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Parush A, Mastoras G, Bhandari A, Momtahan K, Day K, Weitzman B, Sohmer B, Cwinn A, Hamstra SJ, Calder L. Can teamwork and situational awareness (SA) in ED resuscitations be improved with a technological cognitive aid? Design and a pilot study of a team situation display. J Biomed Inform 2017; 76:154-161. [PMID: 29051106 DOI: 10.1016/j.jbi.2017.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/26/2017] [Accepted: 10/16/2017] [Indexed: 12/01/2022]
Abstract
Effective teamwork in ED resuscitations, including information sharing and situational awareness, could be degraded. Technological cognitive aids can facilitate effective teamwork. OBJECTIVE This study focused on the design of an ED situation display and pilot test its influence on teamwork and situational awareness during simulated resuscitation scenarios. MATERIAL AND METHODS The display design consisted of a central area showing the critical dynamic parameters of the interventions with an events time-line below it. Static information was placed at the sides of the display. We pilot tested whether the situation display could lead to higher scores on the Clinical Teamwork Scale (CTS), improved scores on a context-specific Situational Awareness Global Assessment Technique (SAGAT) tool, and team communication patterns that reflect teamwork and situational awareness. RESULTS Resuscitation teamwork, as measured by the CTS, was overall better with the presence of the situation display as compared with no situation display. Team members discussed interventions more with the situation display compared with not having the situation display. Situational awareness was better with the situation display only in the trauma scenario. DISCUSSION The situation display could be more effective for certain ED team members and in certain cases. CONCLUSIONS Overall, this pilot study implies that a situation display could facilitate better teamwork and team communication in the resuscitation event.
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Affiliation(s)
- A Parush
- Carleton University, Department of Psychology, Ottawa, ON, Canada; Israel Institute of Technology, Faculty of Industrial Engineering and Management, Israel.
| | - G Mastoras
- University of Ottawa, Department of Emergency Medicine, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - A Bhandari
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - K Momtahan
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada
| | - K Day
- University of Ottawa, Academy for Innovation in Medical Education, Faculty of Medicine, Ottawa, ON, Canada
| | - B Weitzman
- University of Ottawa, Department of Emergency Medicine, Ottawa, ON, Canada
| | - B Sohmer
- University of Ottawa Heart Institute, Division of Cardiac Anesthesiology, Ottawa, ON, Canada
| | - A Cwinn
- University of Ottawa, Department of Emergency Medicine, Ottawa, ON, Canada
| | - S J Hamstra
- University of Ottawa, Faculty of Education, Ottawa, ON, Canada; Accreditation Council for Graduate Medical Education, Ottawa, ON, Canada
| | - L Calder
- University of Ottawa, Department of Emergency Medicine, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada; Canadian Medical Protection Association, Ottawa, ON, Canada
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Abstract
The audibility and the identification of 23 auditory alarms in the intensive care unit (ICU) and 26 auditory alarms in the operating rooms (ORs) of a 214-bed Canadian teaching hospital were investigated. Digital tape recordings of the alarms were made and analysed using masked-threshold software developed at the Université de Montréal. The digital recordings were also presented to the hospital personnel responsible for monitoring these alarms on an individual basis in order to determine how many of the alarms they would be able to identify when they heard them. Several of the alarms in both areas of the hospital could mask other alarms in the same area, and many of the alarms in the operating rooms could be masked by the sound of a surgical saw or a surgical drill. The staff in the OR (anaesthetists, anaesthesia residents, and OR technologists) were able to identify a mean of between 10 and 15 of the 26 alarms found in their operating theatres. The ICU nurses were able to identify a mean of between 9 and 14 of the 23 alarms found in their ICU. Alarm importance was positively correlated with the frequency of alarm identification in the case of the OR, rho = 0.411, but was not significantly correlated in the case of the ICU, rho = 0.155. This study demonstrates the poor design of auditory warning signals in hospitals and the need for standardization of alarms on medical equipment.
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Affiliation(s)
- K Momtahan
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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