CAREER: Mitigating vigilance decrement in the clinical environment

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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.