Dataset Information

Assessment of Innovative Emergency Department Information Displays in a Clinical Simulation Center.

ABSTRACT: The objective of this work was to assess the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. The display concepts were compared to standard displays in a clinical simulation study during which nurse-physician teams performed simulated emergency department tasks. Questionnaires were used to assess the cognitive support provided by the displays, participants' level of situation awareness, and participants' workload during the simulated tasks. Participants rated the new displays significantly higher than the control displays in terms of cognitive support. There was no significant difference in workload scores between the display conditions. There was no main effect of display type on situation awareness, but there was a significant interaction; participants using the new displays showed improved situation awareness from the middle to the end of the session. This study demonstrates that cognitive systems engineering methods can be used to create innovative displays that better support emergency medicine tasks, without increasing workload, compared to more standard displays. These methods provide a means to develop emergency department information systems-and more broadly, health information technology-that better support the cognitive needs of healthcare providers.

SUBMITTER: McGeorge N

PROVIDER: S-EPMC5152766 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Assessment of Innovative Emergency Department Information Displays in a Clinical Simulation Center.

McGeorge Nicolette N Hegde Sudeep S Berg Rebecca L RL Guarrera-Schick Theresa K TK LaVergne David T DT Casucci Sabrina N SN Hettinger A Zachary AZ Clark Lindsey N LN Lin Li L Fairbanks Rollin J RJ Benda Natalie C NC Sun Longsheng L Wears Robert L RL Perry Shawna S Bisantz Ann A

Journal of cognitive engineering and decision making 20151201 4

The objective of this work was to assess the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. The display concepts were compared to standard displays in a clinical simulation study during which nurse-physician teams performed simulated emergency department tasks. Questionnaires were used to assess the cognitive support provided by the displays, par ...[more]

PMID: 27974881

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Project description:BackgroundGaps in quality of pediatric emergency care have been noted in community emergency departments (CEDs), where >85% of children receive care. In situ simulation provides opportunities for hands-on experiences and can help close these gaps. We aimed to develop, implement, and evaluate an innovative, replicable, and scalable pediatric in situ simulation-based CED curriculum, under the leadership of a local colleague, through collaborative approach with a regional academic medical center (AMC).MethodsKern's model was used as follows: problem identification and general needs assessment-pediatric readiness assessment and discussions with CED physician and nursing leadership; targeted needs assessment-review of recent pediatric transfer cases; goals and objectives-enhance pediatric knowledge and skills of interprofessional teams and detect latent safety threats; educational strategies-codeveloped by CED and AMC, included prelearning using podcasts and videos, simulation and facilitated debriefing, resource sharing after simulations; implementation-3-h simulation sessions facilitated in person by the CED team and remotely by AMC (leadership required participation and paid staff); and evaluation and feedback-retrospective pre-post survey, Simulation Effectiveness Tool-Modified (SET-M), Net Promoter Score (NPS), and review/feedback meetings.ResultsBased on needs assessment, the selected cases included newborn resuscitation, seizure, asthma, and tetrahydrocannabinol ingestion causing altered mental sensorium in a child. Twenty-four 3-h simulation sessions were conducted over 1 year. A total of 168 participants completed the sessions, while 75 participants (54.7% nurses, 22.7% physicians, and others) completed feedback surveys. Seventy-six percent of participants reported completing presimulation education material. Participants reported improved skills at appropriately evaluating a critically ill newborn and critically ill infant/toddler and improved teamwork during the care of a pediatric patient. The majority agreed that simulation was effective in teaching pediatric resuscitation. The NPS was 84% (excellent).ConclusionsA locally facilitated CED in situ simulation curriculum was successfully developed and implemented under local leadership, with remote collaboration by AMC. The curriculum was well received and effective.

Project description:ObjectiveGiven the aging population and growing burden of frailty, we conducted this scoping review to describe the available literature regarding the use and impact of frailty assessment tools in the assessment and care of emergency department (ED) patients older than 60 years.MethodsA search was made of the available literature using the Covidence system using various search terms. Inclusion criteria comprised peer-reviewed literature focusing on frailty screening tools used for a geriatric population (60+ years of age) presenting to EDs. An additional search of PubMed, EBSCO, and CINAHL for articles published in the last 5 years was conducted toward the end of the review process (January 2023) to search specifically for literature describing interventions for frailty, yielding additional articles for review. Exclusion criteria comprised articles focusing on an age category other than geriatric and care environments outside the emergency care setting.ResultsA total of 135 articles were screened for inclusion and 48 duplicates were removed. Of the 87 remaining articles, 20 were deemed irrelevant, leaving 67 articles for full-text review. Twenty-eight were excluded for not meeting inclusion criteria, leaving 39 full-text studies. Use of frailty screening tools were reported in the triage, care, and discharge decision-making phases of the ED care trajectory, with varying reports of usefulness for clinical decision-making.ConclusionThe literature reports tools, scales, and instruments for identifying frailty in older patients at ED triage; multiple frailty scores or tools exist with varying levels of utilization. Interventions for frailty directed at the ED environment were scant. Further research is needed to determine the usefulness of frailty identification in the context of emergency care, the effects of care delivery interventions or educational initiatives for front-line medical professionals on patient-oriented outcomes, and to ensure these initiatives are acceptable for patients.

Project description:BackgroundOne way to measure emergency department (ED) performance is using key performance indicators (KPIs). Thus, identifying reliable KPIs can be critical in appraising ED performance. This study aims to introduce and classify the KPIs related to ED in simulations through the Balanced Scorecard (BSC) framework.MethodThis scoping review was performed in 2024 without any time limitation based on the Arksey and O'Malley framework. The electronic databases of PubMed, Scopus, Web of Science, EMBASE, MathSciNet, Google Scholar, and Persian databases such as IranDoc, MagIran, and SID were searched. The winter simulation conference was also investigated through manual searching. Furthermore, the screening process of included studies was based on the PRISMA reporting checklist. The data were analyzed by content analysis deductively and inductively. The extracted KPIs were coded as analysis units and transferred to the MAXQDA2020 software. Then, the KPIs were integrated and organized based on similarity. Moreover, the two authors discussed disagreements to reach a consensus on the final codes. The final KPIs classification was carried out based on the BSC framework to achieve a holistic view. The BSC is a managerial tool for evaluating organizations' performance via different dimensions. It contains four main dimensions: Customer, Financial, Growth and infrastructure, and Internal Processes. In addition, the management (vision, objectives, and strategies) has been positioned at the heart of the framework.ResultInitially, 4257 articles were retrieved, and 125 articles were included after screening. Finally, 109 KPIs were extracted and classified into five categories. They include input, processing time, cost and revenue, utilization and productivity, and output indicators. Then, each category of KPIs was positioned in the BSC framework dimensions. Additionally, the findings showed that most indicators were related to the time of process indicators.ConclusionsThe study findings have collected a comprehensive set of KPIs to measure ED performance in simulations. These results can assist policymakers, managers, and researchers in measuring ED performance and help improve ED performance through a holistic view.

Dataset Information

Assessment of Innovative Emergency Department Information Displays in a Clinical Simulation Center.

Publications

Assessment of Innovative Emergency Department Information Displays in a Clinical Simulation Center.

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