Emergency Department Simulation for Research and Training in Health Care IT

描述（由申请人提供）：急诊科（ED）是患者安全研究的重要领域，因为它们每年为全国超过100，000，000名患者提供护理，在许多社区，它们是进入医疗机构的主要门户。如果没有患者跟踪系统（电子或手动“白色板”），今天的ED就无法运行，该系统包含有关患者的临床和后勤信息，并为护理人员提供有关患者状态的信息（指定的提供者、治疗状态、实验室结果、位置）。跟踪系统在传达许多直接影响患者安全的因素方面发挥着关键作用。随着信息技术更好地集成到医疗保健系统中，ED将过渡到电子患者跟踪系统。基于模拟的研究对于确保在引入该技术时，在导致不良事件之前先验地识别并解决任何新的故障模式机会至关重要。拟议的研究提供了一个独特的利用模拟病人安全为导向的医疗保健研究和培训。与已经开发用于研究和训练的患者模拟器的许多示例（例如，人体模型患者进行麻醉训练），所提出的研究利用沉浸式实验室环境来研究护理人员与患者跟踪系统的交互。本研究的目标是证明使用模拟进行可用性测试、迭代设计改进和电子患者跟踪系统使用培训，以帮助预测可能危及患者安全的因素。患者跟踪系统显示和界面将在多个计算机屏幕和大屏幕显示器上进行模拟，其设置允许护理参与者与模拟患者跟踪系统、代表性临床任务和其他人（护理参与者或研究同盟者）进行交互。显示在患者跟踪系统上的信息将从急诊科（艾德）环境的实时、交互式、离散事件模拟中提取，并且将在两个实验中测量参与者的意识、决策和行动。本研究实施模拟研究急诊科（艾德）的工作人员使用的计算机化的病人跟踪系统，以改善这些系统的设计，以支持更好的病人护理医院急诊科。

DESCRIPTION (PROVIDED BY APPLICANT): Emergency Departments (EDs) are an important area for patient safety research as they provide care to over 100,000,000 patients per year nationwide, and in many communities they are the primary portal for entry into a healthcare institution. Today's EDs could not function without a patient tracking system (electronic or manual "white boards") which contain clinical and logistical information about patients and provide caregivers with information about patient status (designated providers, treatment status, laboratory results, location). Tracking systems play a critical role in communicating many factors that have a direct effect on patient safety. As information technology becomes better integrated into the healthcare system, EDs will transition to electronic patient tracking systems. Simulation-based research is critical to ensure that as this technology is introduced any new opportunities for failure modes will have been identified a priori and addressed before they cause adverse events. The proposed research provides a unique utilization of simulation for patient safety oriented health care research and training. In contrast to numerous examples of patient simulators that have been developed for use in research and training (e.g., mannequin patients for anesthesia training), the proposed research utilizes an immersive laboratory environment to study caregiver interaction with patient tracking systems. The goals of this research are to demonstrate the use of simulation for usability testing, iterative design improvement, and training in the use of electronic patient tracking systems in order to help predict factors that have the potential to compromise patient safety. Patient tracking system displays and interfaces will be simulated on multiple computer screens and large screen displays, in a setting that allows caregiver participants to interact with the simulated patient tracking system, representative clinical tasks, and other people (caregiver participants or research confederates). Information displayed on the patient tracking system will be drawn from a real-time, interactive, discrete event simulation of an emergency department (ED) environment, and participant awareness, decisions, and actions will be measured in two experiments. This research implements simulation to study Emergency Department (ED) staff use of a computerized patient tracking system, in order to improve the design of these systems to support better patient care in hospital EDs.