A Layered, Multi-Agent System To Facilitate Healthcare Team Processes

描述（由申请人提供）：农村医院对紧急剖宫产的反应（ECD）不仅由于监测和早期发现分娩过程中胎儿和/或产妇窘迫的效率低下，而且由于农村环境的条件。许多农村医院缺乏资源，无法配备24小时的外科工作人员和为剖宫产预留的手术室。尽管有更先进、更廉价的技术，但ECD团队经常使用不适当的寻呼机和电话方法被叫到手术现场。那些必须或选择生活在农村地区的人，与生活在大城市的人相比，同样值得得到及时有效的产科急诊护理。医疗保健研究和质量机构将抢救失败定义为，一旦发现早期医疗并发症，采取的行动缺乏有效性和及时性，作为医疗质量的衡量标准之一。反应迟缓以及错误和遗漏可能导致未能抢救胎儿和母亲，从而导致死亡率和新生儿发病率增加。基于现有原型的初步工作，Bauer实验室建议测试可行性，并进一步研究和开发智能电子召唤和企业管理系统，旨在根据最佳实践指南协调ECD团队的有效和及时集合以及患者和手术室的准备。我们的系统不仅可以召集手术团队，还可以促进团队成员之间的沟通，协调团队决策，规范准备活动，并使人员了解团队，患者和手术室的状态。此外，我们的系统还提供了电子病历（EMR）与商业资产管理和患者跟踪解决方案之间的接口，旨在提供所需的决策和协调支持。在第一阶段，我们建议：A)在模拟下充分评估现有原型的有效性和可操作性

DESCRIPTION (provided by applicant): Response to an Emergency Cesarean Delivery (ECD) at rural hospitals is complicated not only by inefficiencies in monitoring and early detection of fetal and/or maternal distress during labor, but by the conditions of the rural settin. Many rural hospitals lack the resources to have round-the-clock surgical staff and operating rooms reserved for cesarean delivery. Despite the availability of superior inexpensive technologies, an ECD team is often summoned to surgery using inadequate pager and telephone methods. People who must, or choose to, live in rural areas are no less deserving of timely and effective emergency obstetrical care than those in large cities. The Agency for Healthcare Research and Quality defines failure to Rescue, the lack of effectiveness and timeliness of actions taken once early medical complications are recognized, as one of the measures of quality of care. Delays in response as well as errors and omissions can lead to failures to rescue the fetus and mother, leading to increased mortality and neonatal morbidity. Based on preliminary work with an existing prototype, Bauer Labs proposes to test the feasibility and to conduct further research and the development of an intelligent e-summoning and enterprise management system aimed at coordinating the effective and timely assembly of the ECD team and the preparation of patients and operating room according to best practice guidelines. Our system has the capability to not only summon the surgical team, but also to facilitate communication among team members, coordinate team decisions, standardize preparation activities, and keep personnel informed of the status of the team, the patient, and the operating room. Furthermore, our system provides an interface between the electronic medical record (EMR), and commercially available asset management and patient tracking solutions aimed at providing needed decision and coordination support. In phase 1, we propose to: A) Fully evaluate the effectiveness and operability of the existing prototype under a simulated clinical ECD and gather input from users on further system development. B) Build a robust and reliable second generation prototype meeting the technical and operability requirements identified in the previous evaluation. C) Develop the methods to integrate patient medical information from the EMR into the summoning system using Bauer Lab's proprietary multi-agent system technology. D) Develop the interface between our system with off-the-shelf asset management and patient tracking solutions. E) Evaluate the effectiveness and operability of our system in reducing errors, increasing communication, and meeting the 30-minute "decision-to-incision" interval target during total team and hospital ECD simulation trials. The ultimate goal o this project is to demonstrate the technical feasibility of using intelligent and integrated healthcare delivery management systems based on Bauer Lab's proprietary multi-agent system technology to prevent failures to rescue by intelligently integrating clinical, logistical, and operational information, and presenting it to the care team in a manner that integrates non-intrusively with the clinical workflow.