Agency for Healthcare Research in Quality – “STRAIT: Simulation Training for Rapid Assessment and Improved Teamwork”
The training initiative, called STRAIT (Simulation Training for Rapid Assessment and Improved Teamwork), will be initially targeted at anesthesia provider-post-anesthesia care unit (PACU) nurse handoffs. the Specific Aims of this project are: 1) to develop a simulation-based training intervention, STRAIT, directed initially toward PACU handoffs; 2) to determine if the implementation of the STRAIT initiative improves the quality of PACU handoffs; 3) to study the impact of a single focused initiative to improve handoffs on broader aspects of teamwork in the PACU and on institutional outcomes. [more information]
The Impact of Performance-Shaping Factors on Anesthesia Care Task Distribution, Vigilance, Workload, and Non-Routine Events
The purpose of this project is to: 1) elucidate the incidence, type, and etiology of various performance-shaping factors including those that may be potentially disruptive or informative; and 2) delineate the effects of these factors on anesthesia providers’ task performance, vigilance and workload, and on the occurrence of non-routine events (NRE). A NRE is any event that deviates from optimal care for a specific patient in a specific clinical situation. Video will be captured and behavioral task analysis (i.e., time-motion analysis) as well as workload and vigilance assessments will be conducted for each observed case. At the end of the case, the anesthesia provider will be queried using an established instrument as to whether any NRE occurred in the case. During real-time observation and off-line videoanalysis, we will identify and classify intraoperative events and tasks including their timing, type, and source of initiation and termination (self or external). Multivariate models will be used to assess the effect of different types of environmental influences and provider-initiated activities on clinical task distribution, workload, vigilance, and NRE occurrence. The proposed work will provide a detailed description of the nature and impact of the effects of these performance-shaping factors thus allowing future practices and policies to be guided by objective evidence rather than opinion. The findings will also inform future redesign of the OR environment, anesthesia equipment, information technology, and curricula.
National Institutes of Health/Medvis, LCC – “Commercialization of Graphical Display for Intensive Care Environments”
The objective of this project is to develop and test information visualization display technology that will aid clinicians in diagnosing and treating unexpected events in critical care environments. Our research plan is to build upon previous work and extend the display to include more variables to give the clinicians a holistic understanding of the patients gas exchange state. Usability testing will guide design enhancements. Critical care clinicians will assess the status of a patient in 4 different scenarios with and without the new display and be evaluated.