Military Operating Room of the Future
Abstract
Effective handwork examines multiple handoff types, in multiple phases of care, and uses multiple dimensions of intervention, based on a previous model offs of care are frequently cited as critical for maintaining safety and avoiding communication problems. This program of improvement, to fundamentally improve transitions of care along the trauma pathway. We have considered all potential handoffs and care transitions during trauma care, their characteristics and how they might affect care, and mapped out the key transition processes along the care pathway. Next, using data collected during our first phase of work, we conducted an analysis of the variety of paths that patients take, the frequencies of each path, the number of transitions they experience, and the disruptions that occur during transition. Our analysis of flow disruptions, process maps, and direct observations suggest that it is the handoffs to ICU which are the most at risk, as they involve an entire change in care team, happen with the sickest patients, and are relatively unstructured. Observing high risk transfers from the OR to ICU, we have been able to statistically model the process in terms of task, team and technology. We have also studied handoffs into the surgical ICU and found differences in self-reported expectations and performance between the nurses and the physicians. Three interventions are already in development as an extension of previous work, with simulation evaluation planned. We have commenced early development of a Smartphone application that assists in the early management of trauma patient information. A second intervention currently being explored is a checklist for improving patients admission into CT. The final intervention development is based on an adaptation of our previous work from motor racing pit-stops.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2013
- Accession Number
- ADA622329
Entities
People
- Bruce Gewertz
Organizations
- Cedars-Sinai Medical Center