Accession Number : ADA567887


Title :   Military Operating Room of the Future


Descriptive Note : Annual rept. 29 Sep 2011-28 Sep 2012


Corporate Author : CEDARS-SINAI MEDICAL CENTER LOS ANGELES CA


Personal Author(s) : Gewertz, Bruce


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a567887.pdf


Report Date : Oct 2012


Pagination or Media Count : 20


Abstract : Effective handoffs of care are frequently cited as critical for maintaining safety and avoiding communication problems. This program of work examines multiple handoff types, in multiple phases of care, and uses multiple dimensions of intervention, based on a previous model of improvement, to fundamentally improve transitions of care along the trauma pathway. We have considered all potential handoffs and care transitions during trauma care, their characteristics and how they might affect care, and mapped out the key transition processes along the care pathway. Next, using data collected during our first phase of work, we conducted an analysis of the variety of paths that patients take, the frequencies of each path, the number of transitions they experience, and the disruptions that occur during transition. On average 87% of patients experienced a transition flow disruption during their care, with 49% associated with co-ordination problems. We have also analyzed previous incident data to examine core weaknesses in handoffs across the breadth of care. We will examine three types of handoff: key team handoffs along the trauma pathway; micro-transitions during this period associated with the fluidity of the trauma team; and shift-to-shift handoffs in the ICU. In the next four months we will finalize and deploy task, process and teamwork observation metrics for the variety of handoffs and transitions that occur during trauma care, continue to analyze existing data, and conduct evaluative part-task simulations of our early interventions. Two interventions - Smartphone technology and a Checklist - are already in development as an extension of previous work, with simulation evaluation planned.


Descriptors :   *COMMUNICATION AND RADIO SYSTEMS , *HUMAN FACTORS ENGINEERING , *PROBLEM SOLVING , COOPERATION , INTERVENTION , PATIENTS , SAFETY , SIMULATION , TEAMS(PERSONNEL) , TEST AND EVALUATION , TRANSITIONS , TRAUMA


Subject Categories : Linguistics
      Medicine and Medical Research
      Human Factors Engineering & Man Machine System


Distribution Statement : APPROVED FOR PUBLIC RELEASE