skills (SAFE-TeamS) in which actors portray health care team members in simulated challenging teamwork scenarios. Participants are scored on scenario-specific ideal behaviors associated with assistance, conflict resolution, communication, assertion, and situation assessment. This research sought to provide evidence of the validity and feasibility of SAFE-TeamS as a tool to support the advancement of science related to team skills training.

A Cognitive Modeling Approach to Decision Support Tool Design for Anesthesia Provider Crisis Management.

Prior research has revealed existing operating room (OR) patient monitors to provide limited support for prompt and accurate decision making by anesthesia providers during crises. Decision support tools (DSTs) developed for this purpose typically alert the anesthesia provider to existence of a problem but do not recommend a treatment plan. There is a need for a human-centered approach to the design and development of a crisis management DST.

Can we make postoperative patient handovers safer? A systematic review of the literature.

Postoperative patient handovers are fraught with technical and communication errors and may negatively impact patient safety. We systematically reviewed the literature on handover of care from the operating room to postanesthesia or intensive care units and summarized process and communication recommendations based on these findings. From >500 papers, we identified 31 dealing with postoperative handovers.

Usability evaluation of a personal health record.

The electronic personal health record (PHR) has been championed as a mediator of patient-centered care, yet its usability and utility to patients, key predictors of success, have received little attention. Human-centered design (HCD) offers validated methods for studying systems effects on users and their cognitive tasks. In HCD, user-centered activities allow potential users to shape the design of the end product and enhance its usability.

Adaptation of a postoperative handoff communication process for children with heart disease: a quantitative study.

Handoff communication is a point of vulnerability when valuable patient information can be inaccurate or omitted. An institutional protocol was implemented in 2005 to improve the handoff from the operating room to the intensive care unit after pediatric cardiac surgery. A cross-sectional study of the present process was performed to understand how users adapt a communication intervention over time.

Assessing teamwork in medical education and practice: relating behavioural teamwork ratings and clinical performance.

Background: Problems with communication and team coordination are frequently linked to adverse events in medicine. However, there is little experimental evidence to support a relationship between observer ratings of teamwork skills and objective measures of clinical performance.

Aim: Our main objective was to test the hypothesis that observer ratings of team skill will correlate with objective measures of clinical performance.