Care Transitions and Teamwork in Pediatric Trauma: Implications for Health Information Technology Design (Maryland)

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Project Details - Ended


Trauma is the leading cause of death and permanent paralysis among the pediatric population. Care transitions of critically ill patients, such as trauma patients, to and from the pediatric intensive care unit (PICU), require effective teamwork among the PICU team, other teams and services (e.g., emergency department), as well as family members. This project seeks to develop an 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 project team will analyze and model cognitive teamwork and team processes to design IT-supported pediatric trauma systems using a sociotechnical systems (STS) approach. An extension of the STS Systems Engineering Initiative for Patient Safety (SEIPS) model, called SEIPS 2.0, will be used to ensure that the health IT design supports all team members (e.g., PICU team, pediatric surgery team, and family members) and team processes, given their context, environment, roles, and workflows. A modified version of the Contextual Design methodology will be used to guide the overall design process. Contextual Design is a six-step, user-centered design process that relies on the premise of understanding users’ needs in the field where they actually work or live and using this data as input into the design process.

The specific aims of the project are as follows:

  • Describe cognitive teamwork involved in care transitions of pediatric trauma patients 
  • Develop and test design requirements for future health IT, referred to as the team-centric information technology (TACIT) that supports cognitive teamwork for enhancing safety, quality, and family-centeredness of care 

The study will be conducted in three Level I pediatric trauma centers: Johns Hopkins Children’s Hospital, University of Wisconsin-American Family Children’s Hospital, and the All Children’s Hospital in Florida. Methods for analyzing cognitive teamwork will be diverse (i.e., contextual inquiry, interviews, and focus groups) and will produce a range of outputs (i.e., process maps, information flow diagrams, artifact analysis, collaboration tables, decision wheels, and role network analysis) that will be used to define the TACIT design requirements for the second aim. Using a collaborative process among researchers and the various other stakeholders, the project team will develop preliminary design requirements for the TACIT mock-up and evaluate its usability.