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Managing variations from surgical care plans: challenges for coordination.

Tobias Buschmann Iversen¹, Line Melby, Andreas Dypvik Landmark

¹Department of Computer and Information Science, Norwegian University of Science and Technology, Trondheim, Norway. tobiasbu@idi.ntnu.no

International Journal of Medical Informatics

|September 15, 2012

Summary

Continuous planning in surgery requires hospital information systems to support patient trajectory variations. Systems must inform staff about deviations and provide adaptable information displays for improved awareness and workflow management.

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Area of Science:

Health Informatics
Surgical Workflow Management
Human-Computer Interaction

Background:

Surgical environments necessitate continuous planning to manage frequent deviations from patient treatment plans.
Existing hospital information systems (HIS) are evaluated for their support of common patient trajectory variations.

Purpose of the Study:

To highlight how deviations from planned patient trajectories create distinct information needs.
To inform the design of computer systems that support awareness in surgical settings.

Main Methods:

Employed participant observation in peri-operative settings.
Conducted semi-structured interviews with relevant stakeholders.

Main Results:

Information needs are minimal when patient trajectories align with the plan.
Deviations significantly increase staff information requirements.
Awareness-support systems should communicate plan deviations and connect plans with event time estimations.
Systems should offer users adjustable information density (sparse vs. rich).

Conclusions:

Effective surgical workflow support requires HIS to actively manage and communicate plan variations.
Adaptive information displays in computer systems are crucial for enhancing situational awareness during surgical care.
Future system design should prioritize flexibility to accommodate diverse user information needs in dynamic surgical environments.