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Ascertaining Design Requirements for Postoperative Care Transition Interventions.
Joanna Abraham1,2, Christopher R King1, Alicia Meng1
1Department of Anesthesiology, School of Medicine, Washington University, St. Louis, Missouri, United States.
Applied Clinical Informatics
|February 24, 2021
Summary
Improving operating room to intensive care unit (OR-ICU) handoffs requires flexible standardization. Artificial intelligence (AI) can personalize care transitions by identifying patient-specific risks for better communication.
Area of Science:
- Medical Informatics
- Patient Safety
- Healthcare Systems Engineering
Background:
- Operating room (OR) to intensive care unit (ICU) care transitions are prone to communication errors and lack sustainable standardization protocols.
- Existing standardization methods show limited long-term sustainability, highlighting a need for novel approaches.
- The potential of artificial intelligence (AI) in creating personalized postoperative transition interventions remains largely unexplored.
Purpose of the Study:
- To identify factors influencing the sustainability of standardized OR-ICU handoffs.
- To develop design concepts and prototyping requirements for a sustainable handoff intervention using a human-centered approach.
- To explore the utility of AI-driven risk assessment in improving postoperative handoffs.
Main Methods:
- Conducted four design workshops with 24 OR and ICU clinicians at a major academic medical center.
- Employed open-ended questions, card sorting of handoff information, and scenario-based design ideation and prototyping.
- Analyzed data using thematic analysis; card sorts were tallied to categorize information elements as core, flexible, or unnecessary.
Main Results:
- Limited clinician awareness of protocols and lack of electronic health record (EHR)-integrated interventions hindered sustainability.
- Clinicians favored interventions with core and flexible elements, tailored to patient condition and risks, plus elimination of unnecessary information.
- Divergent views emerged between physicians and nurses regarding the integration of AI-generated postoperative risks into handoffs.
Conclusions:
- Effective interdisciplinary communication requires EHR-integrated, flexibly standardized care transition interventions.
- These interventions should generate patient-centered summaries and risk-based reports automatically.
- Personalized, AI-informed risk assessment holds promise for enhancing the safety and efficiency of OR-ICU handoffs.
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