Matching Items (4)
Design and development of an immersive virtual reality team trainer for advance cardiac life support
Description
Technology in the modern day has ensured that learning of skills and behavior may be both widely disseminated and cheaply available. An example of this is the concept of virtual reality (VR) training. Virtual Reality training ensures that learning can be provided often, in a safe simulated setting, and it may be delivered in a manner that makes it engaging while negating the need to purchase special equipment. This thesis presents a case study in the form of a time critical, team based medical scenario known as Advanced Cardiac Life Support (ACLS). A framework and methodology associated with the design of a VR trainer for ACLS is detailed. In addition, in order to potentially provide an engaging experience, the simulator was designed to incorporate immersive elements and a multimodal interface (haptic, visual, and auditory). A study was conducted to test two primary hypotheses namely: a meaningful transfer of skill is achieved from virtual reality training to real world mock codes and the presence of immersive components in virtual reality leads to an increase in the performance gained. The participant pool consisted of 54 clinicians divided into 9 teams of 6 members each. The teams were categorized into three treatment groups: immersive VR (3 teams), minimally immersive VR (3 teams), and control (3 teams). The study was conducted in 4 phases from a real world mock code pretest to assess baselines to a 30 minute VR training session culminating in a final mock code to assess the performance change from the baseline. The minimally immersive team was treated as control for the immersive components. The teams were graded, in both VR and mock code sessions, using the evaluation metric used in real world mock codes. The study revealed that the immersive VR groups saw greater performance gain from pretest to posttest than the minimally immersive and control groups in case of the VFib/VTach scenario (~20% to ~5%). Also the immersive VR groups had a greater performance gain than the minimally immersive groups from the first to the final session of VFib/VTach (29% to -13%) and PEA (27% to 15%).
ContributorsVankipuram, Akshay (Author) / Li, Baoxin (Thesis advisor) / Burleson, Winslow (Committee member) / Kahol, Kanav (Committee member) / Arizona State University (Publisher)
Created2012
Description
The analysis of clinical workflow offers many challenges to clinical stakeholders and researchers, especially in environments characterized by dynamic and concurrent processes. Workflow analysis in such environments is essential for monitoring performance and finding bottlenecks and sources of error. Clinical workflow analysis has been enhanced with the inclusion of modern technologies. One such intervention is automated location tracking which is a system that detects the movement of clinicians and equipment. Utilizing the data produced from automated location tracking technologies can lead to the development of novel workflow analytics that can be used to complement more traditional approaches such as ethnography and grounded-theory based qualitative methods. The goals of this research are to: (i) develop a series of analytic techniques to derive deeper workflow-related insight in an emergency department setting, (ii) overlay data from disparate sources (quantitative and qualitative) to develop strategies that facilitate workflow redesign, and (iii) incorporate visual analytics methods to improve the targeted visual feedback received by providers based on the findings. The overarching purpose is to create a framework to demonstrate the utility of automated location tracking data used in conjunction with clinical data like EHR logs and its vital role in the future of clinical workflow analysis/analytics. This document is categorized based on two primary aims of the research. The first aim deals with the use of automated location tracking data to develop a novel methodological/exploratory framework for clinical workflow. The second aim is to overlay the quantitative data generated from the previous aim on data from qualitative observation and shadowing studies (mixed methods) to develop a deeper view of clinical workflow that can be used to facilitate workflow redesign. The final sections of the document speculate on the direction of this work where the potential of this research in the creation of fully integrated clinical environments i.e. environments with state-of-the-art location tracking and other data collection mechanisms, is discussed. The main purpose of this research is to demonstrate ways by which clinical processes can be continuously monitored allowing for proactive adaptations in the face of technological and process changes to minimize any negative impact on the quality of patient care and provider satisfaction.
