Developing and Training Interruption Management Strategies for Emergency Physicia

制定和培训急诊医生的中断管理策略

• 批准号: 8571056
• 负责人: Raj M Ratwani
• 金额: $ 9.99万
• 依托单位: MEDSTAR HEALTH RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8571056
• 关键词: Developing; Training; Interruption; Management; Strategies

Project Summary/Abstract The nature of the Emergency Department is such that emergency physicians are frequently interrupted as they perform their duties; emergency physicians have been described as "interruption driven". While many of these interruptions are necessary for the emergency department to function effectively, they can also disrupt emergency physician performance resulting in a very serious patient safety risk. Interrupting emergency physicians leads to an increase in error rates, information loss and the amount of time taken to deliver care. Our innovative approach to mitigate the disruptiveness of interruptions is to develop specific cognitive strategies for emergency physicians to employ when interrupted. Cognitive strategies are deliberate actions that the physician can take during an interruption, which will facilitate the resumption process. To develop the strategies, we leverage a theory from the human factors literature that accounts for the cognitive mechanisms underlying task interruption and resumption. By combining this theory, our prior work, and observational data from the emergency department, a set of trainable cognitive strategies that are tailored to the workflow and needs of the physician will be developed. In Specific Aim 1, we will observe emergency physicians at three different hospitals and document the types of interruptions they encounter as well as the contextual variables surrounding the interruptions. These data will be analyzed for a quantitative understanding of the factors associated with emergency physician interruptions. Specific Aim 2 will utilize the findings from Specific Aim 1 to adapt and develop specific cognitive strategies that are tailored to the needs of emergency physicians. The descriptions of each cognitive strategy will detail the conditions in which each strategy should be applied and process for applying each strategy. The focus of Specific Aim 3 is developing new simulation-based training modules for emergency physicians to learn and practice the specific cognitive strategies. These modules will be developed such that they can be integrated with existing training programs. At the conclusion of this study we will have developed a set of cognitive strategies for emergency physicians to mitigate the disruptiveness of interruptions in the emergency department. This work will also serve as the basis for a follow-on proposal to evaluate the validity and effectiveness of the training and to adapt the intervention to other domains and healthcare workers such as nurses.

项目摘要/摘要 急诊室的性质使得紧急医师经常被打断 履行职责；急诊医师被描述为“中断驱动”。虽然其中许多 急诊科有效运作是必要的，它们也可能破坏 急诊医师的表现导致非常严重的患者安全风险。中断紧急情况 医师导致错误率，信息损失和提供护理所需的时间的增加。 我们减轻中断破坏性的创新方法是发展特定的认知 急诊医生在中断时要使用的策略。认知策略是故意的行动 医师可以在中断期间接受，这将有助于恢复过程。开发 策略，我们利用人为因素文献中的理论，说明了认知机制 潜在的任务中断和恢复。通过结合这一理论，我们的先前工作和观察数据 从急诊室，一套根据工作流程量身定制的可训练的认知策略 医师的需求将得到发展。在特定目标1中，我们将观察三个 不同的医院并记录他们遇到的中断类型以及上下文变量 围绕中断。这些数据将进行分析，以定量了解因素 与急诊医师中断有关。特定目标2将利用特定目标1到 适应并制定根据急诊医生需求量身定制的特定认知策略。这 每个认知策略的描述将详细说明应应用每个策略的条件，并 应用每个策略的过程。特定目标3的重点是开发新的基于模拟的培训 急诊医生学习和实践特定认知策略的模块。这些模块会 可以开发以使它们可以与现有的培训计划集成。在这项研究的结尾 我们将为紧急医生制定一系列认知策略，以减轻 急诊科的中断。这项工作还将作为后续提案的基础 评估培训的有效性和有效性，并将干预措施适应其他领域和 护士等医疗保健工人。