Improving ATLS Performance in Simulated Pediatric Trauma Resuscitation Using a Checklist

Parsons, Samantha E.; Carter, Elizabeth A.; Waterhouse, Lauren J.; Fritzeen, Jennifer; Kelleher, Deirdre C.; O’Connell, Karen; Sarcevic, Aleksandra; Baker, Kelley; Nelson, Erik T.; Werner, Nicole E.; Boehm‐Davis, Deborah A.; Burd, Randall S.

doi:10.1097/sla.0000000000000259

Cited by 46 publications

(28 citation statements)

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“…This current study is a secondary analysis of the simulations performed for this study 29. The IRB approved the previous study and secondary analyses such as this one were also included in that IRB.…”

Section: Methodsmentioning

confidence: 99%

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Trauma resuscitation: can team behaviours in the prearrival period predict resuscitation performance?

Kaplan

Burd

et al. 2017

BMJ STEL

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BackgroundOptimising team performance is critical in paediatric trauma resuscitation. Previous studies in aviation and surgery link performance to behaviours in the prearrival period.ObjectiveTo determine if patterns of human behaviour in the prearrival period of a simulated trauma resuscitation is predictive of resuscitation performance.DesignTwelve volunteer trauma teams performed in four simulation scenarios in a paediatric hospital. The scenarios were video recorded, transcribed and analysed in 10-second intervals. Variation in the amount of utterances per team member in the prearrival period was compared with team performance and implicit coordination during the resuscitation.Key resultsCoders analysed 18 962 s of video. They coded 5204 team member utterances into one of eight communication behaviour categories. Inter-rater reliability was excellent (an average of 83.1% across all four scenarios). The average number of communications occurring during the prearrival period was 18.84 utterances, with a range of 2–42 and a SD of 9.55. The average length of this period was almost 2 minutes (mean =117.30 s, SD=39.20). Lower variance in team member communication during the prearrival better was associated with better implicit coordination (p=0.011) but not team performance (p=0.054) during the resuscitation.ConclusionPatterns of communication in the prearrival trauma resuscitation period predicted implicit coordination and a trend towards significance for team performance which suggests further studies in such patterns are warranted.

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Section: Methodsmentioning

confidence: 99%

“…The 12 teams participated in four scenarios 29. In each scenario, the teams had to identify and manage two potentially life-threatening injuries, including hypotension, pneumothorax, seizure and profound hypothermia.…”

Section: Methodsmentioning

confidence: 99%

Trauma resuscitation: can team behaviours in the prearrival period predict resuscitation performance?

Kaplan

Burd

et al. 2017

BMJ STEL

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“…Our current system uses a black text color for unchecked items and 30% opacity for items that are checked. It was important to deemphasize items that are checked because prior research has found that people often check items before task completion, in anticipation that the task will be performed [14]. They then end up skipping the task or performing it, but forgetting to check it off.…”

Section: From Paper To Digital Formatmentioning

confidence: 99%

“…To assist with memory recall of procedural items in settings with high cognitive load, clinicians have used mnemonics when designing protocols (e.g., “ABC” for “Airway, Breathing, Circulation” in resuscitation), but even these strategies are prone to error [5]. Drawing from experiences with checklists in other safety-critical domains such as aviation, researchers have designed a trauma resuscitation checklist as an alternative approach to improving team performance [14]. This paper-based checklist contains a total of 65 items grouped into four sections: pre-arrival plan, primary survey, secondary survey and prepare for travel (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Design Challenges in Converting a Paper Checklist to Digital Format for Dynamic Medical Settings

Sarcevic¹,

Rosen²,

Kulp³

et al. 2016

Proceedings of the 10th EAI International Conference on Pervasive Computing Technologies for Healthcare

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We describe a mobile digital checklist that we designed and developed for trauma resuscitation-a dynamic, fast-paced medical process of treating severely injured patients. The checklist design was informed by our analysis of user interactions with a paper checklist that was introduced to improve team performance during resuscitations. The design process followed an iterative approach and involved several medical experts. We discuss design challenges in converting a paper checklist to its digital counterpart, as well as our approaches for addressing those challenges. While we show that using a digital checklist during a fast-paced medical event is feasible, we also recognize several design constraints, including limited display size, difficulties in entering notes about the medical process and patient, and difficulties in replicating user experience with paper checklists.

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“…Due to the complex and high-stress nature of this environment, medical errors are common [4], leading to adverse patient outcomes. Recent implementation of checklists [5] and other decision support systems [1], however, has shown improved protocol adherence and reduced errors. Checklists are cognitive aids designed to reduce human errors and cognitive workload.…”

Section: Introductionmentioning

confidence: 99%

Design In The Wild

Kulp

Sarcevic

2017

Proceedings of the 2017 CHI Conference Extended Abstracts on Human Factors in Computing Systems

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Improving ATLS Performance in Simulated Pediatric Trauma Resuscitation Using a Checklist

Abstract: Implementing a checklist during simulated pediatric trauma resuscitation improves adherence to the ATLS protocol without increasing the workload of trauma team members.

Cited by 46 publications

References 25 publications

Trauma resuscitation: can team behaviours in the prearrival period predict resuscitation performance?

Trauma resuscitation: can team behaviours in the prearrival period predict resuscitation performance?

Design Challenges in Converting a Paper Checklist to Digital Format for Dynamic Medical Settings

Design In The Wild

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