Development of a Novel Emergency Department Mapping Tool

Abstract

Objectives: Develop a built environment mapping workflow. Implement the workflow in the emergency department (ED). Demonstrate the actionable representations of the data that can be collected using this workflow. Background: The design of the healthcare built environment impacts the delivery of patient care and operational efficiency. Studying this environment presents a series of challenges due to the limitations associated with existing technology such as radio-frequency identification. The authors designed a customized mapping workflow to collect high-resolution spatial, temporal, and activity data to improve healthcare environments, with emphasis on patient safety and operational efficiency. Method: A large, urban, academic medical center ED collaborated with an architecture firm to create a data collection, and mapping workflow using ArcGIS tools and data collectors. The authors developed tools to collect data on the entire ED, as well as individual patients, physicians, and nurses. Advanced visual representations were created from the master data set. Results: In 48 consecutive hourly snapshots, 5,113 data points were collected on patients, physicians, nurses, and other staff reflecting the operations of the ED. Separately, 84 patients, 10 attending physicians, 10 resident physicians, and 17 nurses were tracked. Conclusions: The data obtained from this pilot study were used to create advanced visual representations of the ED environment. This cost-effective ED mapping workflow may be applied to other healthcare settings. Further investigation to evaluate the benefits of this high-resolution data is required.

Characterizing Multitasking and Workflow Fragmentation in Electronic Health Records among Emergency Department Clinicians: Using Time-Motion Data to Understand Documentation Burden

“…Future studies should examine how the physical design and configuration of EDs, and access to CIS impact the experience of burden among clinicians. 29,30 At many institutions, EHR log files rarely provide data that are sufficiently granular to indicate the precise terminal or location in which a CIS-related task is performed among users. 31 Based on HIPAA and meaningful use mandates, EHR log files (like other audit and disclosure logs for monitoring use) are only required to comply with ASTM International's four specifications for data capture 32,33 : (1) user or clinician identification number, (2) type of actions performed in the EHR, (3) patient record number accessed, and (4) time accessed.…”

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

“…They can be used to model discrete events or system dynamics, or they can be used in agentbased modeling [28,30]. However, a realistic simulation requires a balance of probability distributions and an accurate and meaningful input dataset [28,31], which can be obtained through sensors [9]; georeferencing; a global positioning system (GPS), which is used to create hourly routine snapshots of all tagged individuals [12]; and so on. Different models have been applied in order to analyze the mapping of the workflow and the allocation of activities in built environments [12,27,32,33], as well as for other applications, such as generating floorplan layouts [32,34,35], lighting simulations [36,37], analyses of visual quality [38], behavior prediction [39], determining building envelope costs [40], etc.…”

“…Evidence-based design (EBD) allows for the improvement of the design decisions for planned or existing environments [3,5,6]. Research that is oriented toward design and facility management (FM) has also focused on mapping, modeling, and simulating the building performance [7], behavior [8,9], and organization [10], the allocation of resources [4,11], the flow of people and activities [9,11], the operational efficiency [12,13], the space and layout [14,15], and the optimal paths [16]. Among the existing modeling, simulation, and evaluation methods, there is a lack of straightforward and logical resources that can be used to assess whether the allocation of activities in a built environment is congruent.…”

Design principles for cultivating a creative mindset in medicine

“…This crude prototype confirmed our assumptions that research assistants could collect robust real‐time data on the interactions of multiple occupants within a clinical space. Showing this concept to design researchers and architects accelerated the development of a digital mapping research tool that uses geographic information system software to collect data on the location, behavior, and movement of people in healthcare environments 7 (Figure 3).…”

“…Digital mapping research tool that uses geographic information system (GIS) software to collect data on the location, behavior, and movement of people in healthcare environments. Credit: Kieran Timberlake 7 …”