Towards improving inter-team coordination in the surgical process: a breakdown detection method

Authors:
Svetlena Taneva;Bernhard Plattner;Charlie Byer;Jacqueline Higgins;Anthony Easty
Affiliations:
Swiss Federal Institute of Technology, Zurich, Switzerland & University Health Network, Toronto, Canada;Swiss Federal Institute of Technology (ETH), Zurich, Switzerland;St. Michael's Hospital, Toronto, ON, Canada;University Health Network, Toronto, ON, Canada;University Health Network, Toronto, ON, Canada
Venue:
Proceedings of the 1st ACM International Health Informatics Symposium
Year:
2010

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Abstract

Coordination breakdowns in clinical work are a common concern for patient safety. To design technology that facilitates coordination and prevents breakdowns, we need to be able to reliably detect them and analyze their impact in daily work. A breakdown detection method is proposed as a useful approach to the management of breakdowns in inter-team coordination within the context of the daily operations of surgical units. By mapping information flow expectations for various information needs in clinical work -- such as patient status information flow, schedule status information flow, staffing coordination information flow, etc. -- an analyst can derive a set of predictions that serves as input to the algorithm for detecting the breakdowns. The method was verified over data from three sets of observational studies in two different hospitals. Performance analysis demonstrates excellent detection rate. The method can be utilized to assess the amount of breakdowns for different types of breakdowns, before and after technology implementation.