Project Details - Ongoing
- Grant Number:R01 HS022086
- Funding Mechanism:
- AHRQ Funded Amount:$2,496,571
- Principal Investigator:
- Project Dates:9/30/2013 to 9/29/2019
- Care Setting:
- Medical Condition:
- Type of Care:
- Health Care Theme:
Venous thromboembolism (VTE) is a serious complication for hospitalized patients and may lead to pulmonary embolisms (PE), a significant cause of morbidity and mortality. With proper management, VTE in hospitalized patients is largely preventable. Health information technology (IT) can be used to improve VTE prevention and management, but recent studies have shown that its effectiveness is compromised by a range of sociotechnical issues including poor technology interface design and fit of the technology with clinical workflow and clinician information needs.
This research uses a sociotechnical systems approach to the design of health IT specifically for preventing and managing VTE; this approach can address the issues that have limited the effectiveness of prior health IT for VTE. A sociotechnical systems approach examines the interaction between people and technology in the workplace. Using observations, interviews, focus groups, and a survey in four hospitals of an integrated health care system, researchers will develop a deep understanding of the cognitive and team work involved in VTE prevention and management. The researchers will collect data in four care settings: emergency departments, intensive care units, medical units and surgical units. They will then use this analysis to define sociotechnical design requirements for a clinical decision support (CDS) that supports cognitive and team work for preventing and managing VTE. Using a collaborative process between human factors engineers and physicians on the research team, preliminary design requirements will be developed that will be embedded in CDS mock-ups; the CDS mock-ups will then be evaluated through scenario-based usability evaluation and group debriefings. The results of this analysis will help to define additional questions to address in further data collection. When all data have been collected and analyzed, the research team will finalize the CDS design requirements.
The specific aims of the project are to:
- Evaluate the cognitive and team work involved in VTE prevention and management
- Develop design requirements for a CDS that support cognitive and team work for preventing and managing VTE
The long-term goal of the project is to develop an approach to designing health IT applications, specifically applications for health care quality and safety issues that can benefit from improved integration of guidelines in clinical workflows. The project team will develop a toolkit of cognitive and team work analysis that can be used to design other health IT applications – such as CDS - and be applied to a broader set of health care issues.