A Novel Cognition-based Guidance System to Improve Surgical Safety

在美国，导致可预防不良事件的医疗差错是第三大死亡原因。 人类认知在复杂的健康护理环境中对错误的贡献正日益被认识到。 许多研究已经证明认知表现指标与患者之间存在直接关系 结果。尽管如此，认知在提高安全性中的作用尚未得到足够的重视。心脏 外科手术室是提高患者安全和挽救生命的高影响力领域。在复杂的环境中， 心脏手术和相关的备用注意力能力的减少必然会对 团队发现自身错误的能力在建议的项目中，我们将探索和评估新的方法， 使用过程和患者实时数据以及设备状态信息动态地和主动地提供 从当前手术状态向前引导。建议的认知导向系统将 术中展开。我们认为，通过支持，可以减少心脏手术室中的人为错误 通过动态更新的电子指南进行个人和团队互动，这些电子指南对细节做出响应 正在进行的过程（即，情境感知的），患者的当前医疗状况（即，患者意识），以及 对参与临床医生的认知工作负荷要求（即，工作负载感知）。

Medical errors causing preventable adverse events are the third leading cause of death in the U.S. The role of human cognition in contributing to errors in complex healthcare environments is increasingly being recognized. Many studies have demonstrated a direct relationship between cognitive performance metrics and patient outcomes. Notwithstanding, the role of cognition in improving safety has not received enough attention. Cardiac surgical OR is a high-impact area to improve patient safety and save lives. High mental workload during complex cardiac surgery and associated reduction of spare attentional capacity is bound to have a detrimental effect on a team's ability to detect their own errors. In the proposed project, we will explore and evaluate novel approaches to using process and patient real-time data, and device status information dynamically and proactively to provide guidance forward from the current surgical state. The proposed Cognition-based Guidance System will be deployed intraoperatively. We believe that human errors in the cardiac OR can be reduced by supporting individual and team interactions via dynamically-updated electronic guidance that are responsive to the details of the on-going process (i.e., context-aware), to the patient's current medical condition (i.e., patient-aware), and to cognitive workload demands on the participating clinicians (i.e., workload-aware).