Department of Mathematics and Industrial EngineeringPolytechnique Montréal Montreal QC H3T 1J4 Canada.
Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine Montreal QC H3T 1C5 Canada.
IEEE J Transl Eng Health Med. 2023 Jan 31;11:151-160. doi: 10.1109/JTEHM.2023.3241215. eCollection 2023.
In a pediatric intensive care unit (PICU) of 32 beds, clinicians manage resources 24 hours a day, 7 days a week, from a large-screen dashboard implemented in 2017. This resource management dashboard efficiently replaces the handwriting information displayed on a whiteboard, offering a synthetic view of the bed's layout and specific information on staff and equipment at bedside. However, in 2020 when COVID-19 hit, the resource management dashboard showed several limitations. Mainly, its visualization offered to the clinicians limited situation awareness (SA) to perceive, understand and predict the impacts on resource management and decision-making of an unusual flow of patients affected by the most severe form of coronavirus. To identify the SA requirements during a pandemic, we conducted goal-oriented interviews with 11 clinicians working in ICUs. The result is the design of an SA-oriented dashboard with 22 key indicators (KIs): 1 on the admission capacity, 15 at bedside and 6 displayed as statistics in the central area. We conducted a usability evaluation of the SA-oriented dashboard compared to the resource management dashboard with 6 clinicians. The results showed five usability improvements of the SA-oriented dashboard and five limitations. Our work contributes to new knowledge on the clinicians' SA requirements to support resource management and decision-making in ICUs in times of pandemics.
在一个拥有 32 张床位的儿科重症监护病房(PICU)中,临床医生每天 24 小时、每周 7 天从 2017 年实施的大型屏幕仪表板管理资源。这种资源管理仪表板有效地取代了手写信息在白板上的显示,提供了床位布局的综合视图和床边工作人员和设备的具体信息。然而,在 2020 年 COVID-19 疫情爆发时,资源管理仪表板显示出了一些局限性。主要是,它向临床医生提供的可视化情况感知(SA)有限,无法感知、理解和预测对资源管理和决策的影响,因为患者流量异常,且这些患者受到冠状病毒最严重形式的影响。为了确定大流行期间的 SA 需求,我们对 11 名在 ICU 工作的临床医生进行了目标导向的访谈。其结果是设计了一个面向 SA 的仪表板,其中包含 22 个关键指标(KIs):1 个用于入院能力,15 个用于床边,6 个以统计数据形式显示在中央区域。我们与 6 名临床医生一起对面向 SA 的仪表板进行了可用性评估。结果显示,面向 SA 的仪表板有五个可用性改进和五个局限性。我们的工作为在大流行期间支持 ICU 资源管理和决策的临床医生的 SA 需求提供了新知识。