Transdisciplinary Learning Lab to eliminate patient harm and reduce waste

描述（由申请人提供）：医疗保健在健康信息技术（HIT）上的8000亿美元投资几乎没有什么可展示的：生产率是平坦的，可预防的患者伤害仍然是美国第三大死亡原因。许多技术的可用性是可悲的;设备彼此不交谈;从HIT系统中获取数据并编写决策支持工具是不必要的负担;医疗方案的规定不足，一次只处理一种伤害，而不是所有患者的伤害;结果在很大程度上是假设的，而不是测量的。简而言之，医疗保健的设计严重不足。 约翰霍普金斯阿姆斯特朗研究所学习实验室的独特定位，通过利用我们的跨学科团队的临床医生，研究人员和工程师从约翰霍普金斯大学的应用物理实验室（APL），医学，护理，公共卫生，工程和艺术与科学学院应用强大的系统工程方法。通过使用这些方法，我们将实现与患者，他们的亲人和其他人合作的目标，以消除可预防的伤害，优化患者的治疗效果和体验，并减少医疗保健中的浪费。我们的综合项目计划结合了设计思维和系统工程，使用了我们的APL团队为美国海军潜艇部队开发的模型。这可以为医疗保健提供一个模型，用于系统地设想和迭代广泛的系统目标以及实现该目标所需的必要组件活动。在这项提案中，我们的学习实验室将致力于三个重要且相互依存的患者安全领域，这些领域将系统工程和医疗服务研究相结合：1）利用设计思维和系统工程方法，为理想的ICU制定高层次的设计要求; 2）利用开放的应用程序编程接口，设计EHR和输液泵之间的互操作性;以及3）在工程护理系统中开发和实施单元级压力指标，以预测和减轻风险

DESCRIPTION (provided by applicant): Health care has little to show for its $800 billion investment in health information technology (HIT): productivity is flat and preventable patient harm remains the third leading cause of death in the U.S. The usability of many technologies is pathetic; devices do not talk to each other; it is needlessly burdensome to get data out of HIT systems and write decision support tools; TREATMENTS protocols are underspecified, working on one harm at a time rather than all patient harms; and outcomes are largely assumed rather than measured. In short, health care is grossly under-engineered. The Johns Hopkins Armstrong Institute Learning Lab is uniquely positioned to apply robust systems engineering methods by leveraging our transdisciplinary team of clinicians, researchers and engineers from the Johns Hopkins University's Applied Physics Lab (APL), and Schools of Medicine, Nursing, Public Health, Engineering, and Arts and Sciences. By using these methods, we will realize our goal of partnering with patients, their loved ones and others to eliminate preventable harm, optimize patient outcomes and experience, and reduce waste in healthcare. Our comprehensive program plan incorporates design thinking and systems engineering, using a model our APL team developed for the US Navy's submarine force. This can provide healthcare with a model for systematically envisioning and iterating a broad system objective and the necessary component activities required to realize that objective. In this proposal, our Learning Lab will work on three significant and interdependent patient safety areas that integrate systems engineering and health delivery research: 1) develop high-level design requirements for an Ideal ICU, utilizing design thinking and system engineering methods; 2) leverage open application programming interfaces to engineer interoperability between EHRs and infusion pumps; and 3) develop and implement an indicator of unit-level stress in an engineered care system to predict and mitigate risk