intensivist wilhelmina children's hospital “opdrachtgever ... · story 3 months old patient...
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User interface “opdrachtgever WKZ”
Erik Koomen Anesthesiologist and Pediatric intensivist Wilhelmina Children's Hospital UtrechtThe Netherlands
Content
❖ WKZ
❖ Probleem => “Smart KinderIC”
❖ Opdracht gedachte
❖ Organisatie….
State of the Union
“By computing health care records, we can avoid dangerous medical mistakes, reduce costs, and improve care.”
(George W. Bush, 2004)
WKZ
Een Kinderziekenhuis
“Zelfstandig ziekenhuis voor kinderen”
- Poliklinieken- Verpleegafdelingen- Operatiekamers- Intensive Care
- Neonatologie (pasgeborenen)- KinderIC (kinderen)
Probleem❖ 14 Beds open format Pediatric ICU without roaming in
for the parents
❖ 2017 / 2021 Opening a new Pediatric ICU
❖ 30 beds (IC and respiratory and cardiac HC unit)
❖ Family centered (roaming in)
❖ Patient friendly / single bed spaces
Napoleon looking at the battlefield
New situation => situational awareness?
Single patient roomRoaming in
Even better……for the patient
No noise or light population.Devices create safety…
Clinical => ICT / technical
❖ Medical team:
❖ Wish to Situational Awareness (No Alarm Fatigue)
❖ Safety: technical support
❖ Parents / patient
❖ Privacy
❖ Good care
Rule engine❖ Decision Support:
❖ No decision making
❖ Optimizing information input to medical team
❖ Combining information (disconnection)
❖ Using
❖ Patient (age)/ illness characteristics (cardiac)
❖ Trend data
Focus ?
❖ Finding the focus
❖ Where in the timeline of care?
❖ Which problem do we solve first?
Fundamentals of decision support
Ambiguity vs severity / complexity
Story❖ 3 months old patient arrives at PICU ill/respiratory distress.
❖ Physical investigation / laboratory investigation
❖ Differential Diagnose: Viral Infections
❖ Respiratory failure => intubation
❖ After intubation stable patient with antibiotics
❖ One week of respiratory support => extubation
❖ Discharge to the ward
How to focus?
❖ Level of attention
❖ Level of ambiguity
❖ Level of illness (ICU) / risk (anesthesia)
Lorem Ipsum Dolor
(Pediatric) ICU setting We need support if the level of attention drops….
Timeline focus rule engine
❖ To start and use a rule engine most efficient:
❖ Period of less attention nurses / doctors
❖ Ambiguity is less potent issue
❖ Risk on acute problems still there, but setting clear.
Neonatologie
Neonatologie
❖ 30-35 beds Neonatologie
❖ Gaan ook verbouwen en denken heel hard ook aan single beds Neo
❖ Organisatie net anders dan kinderIC (werkproces)
❖ Gebruikte systemen / focus op apparatuur net anders
Kinderafdeling Eekhoorn
Kinderafdeling Eekhoorn
❖ Reeds een/twee persoonskamers
❖ Steeds meer apparatuur
❖ Reeds weinig sitautional awareness
❖ Veel alarm fatigue
❖ Nieuwe “paging” 2019
Opdracht (gedachten WKZ)
❖ “Out of the box user interface opzet”
❖ 2 groepen per afdeling (3 afd: Kinderafd / Neo / IC)
❖ Per afdeling 2 gedifferentieerde vragen:
❖ gericht op alarmen / monitoring communicatie
❖ ondersteunen van het werkproces
Opdracht (uitw)
❖ Eerste interview met verpleegkundige(n)
❖ Tweede sessie (eerste schetsen)
❖ Verpleegkundige(n) en Arts (waar mogelijk)
Organisatie
❖ KinderIC: Erik Koomen [email protected] anesthesioloog / kinderintensivist
❖ Neonatologie: Joshua van Duuren [email protected] verpleegkundige en ICT specialist
❖ Kinderafdeling Eekhoorn: Indra Morsing [email protected] kinderarts en fellow kinderIC
Unlimited patient control ….smart ?!!! PICU transport
Nog vragen?