A Layered, Multi-Agent System To Facilitate Healthcare Team Processes

促进医疗团队流程的分层多代理系统

• 批准号: 8337520
• 负责人: Roberto Javier Nicolalde
• 金额: $ 19.39万
• 依托单位: BAUER LABS, LLC
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-18 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8337520
• 关键词: American College of Obstetricians and Gynecologists; Architecture; Caring; Cities; Clinical; Communication; Complex; Computer software; Computerized Medical Record; Cues; Data; Distress; Documentation; Early Diagnosis; Effectiveness; Elements; Emergency Situation; Engineering; Equipment; Evaluation; Event; Failure; Family; Feedback; Fetus; Generations; Goals; Health Services Research; Healthcare; Hospitals; Human; Human Resources; Indium; Information Systems; Joints; Knowledge; Lead; Legal patent; Life; Manuals; Measures; Medical; Medical Care Team; Methodology; Methods; Modeling; Monitor; Morbidity - disease rate; Mothers; Operating Rooms; Operative Surgical Procedures; Oregon; Patients; Performance; Pharmaceutical Preparations; Phase; Plant Roots; Practice Guidelines; Preparation; Procedures; Process; Quality of Care; Resources; Robotics; Rural; Rural Hospitals; Scientist; Simulate; Small Business Innovation Research Grant; Solutions; Surgical incisions; System; Systems Development; Technology; Telephone; Testing; Time; Trauma; United States National Institutes of Health; Universities; Visual; Voice; Work; base; design; fetal; health care delivery; health care quality; health disparity; improved; interoperability; medical complication; meetings; member; mortality; neonatal morbidity; next generation; prevent; prototype; research and development; response; rural area; sensor; simulation; speech recognition; usability; wound

DESCRIPTION (provided by applicant): Response to an Emergency Cesarean Delivery (ECD) at rural hospitals is complicated not only by inefficiencies in monitoring and early detection of fetal and/or maternal distress during labor, but by the conditions of the rural settin. Many rural hospitals lack the resources to have round-the-clock surgical staff and operating rooms reserved for cesarean delivery. Despite the availability of superior inexpensive technologies, an ECD team is often summoned to surgery using inadequate pager and telephone methods. People who must, or choose to, live in rural areas are no less deserving of timely and effective emergency obstetrical care than those in large cities. The Agency for Healthcare Research and Quality defines failure to Rescue, the lack of effectiveness and timeliness of actions taken once early medical complications are recognized, as one of the measures of quality of care. Delays in response as well as errors and omissions can lead to failures to rescue the fetus and mother, leading to increased mortality and neonatal morbidity. Based on preliminary work with an existing prototype, Bauer Labs proposes to test the feasibility and to conduct further research and the development of an intelligent e-summoning and enterprise management system aimed at coordinating the effective and timely assembly of the ECD team and the preparation of patients and operating room according to best practice guidelines. Our system has the capability to not only summon the surgical team, but also to facilitate communication among team members, coordinate team decisions, standardize preparation activities, and keep personnel informed of the status of the team, the patient, and the operating room. Furthermore, our system provides an interface between the electronic medical record (EMR), and commercially available asset management and patient tracking solutions aimed at providing needed decision and coordination support. In phase 1, we propose to: A) Fully evaluate the effectiveness and operability of the existing prototype under a simulated clinical ECD and gather input from users on further system development. B) Build a robust and reliable second generation prototype meeting the technical and operability requirements identified in the previous evaluation. C) Develop the methods to integrate patient medical information from the EMR into the summoning system using Bauer Lab's proprietary multi-agent system technology. D) Develop the interface between our system with off-the-shelf asset management and patient tracking solutions. E) Evaluate the effectiveness and operability of our system in reducing errors, increasing communication, and meeting the 30-minute "decision-to-incision" interval target during total team and hospital ECD simulation trials. The ultimate goal o this project is to demonstrate the technical feasibility of using intelligent and integrated healthcare delivery management systems based on Bauer Lab's proprietary multi-agent system technology to prevent failures to rescue by intelligently integrating clinical, logistical, and operational information, and presenting it to the care team in a manner that integrates non-intrusively with the clinical workflow. PUBLIC HEALTH RELEVANCE: The ability to capture detailed knowledge about clinical processes and use it in real-time to guide procedures, provide decision support, capture and display patient data, and alert the medical team to critical information will be a major improvement in the capabilities of the medical system, leading to the reduction of delays, omissions, and other errors during emergency surgical interventions. These improvements will reduce the time from decision-to-incision in Emergency Cesarean Delivery and reduce the likelihood of mishaps resulting in patient (mother and fetus) morbidity and mortality.

描述（由申请人提供）：农村医院对紧急剖腹产 (ECD) 的反应变得复杂，不仅因为分娩过程中胎儿和/或产妇不适的监测和早期发现效率低下，而且因为农村环境的条件。许多乡村医院缺乏资源，无法配备全天候的手术人员和预留剖腹产手术室。尽管有先进的廉价技术，但 ECD 团队经常被召唤去进行手术，但使用的寻呼机和电话方法并不充分。必须或选择居住在农村地区的人们并不比大城市的人们更需要及时、有效的紧急产科护理。医疗保健研究和质量局将“救援失败”定义为护理质量的衡量标准之一，即一旦发现早期医疗并发症，所采取的行动缺乏有效性和及时性。反应延迟以及错误和遗漏可能会导致胎儿和母亲抢救失败，从而导致死亡率和新生儿发病率增加。基于现有原型的初步工作，鲍尔实验室建议测试可行性，并进一步研究和开发智能电子召唤和企业管理系统，旨在根据最佳实践指南协调 ECD 团队的有效和及时的组装以及患者和手术室的准备。我们的系统不仅能够召集手术团队，还能够促进团队成员之间的沟通，协调团队决策，标准化准备活动，并使人员了解团队、患者和手术室的状态。此外，我们的系统提供电子病历 (EMR) 与商用资产管理和患者跟踪解决方案之间的接口，旨在提供所需的决策和协调支持。在第一阶段，我们建议：A）在模拟环境下全面评估现有原型的有效性和可操作性 临床 ECD 并收集用户对进一步系统开发的意见。 B) 构建坚固可靠的第二代原型，满足先前评估中确定的技术和可操作性要求。 C) 开发使用 Bauer Lab 专有的多代理系统技术将患者医疗信息从 EMR 集成到召唤系统中的方法。 D) 开发我们的系统与现成资产管理和患者跟踪解决方案之间的接口。 E) 评估我们的系统在整个团队和医院 ECD 模拟试验期间减少错误、增加沟通以及满足 30 分钟“决策到切开”间隔目标方面的有效性和可操作性。该项目的最终目标是展示使用基于 Bauer Lab 专有的多代理系统技术的智能集成医疗服务管理系统的技术可行性，通过智能集成临床、后勤和操作信息，并以非侵入式与临床工作流程集成的方式将其呈现给护理团队，来防止救援失败。 公共卫生相关性：获取有关临床流程的详细知识并实时使用它来指导手术、提供决策支持、获取和显示患者数据以及提醒医疗团队注意关键信息的能力将是医疗系统能力的重大改进，从而减少紧急外科干预期间的延误、遗漏和其他错误。这些改进将减少紧急剖腹产从决策到切开的时间，并减少导致患者（母亲和胎儿）发病和死亡的事故的可能性。