Use of design thinking and human factors approach to improve situation awareness in the pediatric intensive care unit.

Autor: Gifford A; Brigham Young University, Provo, Utah, USA., Butcher B; College of Design, Art, Architecture, and Planning, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Chima RS; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Moore L; Pediatric Intensive Care Unit, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Brady PW; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Zackoff MW; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Dewan M; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Jazyk: angličtina
Zdroj: Journal of hospital medicine [J Hosp Med] 2023 Nov; Vol. 18 (11), pp. 978-985. Date of Electronic Publication: 2023 Oct 04.
DOI: 10.1002/jhm.13216
Abstrakt: Background: Optimal design of healthcare spaces can enhance patient care. We applied design thinking and human factors principles to optimize communication and signage on high risk patients to improve situation awareness in a new clinical space for the pediatric ICU.
Objective: To assess the impact of these tools in mitigating situation awareness concerns within the new clinical space. We hypothesized that implementing these design-informed tools would either maintain or improve situation awareness.
Design, Settings, and Participants: A 15-week design thinking process was employed, involving research, ideation, and refinement to develop and implement new situation awareness tools. The process included engagement with interprofessional clinical teams, scenario planning, workflow mapping, iterative feedback collection, and collaboration with an industry partner for signage development and implementation.
Intervention: Improved and updated communication devices and bedside mitigation plans.
Main Outcome and Measures: Process metrics included individual and shared situation awareness of PICU care teams and our patient outcome metric was the rate of cardiopulmonary resuscitation (CPR) events pre- and post-transition.
Results: When evaluating all patients, shared situation awareness for accurate high-risk status improved from 81% pre-transition to 92% post-transition (p = .006). When assessing individual care team roles, accuracy of patient high-risk status improved from 88% to 95% (p = .05) for RNs, 85% to 96% (p = .003) for residents, and 88% to 95% (p = .03) for RTs. There was no change in the rate of CPR events following the transition.
(© 2023 The Authors. Journal of Hospital Medicine published by Wiley Periodicals LLC on behalf of Society of Hospital Medicine.)
Databáze: MEDLINE
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