Development of a Simulation Environment to Study Emergency Department Information Technology

Pennathur, Priyadarshini R.; Cao, Dapeng; Shi, Zheng; Lin, Li; Bisantz, Ann M.; Fairbanks, Rollin J.; Guarrera, Theresa K.; Brown, Jennifer L.; Perry, Shawna J.; Wears, Robert L.

doi:10.1097/sih.0b013e3181c82c0a

Cited by 19 publications

(12 citation statements)

References 36 publications

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“…The most frequently used computerized ED model of emergency department patient flow is discrete event simulation (DES) [10], which is used to predict the effects of operational changes on patient throughput, waiting times, efficiency, length of stay, resource utilization and interaction of processes within a system [10, 12, 13]. An extension of DES is agent based modeling (ABM), which models behavior and its outcomes at the individual level [10].…”

Section: Introductionmentioning

confidence: 99%

A preliminary study of a novel emergency department nursing triage simulation for research applications

et al. 2017

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BackgroundStudying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED.MethodsTen experienced female ED triage nurses (mean age 51) mastered navigating a virtual reality model of triage of 4 patients in an ED with which they were familiar, after which they were presented in a testing session with triage of 6 patients whose cases were developed using the Emergency Severity Index to represent a range of severity and complexity. Attitudes toward the simulation, and perceived workload in the simulation and on the job, were assessed with questionnaires and the NASA task load index. Z-scores were calculated for data points reflecting subject actions, the time to perform them, patient prioritization according to severity, and the importance of the tasks. Data from questionnaires and scales were analyzed with descriptive statistics and paired t tests using SPSS v. 21. Microsoft Excel was used to compute a correlation matrix for all standardized variables and all simulation data.ResultsNurses perceived their work on the simulation task to be equivalent to their workload on the job in all aspects except for physical exertion. Although they were able to work with written communications with the patients, verbal communication would have been preferable. Consistent with the workplace, variability in performance during triage reflected subject skill and experience and was correlated with comfort with the task. Time to perform triage corresponded to the time required in the ED and virtual patients were prioritized appropriately according to severity.ConclusionsThis computerized simulation appears to be a reasonable accurate proxy for ED triage. If future studies of this kind of simulation with a broader range of subjects that includes verbal communication between virtual patients and subjects and interactions of multiple subjects, supports the initial impressions, the virtual ED could be used to study the impact of disaster scenarios on staff functioning.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2337-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

A preliminary study of a novel emergency department nursing triage simulation for research applications

et al. 2017

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“…We contend that this distinction offers a more realistic and meaningful way to reach the desired target (State B) as represented by vector R 4 . Some recent examples that implement this approach along pathway P 2 include the development efforts in the domains of human spaceflight ) (to be used as a specific case study example in this paper) and health care informatics (Pennathur et al 2010;McGeorge et al 2015;Hettinger et al 2017). In an era where technological capability is ever increasing, systems engineers and designers of technology must understand the realistic work demands before hypothesizing technological solutions.…”

Section: Discussionmentioning

confidence: 99%

“…The challenge now shifts to being able to effectively iterate between the staged and spartan environments. Some useful simulation descriptions exist that describe aspects of the domain that are important to consider (Harvey et al 2003;Pennathur et al 2010;Williams, Medicine & Administration 2014); these resources however remain embedded within their own specific domains and do not address the envisioned world problem directly. The envisioned context in some ways must maintain traits that resemble the existing domain to promote subject-matter expert (SME) adoption, but in some ways there will be significant departures.…”

Section: Gulf Of Extentmentioning

confidence: 99%

Addressing the envisioned world problem: a case study in human spaceflight operations

Miller

Feigh

2019

Des. Sci.

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The construction of future technological systems in work domains that do not yet exist, known as the envisioned world problem, is an increasingly important topic for designers, particularly given the rapid rate of technological advancement in the modern era. This paper first discusses the theoretical underpinnings of using cognitive work analysis (CWA) for developing a decision support system (DSS) situated within the envisioned world problem and recasts the problem as pathway-dependent processes. Using this pathwaydependent framework, each stage of the envisioning process is described to reveal how human factors experts can link existing work domains to envisioned instances. Finally, a case study example of the envisioning process that incorporates CWA modelling is demonstrated as it pertains to the advancement of the human spaceflight domain. As a result, this paper provides a unified treatment of the envisioned world problem with an endto-end example of one approach to designing future technologies for future work domains.

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“…The benefits of discrete event modeling to iteratively design and test technologies and work processes, such as an electronic patient tracking system, allows assessment of human performance measures before they are implemented. Unexpected consequences may ensue from these technological solutions that they failed to provide support for providers work activities and have negative consequences on performance and potential patient safety [145]. Discrete event modeling is applicable to GHS contingency planning, such as deployable field hospitals and EVD treatment centers.…”

Section: Modeling and Simulation For Global Health Security Preparednessmentioning

confidence: 99%

Simulation and Modeling Applications in Global Health Security

French

2020

Advanced Sciences and Technologies for Security Applications

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Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats [1]. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats [2].Ebola Virus Disease (EVD), Middle East Respiratory Syndrome (MERS) and other emerging infectious diseases (EID) are also concerns for GHS. The world faces increasing challenges related to natural and manmade disasters as the frequency and magnitude of disasters have increased significantly over the past 30 years. Healthcare workers protect the well-being of people around the world by preventing, detecting, and responding to public health threats. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging threats [3].There is a global public health workforce shortage. The WHO tracks healthcare workforce data on 186 countries, and 57 were insufficient in healthcare provider availability and accessibility [4]. The 2013-2016 African EVD epidemic revealed WHO organizational deficiencies in coordinating responses to public health emergencies and a shifting of priorities away from global health security threats [5]. It Providing initial and sustainment training to the diverse GHS healthcare workforce is expensive and inefficient utilizing the traditional classroom model. Greater demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate healthcare providers in the ever-expanding body of disaster medicine knowledge [22].Many of these challenges can be met with gaming and simulation technologies new generations of GHS responders have embraced. Simulation-based training (SBT) has been demonstrated to provide effective learning and is increasingly being integrated into healthcare provider education [23]. The advantages of SBT may be summarized as follows: (1) safety-simulated lives and health can be jeopardized to any extent required for training without harming any people; (2) economy-simulated material and equipment can be used, misused, and expended;(3) visibility-simulation can provide visibility in two ways; you can make the invisible visible and control the visibility of details allowing the learner to discern the forest from the trees or the trees from the forest as needed; (4) time control -simulator time can be sped up, slowed down, or stopped. It can also be completely reversed, allowing learners to replicate specific problems, events, or opera...

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Development of a Simulation Environment to Study Emergency Department Information Technology

Cited by 19 publications

References 36 publications

A preliminary study of a novel emergency department nursing triage simulation for research applications

A preliminary study of a novel emergency department nursing triage simulation for research applications

Addressing the envisioned world problem: a case study in human spaceflight operations

Simulation and Modeling Applications in Global Health Security

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