Emergency Department Simulation for Research and Training in Health Care IT

描述（由申请人提供）：急诊科（EDs）是患者安全研究的重要领域，因为他们每年在全国范围内为超过1亿名患者提供护理，在许多社区，急诊科是进入医疗机构的主要门户。今天的急诊科如果没有病人跟踪系统（电子或手动“白板”）就无法正常工作，该系统包含有关病人的临床和后勤信息，并向护理人员提供有关病人状况的信息（指定提供者、治疗状况、实验室结果、位置）。跟踪系统在传达对患者安全有直接影响的许多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，急诊科将过渡到电子患者跟踪系统。基于仿真的研究对于确保在引入该技术时，任何新的失效模式机会都将被先验地识别出来，并在它们引起不良事件之前加以解决，至关重要。本研究为病患安全导向的医疗照护研究与训练提供独特的模拟应用。与许多已开发用于研究和培训的患者模拟器（例如，用于麻醉培训的人体模型患者）的例子相反，拟议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互动。本研究的目的是演示在可用性测试、迭代设计改进和使用电子患者跟踪系统的培训中使用模拟，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模拟，在一个允许护理人员参与者与模拟的患者跟踪系统、代表性临床任务和其他人（护理人员参与者或研究伙伴）进行交互的环境中。显示在患者跟踪系统上的信息将从急诊（ED）环境的实时、交互式、离散事件模拟中提取，参与者的意识、决策和行动将在两个实验中进行测量。本研究采用模拟的方法来研究急诊科（ED）员工使用电脑化病人追踪系统，以改善这些系统的设计，以支持医院急诊科更好的病人护理。

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.