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Creating Learning Systems with Mobile Technology to Improve Coordination in

Perioperative Services(Periop MLS)

Investigative Team:

Dr. Kevin Taaffe Dr. Lawrence Fredendall

Dr. Joel GreensteinDr. Nathan Huynh

Dr. Jose Vidal

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Creating Learning Systems with Mobile Technology to Improve Coordination in

Perioperative Services(Periop MLS)

Participating Healthcare Organizations:

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Overarching Goal

Create new tools for healthcare providers to achieve improved coordination among Perioperative Services (Periop) departments by Improving individual workflows Resolving systemic issues Changing staff behavior

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Research Objectives

1. Enhance communication and coordination among Periop staff and quality of care by gathering important workflow milestones and introducing artificial intelligence techniques through the use of a smart-app.

2. Analyze workflow data (gathered with smart-apps) using data analytics to provide intuitive displays of real-time information for frontline staff and a daily performance dashboard for managers.

3. Induce behavioral and cultural change in healthcare systems through training and education.

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Objective 1 Tasks

1. Gather Periop process workflow information at each participating facility.

2. Create a smart-app that runs on a tablet that can receive spoken information.

3. Incorporate artificial intelligence capabilities into the smart-app.

4. Conduct Phase 1 pilot studies using the developed smart-app.

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Objective 2 Tasks

1. Analyze data and generate performance dashboards for managers.

2. Provide status displays for staff.3. Conduct Phase 2 pilot studies with

Periop managers and staff.4. Conduct surveys of frontline staff and

Periop managers.

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Objective 3 Tasks

1. Introduce staff to process interventions via simulation experiments of Periop.

2. Create a simulation model with a virtual Periop environment and agents.

3. Conduct training sessions using the developed agent-based model.

4. Provide a workshop of activities at state-level healthcare organizations.

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Project Schedule

Task Task Description Year 1 Year 2 Year 3 Year 4

1.1Gather Periop workflow data

                               

1.2 Create smart-app                                

1.3Incorporate artificial intelligence

                               

1.4 Phase 1 pilot studies                                

2.1Create dashboard/metric options

                               

2.2 Provide status displays                                

2.3 Phase 2 pilot studies                                

2.4 Follow-up staff surveys                                

3.1Process improvement experiments

                               

3.2Create agent-based simulation

                               

3.3 Conduct training sessions                                

3.4 Provide workshop(s)                                

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Team Roles

Drs. Taaffe and Huynh will act as the principal investigators at their respective institutions

Drs. Huynh and Vidal will lead the smart-app development efforts (Objective 1)

Drs. Fredendall and Greenstein will lead the effort on lean operations, continuous improvement, and human-computer interaction (Objective 2)

Drs. Taaffe, Huynh, and Vidal will lead the effort on simulation and training (Objective 3)

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Expected Benefits:Participating Healthcare Partners

Enhance the ability to provide patient-centered care by: Recording milestone tasks using handheld devices or tablets Using voice-activated data entry while obtaining required data

Enhance frontline staff’s situational awareness by: Presenting context-sensitive information on the devices Using data analytics and artificial intelligence to provide

feedback/instructions Improve operational performance by:

Providing managers with process improvement suggestions Show how decisions affect patient care metrics via an

offline “day of surgery” simulation model to provide: Visual training to surgeons, managers, and frontline staff Increased acceptance of changes by healthcare staff

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Additional Benefits

Useful insights Why tasks are delayed or interrupted “Workarounds” being done by staff

Patient safety and quality of care Reduce the need for patient flow “workarounds” Data visualization techniques identify most effective

use of improvement efforts for staff and managers Hospital recognized as leader in process

improvement Using mobile technology for system improvement Publishing with research faculty about healthcare

innovations

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Facility/Staff Resources Needed

Staff cooperation to ensure mobile app compatibility for day of surgery workflow Selected staff to be interviewed in depth Selected staff to allow “shadowing” of their

workflow Staff comments during technology development

Additional input via surveys Pilot testing

Staff participation in simulation training IRB application in progress for initial interviews

IRB amendments to be filed for specific time studies, patient interaction, or unique surveys to administer

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Objective 1 Near-Term Plan

Action Where When

Collect voice of customer PH 5/15/13 – 8/15/13

Identify high-level workflow and milestones

PH 5/15/13 – 8/15/13

Create detailed workflow maps via observations / shadowing

PH 8/15/13 – 12/15/13

Initial user trials (students)

Clemson, USC 4/15/13 – 6/15/13

Staff user trials GHS, PH, MUSC …

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Status of Smart-App Development Platform: Android, Jelly Bean 4.2 Test Devices: Nexus 4, 7, and 10

A simple speech-to-text app has been developed.

Research team is evaluating a proposed algorithm for classifying text.

Simulation Experiment (GHS, 2011)15