Teamwork and Care Transitions in Pediatric Trauma Understanding Clinical Information Needs and Health Care Decision Making Processes in the Context of Health Information

Overview: Ineffective care transitions and handoffs between different units in a hospital can pose significant risks to patient safety, and result in poor clinical and financial outcomes; this is especially true for pediatric trauma care transitions that often take place under high-stress and time-pressure. This proposal is aimed at developing a deep and broad understanding of the cognitive work of clinician teams and family members involved in pediatric trauma care transitions in order to design usable and useful health information technologies. The results of our research will aid in producing innovative concepts, tools, and methods needed for the next generation of information technology-supported work systems that provide integrated, seamless, safe, and patient and family-centered care.

Aims:

– to describe cognitive teamwork involved in care transitions of pediatric trauma patients.

– to develop and test design requirements for future HIT, referred to as the team-centric information technology (TACIT), that supports cognitive teamwork for enhancing safety, quality, and family-centeredness of care.

Funding: Agency for Healthcare Research and Quality (AHRQ)

Ayse Gurses, PhD
Associate Professor, School of Medicine
Johns Hopkins University

Michael Rosen, PhD
Associate Professor, School of Medicine
Johns Hopkins University

James Fackler, MD
Associate Professor, School of Medicine
Johns Hopkins University

Peter Pronovost, MD, PhD
Director of the Armstrong Institute for Patient Safety and Quality
Professor, School of Nursing
Johns Hopkins University

Fray Stewart, MD
Director of Pediatric Trauma and Burn Program
Assistant Professor, Department of Surgery
Johns Hopkins University

Elizabeth Hunt, MD, PhD
Assistant Professor, Anesthesiology and Critical Care Medicine
Johns Hopkins University

David Thompson, DNSc, MS
Director of Patient Safety Education
Associate Professor, Anesthesiology and Critical Care Medicine
Johns Hopkins University

Martha Stevens, MD
Assistant Professor, Pediatrics
Johns Hopkins University

Pascale Carayon, PhD
Procter & Gamble Bascom Professor in Total Quality
Department of Industrial and Systems Engineering
Director, Center for Quality and Productivity Improvement
University of Wisconsin-Madison

Peter Hoonakker, PhD
Research Scientist, Associate Director of Research
Center for Quality and Productivity Improvement
University of Wisconsin-Madison

Tom Brazelton, MD, MPH|
School of Medicine and Public Health
University of Wisconsin-Madison

Roger Brown, PhD
Professor, School of Nursing
University of Wisconsin-Madison

Shannon Dean, MD
School of Medicine and Public Health
University of Wisconsin Madison

Michelle Kelly, MD
School of Medicine and Public Health
University of Wisconsin Madison

Jonathan Kohler, MD
Assistant Professor, Department of Surgery
University of Wisconsin-Madison

Joshua Ross, MD
School of Medicine and Public Health
University of Wisconsin-Madison

Abigail Wooldridge, PhD
Assistant Professor
Department of Industrial & Enterprise Systems Engineering
University of Illinois at Urbana-Champaign

Nicole Chandler, MD
Department of Pediatric Surgery
All Children’s Hospital
Johns Hopkins Medicine

Deborah Rusy, MD, MBA
School of Medicine and Public Health
University of Wisconsin-Madison

Ant Ozok, PhD
Associate Professor, Department of Information Systems
University of Maryland, Baltimore County

Emilie Roth, PhD
Cognitive Engineering Specialist
Roth Cognitive Engineering

Betsy Hose
Research Assistant
Center for Quality and Productivity Improvement
University of Wisconsin-Madison

Jordan Ramsey
Research Assistant
Center for Quality and Productivity Improvement
University of Wisconsin-Madison

2019

Hose, B.-T., Hoonakker, P., Wooldrige, A., Brazelton, T., Dean, S., Eithun, B., Fackler, J., Gurses, A.P., Kelly, M.M., Kohler, J.E., McGeorge, N., Ross, J., Rusy, D. and Carayon, P. Physician Perceptions of the Electronic Problem List in Pediatric Trauma Care. Appl Clin Inform, 10(1), 113-122. https://doi.org/10.1055/s-0039-1677737

Hoonakker, P.L.T., Carayon, P., Hose, B-Z, Ramsey, J., Eithun, B., Kim, M.K., Koffarnus, K.S., Kohler, J.E., Nieman, J.A., Reisman, M.M., Ross, J.C.,., Rusy, D.A., Soetenga, D.J., (2019). Proactive Risk Assessment of Team Health IT for Pediatric Trauma Care Transitions (T3). In: Health and Social Care Systems for the Future: Demographic Changes, Digital Age and Human Factors (Cotrim, T.P., Serranheira, F., Sousa, P., Hignett, S., Albolino, S., Tartaglia, R. (eds.)), pp. 213-221.

