Improving Patient Safety and Clinician Cognitive Support Through eMAR Redesign

撰写项目摘要/摘要 拟议研究的目标是减少与以下疾病相关的患者安全风险 电子用药记录(EMAR)，(1)了解当前可用性 和安全间隙，以及(2)创建设计和开发文档、线框以及 原型作为未来eMAR的基础，将消除这些差距。在……里面 特别是，我们关注护士之间的沟通和信息流挑战， 药剂师和医生在给药和使用eMAR期间。这个 建议的研究是对特别强调通知(NOT-HS-16-009)的直接回应。我们 将通过以下方式发展对eMAR的可用性和安全风险的广泛理解 分析170万份患者安全事件报告和详细用药的大型数据集 与错误相关的叙述。然后，我们将对当前的eMAR进行启发式分析，并 对医生、护士和药剂师的采访和观察。这些数据将有助于 通知eMAR设计文档、线框和原型的开发 为未来的发展奠定了基础。 这个项目利用了研究团队在人为因素和安全方面的广泛专业知识。 科学、健康信息技术(Health IT)、信息学和数据科学。我们的研究 团队包括医生、护士、药剂师和人为因素工程师，以及 自然语言处理。此外，我们的合作伙伴还包括一个患者安全组织 和一家医疗IT供应商。该提案涉及征求建议书的基本方面 通过提供有关医疗IT安全的新见解，并通过以下方式改进当前实践 开发可供医疗IT供应商立即使用的用例和新原型。 这项研究的贡献将包括对卫生信息技术的作用的基本理解 在药物管理过程中，重点是沟通和信息流、设计、 面向供应商和提供商的开发和测试文档，以及eMAR线框和 改进开发的原型。我们的研究还将为办公室这样的组织提供 与药物有关的测试方案的国家协调员，以评估当前的卫生信息技术 系统。

Project Summary/Abstract Written The objective of the proposed research is to reduce the patient safety hazards associated with electronic medication administration records (eMARs) by, (1) understanding current usability and safety gaps, and (2) creating design and development documents, wireframes, and prototypes to serve as the foundation for future eMARs that will eliminate these gaps. In particular, we focus on communication and information flow challenges between nurses, pharmacists, and physicians during medication administration and use of the eMAR. The proposed research is in direct response to special emphasis notice (NOT-HS-16-009). We will develop a broad understanding of usability and safety hazards associated with eMARs by analyzing a large dataset of 1.7 million patient safety event reports and detailed medication error related narratives. We will then conduct heuristic analyses of current eMARs, and interviews and observations of physicians, nurses, and pharmacists. These data will serve to inform the development of eMAR design documents, wireframes, and prototypes as the foundation for future development. This project utilizes the extensive expertise of the research team in human factors and safety science, health information technology (health IT), informatics, and data science. Our research team includes physicians, nurses, pharmacists, and human factors engineers, and experts in natural language processing. In addition, our partnerships include a patient safety organization and a health IT vendor. The proposal addresses fundamental aspects of the call for proposals by providing new insights on the safety of health IT and improves current practices by developing use cases and new prototypes for immediate use by healthIT vendors. Contributions from this research will include a fundamental understanding of the role of health IT during medication administration with a focus on communication and information flow, design, development and testing documents for vendors and providers, and eMAR wireframes and prototypes to improve development. Our research will also provide organizations like the Office of the National Coordinator with medication related test scenarios to assess current health IT systems.