Indiana University-Purdue University Indianapolis (IUPUI) / Healthcare providers in hospital intensive care units (ICUs) maintain patient
situation awareness by following task management and communication practices. They
create and manipulate several paper-based and digital information sources, with the
overall aim to constantly inform themselves and their colleagues of dynamically evolving
patient conditions. However, when increased communication means that healthcare
providers potentially interrupt each other, enhanced patient-situation awareness comes at
a price. Prior research discusses both the use of technology to support increased
communication and its unintended consequence of (wanted and unwanted) notification
interruptions.
Using qualitative research techniques, I investigated work practices that enhance
the patient-situation awareness of physicians, fellows, residents, nurses, students, and
pharmacists in a medical ICU. I used the Locales Framework to understand the observed
task management and communication work practices. In this study, paper notes were
observed to act as transitional artifacts that are later digitized to organize and coordinate
tasks, goals, and patient-centric information at a team and organizational level. Non
digital information is often not immediately digitized, and only select information is
communicated between certain ICU team members through synchronous mechanisms
such as face-to-face or telephone conversations. Thus, although ICU providers are
exceptionally skilled at working together to improve a critically ill patient’s condition, the use of paper-based artifacts and synchronous communication mechanisms induces
several interruptions while contextually situating a clinical team for patient care.
In this dissertation, I also designed and evaluated a mobile health technology tool,
known as PANI (Patient-centered Notes and Information Manager), guided by the
Locales framework and the participatory involvement of ICU healthcare providers as co
designers. PANI-supported task management induces minimal interruptions by: (1)
rapidly generating, managing, and sharing clinical notes and action-items among
clinicians and (2) supporting the collaboration and communication needs of clinicians
through a novel visual and tactile notification system. The long-term contribution of this
research suggests guidelines for designing mobile health technology interventions that
enhance ICU patient situation-awareness and reduce unwanted interruptions to clinical
workflow.
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/12304 |
| Date | 29 March 2016 |
| Creators | Srinivas, Preethi |
| Contributors | Bolchini, Davide, Faiola, Anthony, Brady, Erin, Khan, Babar, Doebbeling, Bradley |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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