Real Time Documentation of Medical Emergencies

Interaction Design graduate student Kris Martin finishes his M.F.A Thesis on real time documentation for the development of an mobile device-based medical emergency black box information system (MEBBIS) with Prof. Axel Roesler and Dr. Brian Ross, Bala Nair, and Alan Au at the UW School of Medicine’s Institute for Simulation and Interprofessional Studies (ISIS). MEBBIS supports the real time documentation of Code Blue events.

In hospitals, Code Blue is generally used to indicate that a patient requires immediate resuscitation, most often as the result of a cardiac arrest. Within the medical field, such an event is known as a “code”. For the doctors and nurses working to save lives, distractions from the task at hand resulting in delays or mistakes literally may make the difference between life and death. Medical professionals are required to address the emergency, and revive the critically ill patient but also, as importantly, to produce documentation that is critical to the hand off the patient to other healthcare teams along the chain of care. As can be expected, in the rush to provide lifesaving interventions, real-time clinical documentation can take a back seat.

The existing protocol for documentation of code blue events requires the second nurse to arrive to record every significant event in written form. Observation of code blue drills at the hospital revealed that the demands of the situation do not permit everything to be captured in real time. In most cases, the documenter is only able to take brief notes which serve as an outline. Studies of similar real time documentation tasks show that in order to bridge missing information as result of the time pressure generated by cascading events during recording, additional information is added retrospectively after the conclusion of the event. As a result, documentation errors and omissions can occur.

In the course of this ongoing 2-year research project we are exploring how a work-centered interaction design approach can improve the documentation of medical emergencies – How can we faciliatate the real time recording of dynamic events, implemented into an interactive system to effectively support the care of the patient by enhancing the caregivers’ access to relevant information, and simultaneously generate a record of the sequence of conditions, treatments, and decisions made along the way.

Category: Research

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