Wooldridge, A. R., Carayon, P., Hoonakker, P. L. T., Hose, B.-Z., Ross, J., Kohler, J., Brazelton, T., Eithun, B., Kelly, M., Dean, S., Rusy, D., Durojaiye, A. & Gurses, A. P. (2019). Complexity of the Pediatric Trauma Care Process: Implications for Multi-Level Awareness. Cognition, Technology and Work, 21: 397-416. doi:10.1007/s10111-018-0520-0.

Hoonakker, P.L.T., Wooldridge, A.R, Carayon, P., Hose, B.-Z., Eithun, B.L., Brazelton, T.B., Dean, S.M., Kelly, M.M., Kohler, J.E, Ross, J.C., Rusy, D.A., Gurses, A.P. (published online). Information Loss during Pediatric Trauma Care Transitions: Things Falling Through the Cracks. Paper published online in Internal and Emergency Medicine. https://doi.org/10.1007/s11739-019-02110-7

2018

Durojaiye, A.B., McGeorge, N.M., Puett, L.L., Stewart, D., Fackler, J.C., Hoonakker, P.L.T., Lehmann, H.P., Gurses, A.P. (2018). Mapping the flow of pediatric trauma patients using process mining on trauma registry data. Applied Clinical Informatics, 9 (3); pp. 654-666. https://doi.org/10.1055/s-0038-1668089.

Hoonakker, P.L.T., Wooldridge, A.R, Carayon, P., Hose, B.-Z., Eithun, B.L., Brazelton, T.B., Dean, S.M., Kelly, M.M., Kohler, J.E, Ross, J.C., Rusy, D.A., Gurses, A.P (2019). Things Falling Through the Cracks: Information Loss During Pediatric Trauma Care Transitions. In: Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y. (eds) Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018), pp. 479-488. IEA 2018, Florence, Italy, August 26-30, 2018. Advances in Intelligent Systems and Computing, vol 818. Springer, Cham. https://doi.org/10.1007/978-3-319-96098-2_60

Hose BZ., Carayon, P., Hoonakker, P.L.T., Wooldridge, A.R, Brazelton, T.B., Eithun, B.L., Kelly, M.M., Dean, S.M., Eithun, B., Kelly, M., Kohler, J.C., Ross, J.E, Rusy, D.A., Gurses, A.P. (2018) Challenges of Disposition Decision Making for Pediatric Trauma Patients in the Emergency Department. In: Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y. (eds) Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018). IEA 2018. Advances in Intelligent Systems and Computing, vol. 818. Springer, Cham. https://doi.org/10.1007/978-3-319-96098-2_44

Wooldridge, A. R., Carayon, P., Hoonakker, P., Hose, B.-Z., Gurses, A. (Accepted). Redefining the Scope of the Care Transition Process: A Study of Pediatric Trauma Care Transitions. Paper accepted for presentation at the HFES Conference, Philadelphia, PA, Oct 1-5, 2018.

2017

Hose, B-Z., Carayon, P., Hoonakker, P., Wooldridge, A.R., Ross, J., Kohler, J., Brazelton, T., Eithun, B., Kelly, M., Dean, S., Rusy, D., Gurses, A. (2017). Information Needs of Physicians in Pediatric Trauma. Poster presented at the Human Factors and Ergonomics in Healthcare Conference, March 5-8, 2017, New Orleans, Louisiana.

Wooldridge, A. R., Carayon, P., Hoonakker, P., Hose, B.-Z., Ross, J., Kohler, J., Brazelton, T., Eithun, B., Kelly, M., Dean, S., Rusy, D., Gurses, A. (2017). Understanding Team Complexity in Pediatric Trauma Care. Poster presented at the Human Factors and Ergonomics in Healthcare Conference, March 5-8, 2017, New Orleans, Louisiana.

Wooldridge, A., Gurses, A., Carman, E.M., Waterson, P. Sesto, M., Hoonakker, P.L.T. (2017). Designing and managing healthcare transitions. Proceedings of the ODAM conference, Banff, Canada, July 31-Aug 3, 2017, pp. 538-542.

2016

McGeorge, N.M., Durojaiye, A.B., Fackler, J.C., Xie, A., Rosen, M.A., Hundt, E.A., Steward, D., Puett, L.L., Wooldridge, A.R., Carayon, P., Hoonakker, P., Gurses, A.P. (2016). Pediatric Trauma Care Transitions: Understanding Teamwork for Health IT Design. Seventh Annual Johns Hopkins Medicine Patient Safety Summit: Working Together to Achieve Zero Preventable Harm, October, 2016, Baltimore, MD.