Leveraging Health Information Technology to Improve Trauma Resuscitation

项目摘要/摘要 尽管快速运送到适当的设施，许多创伤患者在护理的第一个小时就不必要地死亡。创伤是 46岁以下美国人的主要死因和年龄前几年潜在寿命损失的最大原因 75%，超过癌症或心脏病的发病率。高达20%的创伤死亡可能是可以预防的。据估计， 沟通失误(导致错误、创伤团队困惑和次优护理)是主要原因 第一阶段护理期间的死亡原因。在一定程度上，这种误解源于复杂和混乱的性质。 创伤复苏环境。虽然这是创伤小组处理的固有情况，但也有一些方面 可以改变的环境，以改善通信和捕获的患者数据的质量。目前， 美国的许多创伤中心依赖于在创伤复苏期间记录数据。因为护士抄写员被指控 数据输入、人为错误进一步导致数据不准确或遗漏，从而可能影响管理质量 创伤案例。用纸捕获数据也很困难，因为传输的信息量太大，信息零散 各种显示器上显示的信息的性质，以及信息不会同时流向 治疗小组。不幸的是，当前的电子健康记录(EHR)不支持数据的快速输入，事实上， 已知会减缓许多过程。此外，目前使用的方法都没有考虑到前线工作人员 工作流程也不能提供情景感知。为了解决这些问题，我们开发了一种电子产品的原型 该平台与一个可无缝集成到当前复苏工作流程中的情况感知监测器相结合。我们 在早期的工作中，我已经与创伤人员一起进行了可用性测试，在那里我们建立了 所有系统组件，表明用户接受界面设计，以便由抄写员和护士快速输入数据 已验证态势感知监测器(SAM)的数据输出的完整性。这一二期项目的目标是 将此独立产品集成到常用的电子健康记录平台中，以优化安全性、数据 共享和更轻松地采用该平台。我们将严格测试系统是否正确集成、同化到 护理工作流程和可用性。测试将使用模拟创伤复苏和真实创伤进行。这 通过更高效、更完整的设备，极大地提高复苏效果和患者安全的潜力 和准确的数据捕获。我们的技术将通过改善情况感知对患者的预后产生积极影响 以及更快的干预速度。在成功完成第二阶段拨款后，我们将准备继续我们的销售计划，并 致力于在广受欢迎的EHR平台上进行更广泛的整合。

PROJECT SUMMARY/ ABSTRACT Despite rapid transport to appropriate facilities, many trauma patients needlessly die in the first hour of care. Trauma is the leading cause of death for Americans under the age of 46 and greatest cause of potential life years lost before the age of 75, exceeding that of either cancer or heart disease. Up to 20% of traumatic deaths may be preventable. It is estimated that miscommunication (that leads to errors, trauma team confusion and suboptimal care), is the leading attributable cause of death during the first phase of care. In part, this miscommunication stems from the complex and chaotic nature of the trauma resuscitation environment. While that is inherent in the cases that trauma teams address, there are facets of the environment that could be changed to improve communication and the quality of patient data captured. Presently, many trauma centers in the U. S. rely on to record data during trauma resuscitation. Since nurse scribes are charged with data inputs, human error further contributes to data inaccuracies or omissions that may impact the quality of managing a trauma case. Data capture with paper is also difficult due to the sheer volume of information transmitted, the fragmented nature of the information presented on various displays, and the fact that information does not flow concurrently to the treatment team. Unfortunately, current electronic health records (EHRs) do not support rapid input of data, and in fact, are known to slow many processes. Furthermore, none of the current methods used take into account front line staff workflow nor provide situational awareness. To address these problems, we have developed a prototype electronic platform coupled to a situation awareness monitor that integrates seamlessly into current resuscitation workflows. We have already conducted usability testing with trauma staff in earlier work, where we established wireless connectivity of all system components, demonstrated user acceptance of the interface designs for rapid data input by scribe nurses and validated integrity of data outputs from the situational awareness monitor (SAM). The goal of this Phase II project is to integrate this standalone product into a commonly used electronic health record platform to optimize security, data sharing and easier adoption of the platform. We will rigorously test the system for proper integration, assimilation into nursing workflow and usability. Testing will be conducted using simulated trauma resuscitations and real traumas. This device has the potential to greatly improve resuscitation effectiveness and patient safety through efficient, more complete and accurate data capture. Our technology will positively impact patient outcomes through improved situation awareness and faster intervention. Upon successful completion of this Phase II Grant we will be ready to pursue our sales plan and work towards broader integration across a popular EHR platform.