CAREER: Mitigating vigilance decrement in the clinical environment

随着时间的推移，保持一致的警戒水平对高风险系统中的工人至关重要。警觉性下降是指在监测和筛选偶然和不可预测的信号时经常发生的性能下降，危及健康和安全，并威胁工人的效率。警觉性降低在临床医疗环境中很常见，因为临床环境要求轮班工作，工作时间长，休息时间有限。鉴于警戒对临床医生的工作满意度和生产力、患者安全和医疗质量的影响，监测警觉的减少至关重要。即便如此，临床警戒度的监测在很大程度上依赖于行为指标，这些指标依赖于回顾或基于实验室的数据，这两种指标都不适用于在临床上持续实时跟踪个人的警戒水平。到目前为止，还没有人的技术界面来提供个性化的监测和干预，以减轻现实世界的临床操作中的警觉下降。本项目的目标是验证研究假设，即基于传感器的自我监测系统可以减少警戒下降。这项研究的预期结果包括：(1)使用生理反应(即心率、皮肤温度、皮肤电活动)和眼球运动来评估警戒降低的指标；(2)使用概率模型预测警戒降低的框架；(3)提供个性化干预以减轻警戒降低的人类技术界面；以及(4)用于衡量针对任何高危环境的警戒降低干预措施的有效性的评估工具包。从实地研究、对照实验和可用性研究中收集的数据将被整合到一个框架中，该框架可用于监测和减轻警戒程度的下降。该项目将提供关于如何最好地模拟和减轻临床环境中警觉性降低的洞察力，并将其潜在地整合到使用最新和客观数据的医院工作人员调度中。从长远来看，使用用户友好和低成本、轻量级商用现成可穿戴传感器的监控界面将使其非常适合远程医疗系统和临床以外的环境，如交通和空中交通管制，在这些环境中，操作员需要在高工作量情况下执行苛刻的任务。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Maintaining consistent levels of vigilance over time is critical for workers in high-risk systems. Vigilance decrement, the decline in performance that often occurs when monitoring and screening for occasional and unpredictable signals, endangers health and safety and threatens the efficiency of workers. Vigilance decrement is common in clinical healthcare environments, as clinical environments require shift work and long working hours with limited time for rest. Monitoring vigilance decrement is critical given the impact of vigilance on job satisfaction and productivity of clinicians, patients safety, and healthcare quality. Even so, monitoring of clinical vigilance relies largely on behavioral indicators that depend on retrospective or laboratory-based data, neither of which is feasible for continuously tracking vigilance levels for individuals in real time in the clinic. To date, no human technology interfaces have been deployed to provide personalized monitoring and intervention to mitigate vigilance decrement in real world clinical operations.The goal of this project is to test the research hypothesis that a sensor-based self-monitoring system can reduce vigilance decrement. The anticipated outcomes of this study include (1) assessment metrics for vigilance decrement using physiological responses (i.e., heart rate, skin temperature, electrodermal activity) and eye movement; (2) a framework for predicting vigilance decrement using probabilistic models; (3) a human technology interface that provides personalized interventions to mitigate vigilance decrement; and (4) an evaluation toolkit for measuring the effectiveness of the intervention on vigilance decrement for any high-risk environment. Data collected from field studies, controlled experiments, and usability studies will be integrated into a framework that can be used to monitor and mitigate vigilance decrement. The project will provide insight into how best to model and mitigate vigilance decrement in the clinical environment, with its potential integration into hospital staff scheduling using up-to-date and objective data. In the long term, the monitoring interface using user-friendly and low-cost, lightweight commercial off-the-shelf wearable sensors will make it well suited for use in remote healthcare systems and beyond clinical settings, such as transportation and air traffic control, where operators need to perform demanding tasks under high workload situations.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.