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

描述(由申请人提供)： 管理安全护理的信息，特别是在新的卫生信息技术环境中，对于护理提供者来说仍然是一项具有认知挑战性的工作。在构建医疗IT系统时为提供者提供足够的认知支持，可以通过减少变通方法和医疗差错来提高提供者的工作效率。为了对信息支持建模，认知工程师传统上对任务-技术-人三位一体的模型进行建模。但是，研究人员的初步工作表明，低水平的信息确实将护理任务以及提供者如何利用技术履行他们的任务联系在一起。研究人员试行了一种基于信息的认知工作设计技术，用于对低级别医疗信息提供者在其认知工作中创建、使用和共享的建模。这项技术，当扩展到医疗差错建模时，将提高患者的安全性。然而，为了推广成功，研究人员需要提高她在健康信息学和医疗差错建模方面的技能，同时还需要全面了解健康结果建模。这份独立之路(K99/R00)拨款申请描述了一项培训和职业发展计划，该计划将允许候选人--约翰·霍普金斯医学院质量和安全研究组的博士后研究员--实现这些目标。培训部分将在H.Lehmann博士(JHU SOM，卫生信息学)的指导下进行。Peter Pronovost博士(JHU SOM，患者安全)、Ayse Gurses博士(JHU SOM，患者安全)和Ann Bisantz博士(纽约州立大学，水牛城，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提供者创建和用于护理的低级别信息，为提供者的工作设计卫生IT系统。在获奖期间，研究将集中在以下具体目标上：(1)与患者状态变化相对应的地图提供者流程工作流程；(2)识别提供者在护理流程中创建和使用的低级信息属性，并将它们与每个主要护理流程步骤中的潜在医疗错误相关联；以及(3)展示低级信息属性作为医疗IT支持系统设计基础的效用。

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.