An initial review of paper checklists from actual trauma resuscitations revealed that trauma team leaders frequently wrote notes on the checklist. To understand this note-taking practice, we are performing content analysis of checklists that are being collected on a daily basis at the hospital. To date, we found nine major categories of information that leaders record during resuscitations, including patient values, physical assessment findings, and pre-hospital information. An analysis of types and amount of notes written by leaders of different experience levels showed that more experienced leaders recorded more patient values and physical findings, while less experienced leaders recorded more notes about their activities and task completion status. These findings suggested that a checklist designed for a high-risk, fast-paced medical event has evolved into a dual function tool, serving both as a compliance and memory aid. Based on these findings, we formulated early checklist designs for a tablet screen and focused on supporting this dual function. We used Android as our mobile operating system to allow for easier integration with existing hospital systems, as well as integration with the decision-support system components that we are currently developing. The current checklist design is now being trialed at Children’s National Medical Center during day-time trauma resuscitations.

 

Related papers & presentations:

  • Sarcevic, A., Zhang, Z., Marsic, I., and Burd, R. S., “Checklist as a memory externalization tool during a critical care process,” to appear in Proceedings of the American Medical Informatics Association 2016 Annual Symposium (AMIA 2016), pp. TBD, Chicago, IL, November 12-16, 2016.
  • Sarcevic, A., Rosen, B., Kulp, L., Marsic, I., and Burd, R. S., “Design challenges in converting paper to digital checklists for dynamic medical settings,” in Proceedings of the 10th EAI International Conference on Pervasive Computing Technologies for Healthcare – Pervasive Health 2016, pp. TBD, Cancun, Mexico, May 16-19, 2016.
  • Rosen, B., Sarcevic, A., Marsic, I., Burd, R. S., “A dynamic digital checklist for supporting trauma resuscitation teams,” poster presented at the 8th Annual Mid-Atlantic Healthcare Informatics Symposium, Philadelphia, PA, October 23, 2015.
  • Zhang, Z., Sarcevic, A., Yala, M., Burd, R. S., “Informing digital cognitive aids design for emergency medical work by understanding paper checklist use,” in Proceedings of the ACM 2014 Int’l Conference on Supporting Group Work (GROUP 2014), pp. 167-177, Sanibel Island, Florida, November 9-12, 2014.