SALT: The Sodium Alerting Tool

So…What is it? What will it do?

It’s a pediatric surgical ICU Clinical Decision Support System for fluid and electrolyte management.

It will help pediatric surgical intensivists manage fluid and electrolyte problems in complicated pediatric post-operative patients.

It will have a simple interface with some input/output options, like seen in a personal bank website or a pc calculator.

The Concept…In General It must contain inputs for patient specific information such

as weight and electrolytes. Information such as concentrations, volumes, and rates require an input modality. An interface for stored (known) fluid mixtures and concentrations should be included. The user should be provided an additional interface for creating their own mixtures.

The interface should include inputs for specific laboratory values such as Sodium, Potassium, and other electrolytes.

The desired outputs from this system are calculations that can be translated into orders (printed or directed into the HIS) with decision support such as alerting or reminders.

Doctors Feeling Needy :-s The main users of this system are pediatric

surgical intensivists. They are going to be pediatric anaesthesiologist and surgeons. In our case, it was Simon Hillier.

He stated that the real need is for a Pediatric Surgical Intensive Care Unit (PICU)/ anesthesia Information System that supports the special and specific needs of providers and patients in this particular clinical setting.

What are the Requirements? The user desires the ability to have some

configuration control over the application for adjusting the equations for the calculations creating their own orders, managing the logic of the alerts, and formatting the output.

After the interview, we thought the system should accept user inputs using simple data entry fields and drop downs for defaults. Then calculate the appropriate adjustments in fluid management, and ultimately translate those calculations into actionable results and eventually clinical orders that the user can then sign and have the nurse act upon.

Developing Alternative Designs

Possible platforms: PDA, SmartPhone Task Specific Device (The iSALTberry?) Net Browser

Flash Web forms XHTML

Hospital Information System (Web Vs. The Think Client)

Concept Design

Concept Design

Prototype Design

Tasting the SALT: product assessment

Contextual Interview with Interactive Prototype in real environment as a “quick and dirty” Field StudyMet users basic desire functionalityEasy to learn and use“We need this, when can we get it?” –Chad,

PharmD. Three new requirements.

Conclusions:

SALT leaves you thirsty for more SALT needs more work

From MANY perspectives

Users DEFINITELY slow the design/ development process down Especially if they are busy clinicians

But, in the end, IT helps doctors take better care of their patients- and that’s valuable!