Technology, Cognitive Work, and Patient Safety: A Information-Oriented Model

描述（由申请人提供）： 管理安全护理信息，特别是在新的健康IT环境中，仍然是护理提供者的认知挑战性工作。在建立卫生IT系统时，向提供者提供充分的认知支持可以通过减少变通方法和医疗错误来提高提供者的工作效率。为了对信息支持进行建模，认知工程师传统上对任务-技术-人员三元组进行建模。但是，调查人员的初步工作表明，低层次的信息确实与护理任务以及提供者如何使用技术执行任务有关。研究人员已经试行了一种基于信息的认知工作设计技术，用于建模低级医疗保健信息提供者在其认知工作中创建，使用和共享。当该技术扩展到医疗错误建模时，将提高患者的安全性。然而，为了使扩展成功，研究人员需要提高她在健康信息学和医疗错误建模方面的技能，以及对健康结果建模的全面理解。这条独立之路（K99/R00）资助申请描述了一个培训和职业发展计划，将允许候选人，在约翰霍普金斯医学院的质量和安全研究小组的博士后研究员，以实现这些目标。培训部分将在H. Lehmann（JHU SOM，健康信息学）。Peter Pronovost博士（JHU SOM，患者安全）、艾塞Gurses博士（JHU SOM，患者安全）和Ann Bisantz博士（SUNY，布法罗，认知系统工程）将在他们的专业领域提供额外的指导。这个独立之路（K99/R00）项目的长期目标是根据他们创建和用于护理的低级信息为提供者工作设计卫生IT系统。在授予期间，研究将集中在以下具体目标：（1）映射与患者状态变化相对应的供应商流程工作流;（2）识别供应商在护理流程中创建和使用的低级别信息属性，并将其与每个主要护理流程步骤中的潜在医疗错误联系起来;（3）展示低级别信息属性作为健康IT支持系统设计基础的实用性。

DESCRIPTION (provided by applicant): Managing information for safe care, especially in the new health IT environment, continues to be cognitively challenging work for care providers. Adequate cognitive support to providers when building health IT systems can increase provider effectiveness in their work by reducing workarounds and medical errors. To model information support, cognitive engineers traditionally have modeled the task-technology-people triad. But, preliminary work from the investigator suggests that low-level information really binds care tasks and how providers perform their tasks with technologies. The researcher has piloted an information-based cognitive work design technique for modeling low-level healthcare information providers create, use and share in their cognitive work. The technique, when extended to medical error modeling, will improve patient safety. However, for the extension to succeed, the researcher needs to enhance her skills in health informatics, and medical error modeling in addition to acquiring a comprehensive understanding of health outcomes modeling. This Pathway to Independence (K99/R00) grant application describes a training and career development plan that will allow the candidate, a Post Doctoral Research Fellow in the Quality and Safety Research Group at Johns Hopkins School of Medicine to achieve these objectives. The training component will be carried out under the mentorship of Dr. H. Lehmann (JHU SOM, Health Informatics). Drs. Peter Pronovost (JHU SOM, Patient Safety), Ayse Gurses (JHU SOM, Patient Safety) and Ann Bisantz (SUNY, Buffalo, Cognitive Systems Engineering) will provide additional mentoring in their areas of expertise. The long-term goal of this Pathway to Independence (K99/R00) project is to design health IT systems for provider work based on low-level information they create and use for care. During the award period, research will be focused on the following specific aims: (1) Map provider process workflows corresponding to patient state changes; (2) Identify low-level information attributes providers create and use in care processes, and relate them to potential medical errors at each major care process step; and (3) demonstrate utility of low-level information attributes as design bases for health IT support systems.