Franklin Amy, Gantela Swaroop, Shifarraw Salsawit, Johnson Todd R, Robinson David J, King Brent R, Mehta Amit M, Maddow Charles L, Hoot Nathan R, Nguyen Vickie, Rubio Adriana, Zhang Jiajie, Okafor Nnaemeka G
The University of Texas Health Science Center at Houston, 7000 Fannin Suite 600, Houston, TX 77030, United States.
Memorial Hermann Health System, 921 Gessner Rd, Houston, TX 77024, United States.
J Biomed Inform. 2017 Jul;71:211-221. doi: 10.1016/j.jbi.2017.05.024. Epub 2017 Jun 1.
Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making.
在急诊科提供及时有效的护理需要对个体患者进行管理，同时也需要管理整个科室的流程和需求。工作流程的战略变革，如增加一名流程协调护士或一名分诊医生，已显示出在周转时间方面有所改善。然而，这种全局性的战略变革并未解决急诊科个体临床医生实时的、往往是机会主义的工作流程决策问题。我们认为，通过信息可视化实时呈现整个急诊科及其内每位患者的状态，将能更好地支持当下的临床决策，并能迅速进行干预以改善急诊科的流程。这一理念基于我们之前的研究，即我们发现临床医生的工作流程决策往往基于当下的局部视角，而非全局视角。在此，我们通过讨论我们的原型“吞吐量仪表盘”的开发过程及其在支持实时决策方面的潜力，来探讨为急诊科设计和实施可视化的挑战。
