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Unit 7a: Workflow Assessment Safe Workflow Design This material was developed by Johns Hopkins University, funded by the Department of Health and Human.

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Presentation on theme: "Unit 7a: Workflow Assessment Safe Workflow Design This material was developed by Johns Hopkins University, funded by the Department of Health and Human."— Presentation transcript:

1 Unit 7a: Workflow Assessment Safe Workflow Design This material was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000013.

2 At the end of this segment, the student will be able to: Assess decision-making requirements in health or health care Objectives Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 2

3 Clinical Decision-Making Systematic way to handle data and clinical algorithms to decide on a best course of action Algorithm = a step-by-step procedure for solving a problem. Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 3

4 Clinical Decision Making: Uncertainty Technical What should I do? Personal What are the patients’ wishes? Conceptual How do I apply abstract concepts to concrete situations? Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 4

5 Clinical Decision Making: Uncertainty Direct Knowing what we know Knowing what is being researched Knowing what works Indirect Establishing a communication infrastructure Establishing evaluation of processes and outcomes of care Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 5

6 Clinical Decision-Making: Expert Decision-Making Systems Improve task performance and reduce errors within the clinical workspace Depend on: –Analysis of clinical requirements and cognitive processes within the workflow –Provide optimal situation awareness through information visualization Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 6

7 Basic Elements of Decision-Making ProjectionComprehensionPerception Situation Awareness Decision-making Performance Jalote-Parmar A., et al, (2010) Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 7

8 Information Visualization Real-time information needed for clinical task performance and decision-making Should support 2 levels of complexity –Routine tasks –Complex (uncertain)tasks Comprehensive, integrated across phases of care Provide visual cues to avoid ambiguity Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 8

9 Human-Centered Design Cycle Specify Context of Use Analyze Requirements Design Prototype Evaluate Prototype Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 9 Jalote-Parmar A., et al, (2010)

10 Human-Centered Design Cycle Specify Context of Use Analyze Requirements Design Prototype Evaluate Prototype Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 10 Jalote-Parmar A., et al, (2010)

11 Analyze Requirements: Workflow Integration Matrix Current Workflow Future Workflow Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 11 Jalote-Parmar A., et al, (2010)

12 Analyze Requirements: Workflow Integration Matrix Investigate and verify clinical milestone Analyze workflow Verify and prioritize findings with clinicians Communicate with development team Conceptualize and evaluate design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 12 Jalote-Parmar A., et al, (2010)

13 Analyze Requirements: Workflow Integration Matrix Investigate and verify clinical milestone Analyze workflow Verify and prioritize findings with clinicians Communicate with development team Conceptualize and evaluate design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 13 Jalote-Parmar A., et al, (2010)

14 Workflow Analysis Methods QualitativeQuantitative Ethnographic observation Shadowing of individual clinicians Surveys and questionnaires Sensor technologies such as passive infrared sensors, radio identification tags and pressure sensors. Video recordings Human-intensive; produce low-volume, high-quality data Allow time stamping; produce high volume abstract data Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 14

15 Clinical Workflow Cognitive Decision- Making Movement Interaction & Communication Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 15

16 Analyze Requirements: Workflow Integration Matrix Investigate and verify clinical milestone Analyze workflow Verify and prioritize findings with clinicians Communicate with development team Conceptualize and evaluate design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 16 Jalote-Parmar A., et al, (2010)

17 Analyze Requirements: Workflow Integration Matrix Investigate and verify clinical milestone Analyze workflow Verify and prioritize findings with clinicians Communicate with development team Conceptualize and evaluate design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 17 Jalote-Parmar A., et al, (2010)

18 Analyze Requirements: Workflow Integration Matrix Investigate and verify clinical milestone Analyze workflow Verify and prioritize findings with clinicians Communicate with development team Conceptualize and evaluate design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 18 Jalote-Parmar A., et al, (2010)

19 Human-Centered Design Cycle Specify Context of Use Analyze Requirements Design Prototype Evaluate Prototype Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 19 Jalote-Parmar A., et al, (2010)

20 Cognitive Task Analysis Family of methods for understanding the cognitive processes that underlie task performance and the cognitive skills needed to respond adeptly to complex situations. Used to understand decision-making and communication processes Has implications for workflow design Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 20

21 Cognitive Task Analysis Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 21 Fackler, et al.,(2009)

22 Cognitive Task Analysis Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 22 Fackler, et al.,(2009)

23 Cognitive Task Analysis Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 23 Fackler, et al.,(2009)

24 Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 24 Fackler, et al.,(2009)

25 Cognitive Task Analysis Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 25 Fackler, et al.,(2009)

26 Cognitive Task Analysis Critical Care Environments Pattern Recognition Uncertainty Management Strategic vs. Tactical Thinking Team Coordination & Maintenance of Common Ground Creation & Transfer of Meaning Through Stories Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 26 Fackler, et al.,(2009)

27 Summary Clinical decision making is a systematic way of handling data and algorithms to decide on the best course of action Uncertainty (technical, personal, and conceptual) shapes clinical decisions Workflow integration matrices are useful Cognitive task analysis uncovers decision- making and communication processes and has implications for workflow analysis Component 12/Unit 7 Health IT Workforce Curriculum Version 2.0/Spring 2011 27

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