ContributorsVankipuram, Akshay (Author) / Patel, Vimla L. (Thesis advisor) / Wang, Dongwen (Thesis advisor) / Shortliffe, Edward H (Committee member) / Kaufman, David R. (Committee member) / Traub, Stephen J (Committee member) / Arizona State University (Publisher)
Created2018
Description
Hospital Emergency Departments (EDs) are frequently crowded. The Center for
Medicare and Medicaid Services (CMS) collects performance measurements from EDs
such as that of the door to clinician time. The door to clinician time is the time at which a
patient is first seen by a clinician. Current methods for documenting the door to clinician
time are in written form and may contain inaccuracies. The goal of this thesis is to
provide a method for automatic and accurate retrieval and documentation of the door to
clinician time. To automatically collect door to clinician times, single board computers
were installed in patient rooms that logged the time whenever they saw a specific
Bluetooth emission from a device that the clinician carried. The Bluetooth signal is used
to calculate the distance of the clinician from the single board computer. The logged time
and distance calculation is then sent to the server where it is determined if the clinician
was in the room seeing the patient at the time logged. The times automatically collected
were compared with the handwritten times recorded by clinicians and have shown that
they are justifiably accurate to the minute.
Medicare and Medicaid Services (CMS) collects performance measurements from EDs
such as that of the door to clinician time. The door to clinician time is the time at which a
patient is first seen by a clinician. Current methods for documenting the door to clinician
time are in written form and may contain inaccuracies. The goal of this thesis is to
provide a method for automatic and accurate retrieval and documentation of the door to
clinician time. To automatically collect door to clinician times, single board computers
were installed in patient rooms that logged the time whenever they saw a specific
Bluetooth emission from a device that the clinician carried. The Bluetooth signal is used
to calculate the distance of the clinician from the single board computer. The logged time
and distance calculation is then sent to the server where it is determined if the clinician
was in the room seeing the patient at the time logged. The times automatically collected
were compared with the handwritten times recorded by clinicians and have shown that
they are justifiably accurate to the minute.
ContributorsFrisby, Joshua (Author) / Nelson, Brian C (Thesis advisor) / Patel, Vimla L. (Thesis advisor) / Smith, Vernon (Committee member) / Kaufman, David R. (Committee member) / Arizona State University (Publisher)
Created2015
Description
Clinicians confront formidable challenges with information management and coordination activities. When not properly integrated into clinical workflow, technologies can further burden clinicians’ cognitive resources, which is associated with medical errors and risks to patient safety. An understanding of workflow is necessary to redesign information technologies (IT) that better support clinical processes. This is particularly important in surgical care, which is among the most clinical and resource intensive settings in healthcare, and is associated with a high rate of adverse events. There are a growing number of tools to study workflow; however, few produce the kinds of in-depth analyses needed to understand health IT-mediated workflow. The goals of this research are to: (1) investigate and model workflow and communication processes across technologies and care team members in post-operative hospital care; (2) introduce a mixed-method framework, and (3) demonstrate the framework by examining two health IT-mediated tasks. This research draws on distributed cognition and cognitive engineering theories to develop a micro-analytic strategy in which workflow is broken down into constituent people, artifacts, information, and the interactions between them. It models the interactions that enable information flow across people and artifacts, and identifies dependencies between them. This research found that clinicians manage information in particular ways to facilitate planned and emergent decision-making and coordination processes. Barriers to information flow include frequent information transfers, clinical reasoning absent in documents, conflicting and redundant data across documents and applications, and that clinicians are burdened as information managers. This research also shows there is enormous variation in how clinicians interact with electronic health records (EHRs) to complete routine tasks. Variation is best evidenced by patterns that occur for only one patient case and patterns that contain repeated events. Variation is associated with the users’ experience (EHR and clinical), patient case complexity, and a lack of cognitive support provided by the system to help the user find and synthesize information. The methodology is used to assess how health IT can be improved to better support clinicians’ information management and coordination processes (e.g., context-sensitive design), and to inform how resources can best be allocated for clinician observation and training.
ContributorsFurniss, Stephanie Kohli (Author) / Kaufman, David R. (Thesis advisor) / Grando, M. Adela (Committee member) / Johnson, William G. (Committee member) / Arizona State University (Publisher)
Created2017