intensivist wilhelmina children's hospital “opdrachtgever ... · story 3 months old patient...
TRANSCRIPT
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User interface “opdrachtgever WKZ”
Erik Koomen Anesthesiologist and Pediatric intensivist Wilhelmina Children's Hospital UtrechtThe Netherlands
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Content
❖ WKZ
❖ Probleem => “Smart KinderIC”
❖ Opdracht gedachte
❖ Organisatie….
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State of the Union
“By computing health care records, we can avoid dangerous medical mistakes, reduce costs, and improve care.”
(George W. Bush, 2004)
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WKZ
Een Kinderziekenhuis
“Zelfstandig ziekenhuis voor kinderen”
- Poliklinieken- Verpleegafdelingen- Operatiekamers- Intensive Care
- Neonatologie (pasgeborenen)- KinderIC (kinderen)
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Probleem❖ 14 Beds open format Pediatric ICU without roaming in
for the parents
❖ 2017 / 2021 Opening a new Pediatric ICU
❖ 30 beds (IC and respiratory and cardiac HC unit)
❖ Family centered (roaming in)
❖ Patient friendly / single bed spaces
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Napoleon looking at the battlefield
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New situation => situational awareness?
Single patient roomRoaming in
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Even better……for the patient
No noise or light population.Devices create safety…
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Clinical => ICT / technical
❖ Medical team:
❖ Wish to Situational Awareness (No Alarm Fatigue)
❖ Safety: technical support
❖ Parents / patient
❖ Privacy
❖ Good care
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Rule engine❖ Decision Support:
❖ No decision making
❖ Optimizing information input to medical team
❖ Combining information (disconnection)
❖ Using
❖ Patient (age)/ illness characteristics (cardiac)
❖ Trend data
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Focus ?
❖ Finding the focus
❖ Where in the timeline of care?
❖ Which problem do we solve first?
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Fundamentals of decision support
Ambiguity vs severity / complexity
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Story❖ 3 months old patient arrives at PICU ill/respiratory distress.
❖ Physical investigation / laboratory investigation
❖ Differential Diagnose: Viral Infections
❖ Respiratory failure => intubation
❖ After intubation stable patient with antibiotics
❖ One week of respiratory support => extubation
❖ Discharge to the ward
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How to focus?
❖ Level of attention
❖ Level of ambiguity
❖ Level of illness (ICU) / risk (anesthesia)
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Lorem Ipsum Dolor
(Pediatric) ICU setting We need support if the level of attention drops….
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Timeline focus rule engine
❖ To start and use a rule engine most efficient:
❖ Period of less attention nurses / doctors
❖ Ambiguity is less potent issue
❖ Risk on acute problems still there, but setting clear.
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Neonatologie
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Neonatologie
❖ 30-35 beds Neonatologie
❖ Gaan ook verbouwen en denken heel hard ook aan single beds Neo
❖ Organisatie net anders dan kinderIC (werkproces)
❖ Gebruikte systemen / focus op apparatuur net anders
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Kinderafdeling Eekhoorn
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Kinderafdeling Eekhoorn
❖ Reeds een/twee persoonskamers
❖ Steeds meer apparatuur
❖ Reeds weinig sitautional awareness
❖ Veel alarm fatigue
❖ Nieuwe “paging” 2019
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Opdracht (gedachten WKZ)
❖ “Out of the box user interface opzet”
❖ 2 groepen per afdeling (3 afd: Kinderafd / Neo / IC)
❖ Per afdeling 2 gedifferentieerde vragen:
❖ gericht op alarmen / monitoring communicatie
❖ ondersteunen van het werkproces
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Opdracht (uitw)
❖ Eerste interview met verpleegkundige(n)
❖ Tweede sessie (eerste schetsen)
❖ Verpleegkundige(n) en Arts (waar mogelijk)
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Organisatie
❖ KinderIC: Erik Koomen [email protected] anesthesioloog / kinderintensivist
❖ Neonatologie: Joshua van Duuren [email protected] verpleegkundige en ICT specialist
❖ Kinderafdeling Eekhoorn: Indra Morsing [email protected] kinderarts en fellow kinderIC
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Unlimited patient control ….smart ?!!! PICU transport
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Nog vragen?