PubMed Health⌕ Search

Biomedical subjects

Desmond Jordan

Publications and source records attributed to Desmond Jordan.

7 recordsLinked to original sources
PubMed2006

Workflow modeling in critical care: piecing together your own puzzle.

The intensive care unit (ICU) is an instance of a very dynamic health care setting where critically ill patients are being managed. To provide good care, an extensive and coordinated communication amongst the role players, use of numerous information systems and operation of devices for monitoring and treatment purposes are required. The purpose of this research is to study error evolution and management within this environment. The focus is on representing the workflow of critical care environment, which emphasizes the importance such a representation may play in strategizing the management of medical errors. We used ethnographic observation and interview data to build individual pieces of the workflow, dependent on the individual and the activity concerned. Key personnel were intensively followed during their respective patient care activities and the related actions. All interactions were recorded for analysis. These clinicians and nurses were interviewed to complement the observation data and to delineate their individual workflows. These pieces of the ICU workflow were used to develop a generalize-able cognitive model to represent the intricate workflow applicable to other health care settings. The proposed model can be used to identify and characterize medical errors and for error prediction in practice.

Critical Care↗
PubMed2005

Facilitating physicians' access to information via tailored text summarization.

We have developed a summarization system, TAS (Technical Article Summarizer), which, when provided with a patient record and journal articles returned by a search, automatically generates a summary that is tailored to the patient characteristics. We hypothesize that a personalized summary will allow a physician to more quickly find information relevant to patient care. In this paper, we present a user study in which subjects carried out a task under three different conditions: using search results only, using a generic summary and search results, and using a personalized summary with search results. Our study demonstrates that subjects do a better job on task completion with the personalized summary, and show a higher level of satisfaction, than under other conditions.

Abstracting and Indexing↗
PubMed2005

Workflow modeling in critical care: piecing your own puzzle.

The intensive care unit (ICU) is an instance of a very dynamic health care setting where critically ill patients are being managed. It comprises of an extensive amount of communication amongst the role players, use of numerous information systems and operation of devices for monitoring and treatment purposes. The purpose of this research is to study error evolution and management within this environment. Ethnographic observation and semi-structured interview data were used to build individual pieces of the workflow dependent on the individual and the activity concerned. These pieces of the ICU workflow were used to develop a generalizable cognitive model to represent the intricate workflow in health care settings. The proposed model can be used to identify and characterize medical errors and also used for error prediction in practice.

Cognition↗
PubMed2004

Heuristic evaluation of infusion pumps: implications for patient safety in Intensive Care Units.

OBJECTIVE: The goal of this research was to use a heuristic evaluation methodology to uncover design and interface deficiencies of infusion pumps that are currently in use in Intensive Care Units (ICUs). Because these infusion systems cannot be readily replaced due to lease agreements and large-scale institutional purchasing procedures, we argue that it is essential to systematically identify the existing usability problems so that the possible causes of errors can be better understood, passed on to the end-users (e.g., critical care nurses), and used to make policy recommendations. DESIGN: Four raters conducted the heuristic evaluation of the three-channel infusion pump interface. Three raters had a cognitive science background as well as experience with the heuristic evaluation methodology. The fourth rater was a veteran critical care nurse who had extensive experience operating the pumps. The usability experts and the domain expert independently evaluated the user interface and physical design of the infusion pump and generated a list of heuristic violations based upon a set of 14 heuristics developed in previous research. The lists were compiled and then rated on the severity of the violation. RESULTS: From 14 usability heuristics considered in this evaluation of the Infusion Pump, there were 231 violations. Two heuristics, "Consistency" and "Language", were found to have the most violations. The one with fewest violations was "Document". While some heuristic evaluation categories had more violations than others, the most severe ones were not confined to one type. The Primary interface location (e.g., where loading the pump, changing doses, and confirming drug settings takes place) had the most occurrences of heuristic violations. CONCLUSION: We believe that the Heuristic Evaluation methodology provides a simple and cost-effective approach to discovering medical device deficiencies that affect a patient's general well being. While this methodology provides information for the infusion pump designs of the future, it also identifies important insights concerning equipment that is currently in use in critical care environments.

Humans↗
PubMed2004

An evaluation of automatically generated briefings of patient status.

We report on an evaluation of MAGIC, a system that automatically generates briefings of patient status after coronary bypass surgery, completed in the Cardio Thoracic Intensive Care Unit at New York Presbyterian Hospital. Through enhancements in system design, robustness and speed, we compared information obtained by nurses against two briefings, one automatically generated by MAGIC and one provided by physicians upon the patient's arrival to the ICU. Our results show that MAGIC and the physician briefing provide a substantial increase in the amount of information than is available prior to the patient's arrival and that the information MAGIC provides is accurate. In many aspects, MAGIC out-performs the physician briefing; information is reported earlier and is always available. We conclude that MAGIC provides the CT ICU staff early on with a better assessment of the patient's status than in current practice and allows them to better prepare for the patient's arrival.

Coronary Artery Bypass↗
PubMed2002

Usability evaluation of an experimental text summarization system and three search engines: implications for the reengineering of health care interfaces.

This paper describes the comparative evaluation of an experimental automated text summarization system, Centrifuser and three conventional search engines - Google, Yahoo and About.com. Centrifuser provides information to patients and families relevant to their questions about specific health conditions. It then produces a multidocument summary of articles retrieved by a standard search engine, tailored to the user's question. Subjects, consisting of friends or family of hospitalized patients, were asked to "think aloud" as they interacted with the four systems. The evaluation involved audio- and video recording of subject interactions with the interfaces in situ at a hospital. Results of the evaluation show that subjects found Centrifuser's summarization capability useful and easy to understand. In comparing Centrifuser to the three search engines, subjects' ratings varied; however, specific interface features were deemed useful across interfaces. We conclude with a discussion of the implications for engineering Web-based retrieval systems.

Angina Pectoris↗