Hunter Rogers, Kapil Chalil Madathil, Anjali Joseph, Nathan J. Mcneese, C. Holmstedt, R. Holden, J. McElligott
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引用次数: 8
Abstract
Abstract Past research has established that telemedicine improves stroke care through decreased time to treatment and more accurate diagnoses. The goals of this study were to 1) study how clinicians complete stroke assessment using a telemedicine system integrated in ambulances, 2) determine potential errors and usability issues when using the system, and 3) develop recommendations to mitigate these issues. This study investigated use of a telemedicine platform to evaluate a stroke patient in an ambulance with a geographically distributed caregiving team comprised of a paramedic, nurse, and neurologist. It first determined the tasks involved based on 13 observations of a simulated stroke using 39 care providers. Based on these observational studies, a Hierarchical Task Analysis (HTA) was developed, and subsequently, a heuristic evaluation was conducted to determine the usability issues in the interface of the telemedicine system. This was followed by a Systematic Human Error Reduction and Prediction Approach (SHERPA) to determine the possibility of human error while providing care using the telemedicine work system. The results from the HTA included 6 primary subgoals categorizing the 97 tasks to complete the stroke evaluation. The heuristic evaluation found 123 unique violations to heuristics, with an average severity of 2.38. One hundred and thirty-one potential human errors were found with SHERPA, the two most common being miscommunication and selecting an incorrect option. Several recommendations are proposed, including improvement of labeling, consistent formatting, rigid or suggested formatting for data input, automation of task structure and camera movement, and audio/visual improvements to support communication.
期刊介绍:
IISE Transactions on Healthcare Systems Engineering aims to foster the healthcare systems community by publishing high quality papers that have a strong methodological focus and direct applicability to healthcare systems. Published quarterly, the journal supports research that explores: · Healthcare Operations Management · Medical Decision Making · Socio-Technical Systems Analysis related to healthcare · Quality Engineering · Healthcare Informatics · Healthcare Policy We are looking forward to accepting submissions that document the development and use of industrial and systems engineering tools and techniques including: · Healthcare operations research · Healthcare statistics · Healthcare information systems · Healthcare work measurement · Human factors/ergonomics applied to healthcare systems Research that explores the integration of these tools and techniques with those from other engineering and medical disciplines are also featured. We encourage the submission of clinical notes, or practice notes, to show the impact of contributions that will be published. We also encourage authors to collect an impact statement from their clinical partners to show the impact of research in the clinical practices.