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: 8547092
• 负责人: Roberto Javier Nicolalde
• 金额: $ 20万
• 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 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8547092
• 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; public health relevance; 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.

描述(由申请人提供)：农村医院对紧急剖腹产(ECD)的反应不仅因为在分娩过程中对胎儿和/或母亲窘迫的监测和早期发现效率低下，而且还受到农村环境条件的影响。许多农村医院缺乏资源，无法配备全天候的外科工作人员和为剖腹产预留的手术室。尽管有物美价廉的技术，但ECD团队经常被召唤去做手术，使用的寻呼机和电话方法不够充分。必须或选择生活在农村地区的人，与大城市的人一样，值得得到及时有效的产科急救护理。医疗研究和质量机构将未能抢救、一旦发现早期医疗并发症而采取的行动缺乏有效性和及时性定义为医疗质量的衡量标准之一。反应迟缓以及错误和遗漏可能导致未能抢救胎儿和母亲，导致死亡率和新生儿发病率增加。在现有原型的初步工作基础上，鲍尔实验室建议测试可行性，并进行进一步研究和开发智能电子传唤和企业管理系统，旨在协调ECD团队有效和及时的组装以及根据最佳实践指南准备患者和手术室。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，规范准备活动，并让人员随时了解团队、患者和手术室的状况。此外，我们的系统提供了电子病历(EMR)与商业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)充分评估现有原型在模拟环境下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)建立一个坚固可靠的第二代原型，满足上一次评估中确定的技术和可操作性要求。C)利用Bauer Lab专有的多代理系统技术，开发将EMR中的患者医疗信息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)在整个团队和医院ECD模拟试验中，评估我们的系统在减少错误、增加沟通和满足30分钟“决策到切割”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，通过智能地集成临床、后勤和操作信息，并以非侵入性与临床工作流程集成的方式将其提供给护理团队，防止救援失败。