Center for Decision Making and Cognition, Department of Biomedical Informatics, Arizona State University, N 5thSt., Phoenix, AZ 85004, USA.
J Biomed Inform. 2011 Jun;44(3):432-40. doi: 10.1016/j.jbi.2010.05.015. Epub 2010 May 31.
Lapses in patient safety have been linked to unexpected perturbations in clinical workflow. The effectiveness of workflow analysis becomes critical to understanding the impact of these perturbations on patient outcome. The typical methods used for workflow analysis, such as ethnographic observations and interviewing, are limited in their ability to capture activities from different perspectives simultaneously. This limitation, coupled with the complexity and dynamic nature of clinical environments makes understanding the nuances of clinical workflow difficult. The methods proposed in this research aim to provide a quantitative means of capturing and analyzing workflow. The approach taken utilizes recordings of motion and location of clinical teams that are gathered using radio identification tags and observations. This data is used to model activities in critical care environments. The detected activities can then be replayed in 3D virtual reality environments for further analysis and training. Using this approach, the proposed system augments existing methods of workflow analysis, allowing for capture of workflow in complex and dynamic environments. The system was tested with a set of 15 simulated clinical activities that when combined represent workflow in trauma units. A mean recognition rate of 87.5% was obtained in automatically recognizing the activities.
患者安全失误与临床工作流程中的意外干扰有关。工作流程分析的有效性对于理解这些干扰对患者结果的影响至关重要。用于工作流程分析的典型方法,如民族志观察和访谈,在同时从不同角度捕捉活动方面存在局限性。这种局限性,再加上临床环境的复杂性和动态性,使得理解临床工作流程的细微差别变得困难。本研究提出的方法旨在提供一种定量捕捉和分析工作流程的手段。所采用的方法利用无线电识别标签和观察收集的临床团队的运动和位置记录。该数据用于对重症监护环境中的活动进行建模。然后可以在 3D 虚拟现实环境中重播检测到的活动,以进行进一步分析和培训。通过这种方法,所提出的系统增强了现有的工作流程分析方法,可以在复杂和动态的环境中捕捉工作流程。该系统使用一组 15 个模拟临床活动进行了测试,这些活动组合起来代表了创伤单位的工作流程。在自动识别活动方面,获得了 87.5%的平均识别率。