title: Developing a Cognitive and Communications Tool for Burn Intensive Care Unit Clinicians.
abstract: Burn Intensive Care Unit (BICU) work is necessarily complex and depends on clinician actions, resources, and variable patient responses to interventions. Clinicians use large volumes of data that are condensed in time, but separated across resources, to care for patients. Correctly designed health information technology (IT) systems may help clinicians to treat these patients more efficiently, accurately, and reliably. We report on a 3-year project to design and develop an ecologically valid IT system for use in a military BICU.
  
  
  
  We use a mixed methods Cognitive Systems Engineering approach for research and development. Observations, interviews, artifact analysis, survey, and thematic analysis methods were used to reveal underlying factors that mold the work environment and affect clinician decisions that may affect patient outcomes. Participatory design and prototyping methods have been used to develop solutions.
  
  
  
  We developed 39 requirements for the IT system and used them to create three use cases to help developers better understand how the system might support clinician work to develop interface prototypes. We also incorporated data mining functions that offer the potential to aid clinicians by recognizing patterns recognition of clinically significant events, such as incipient sepsis. The gaps between information sources and accurate, reliable, and efficient clinical decision that we have identified will enable us to create scenarios to evaluate prototype systems with BICU clinicians, to develop increasingly improved designs, and to measure outcomes.
  
  
  
  The link from data to analyses, requirements, prototypes, and their evaluation ensures that the solution will reflect and support work in the BICU as it actually occurs, improving staff efficiency and patient care quality.
authors.affiliation: Cognitive Solutions Division, Applied Research Associates, Inc., 1750 Commerce Center Boulevard Drive North, Fairborn, OH 23542.
authors.forename: Christopher
authors.initials: C
authors.lastname: Nemeth
authors.affiliation: Cognitive Solutions Division, Applied Research Associates, Inc., 1750 Commerce Center Boulevard Drive North, Fairborn, OH 23542.
authors.forename: Shilo
authors.initials: S
authors.lastname: Anders
authors.affiliation: Cognitive Solutions Division, Applied Research Associates, Inc., 1750 Commerce Center Boulevard Drive North, Fairborn, OH 23542.
authors.forename: Robert
authors.initials: R
authors.lastname: Strouse
authors.affiliation: Cognitive Solutions Division, Applied Research Associates, Inc., 1750 Commerce Center Boulevard Drive North, Fairborn, OH 23542.
authors.forename: Anna
authors.initials: A
authors.lastname: Grome
authors.affiliation: Cognitive Solutions Division, Applied Research Associates, Inc., 1750 Commerce Center Boulevard Drive North, Fairborn, OH 23542.
authors.forename: Beth
authors.initials: B
authors.lastname: Crandall
authors.affiliation: U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, San Antonio, TX 78234.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Pamplin
authors.affiliation: U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, San Antonio, TX 78234.
authors.forename: Jose
authors.initials: J
authors.lastname: Salinas
authors.affiliation: U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Fort Sam Houston, San Antonio, TX 78234.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mann-Salinas
mesh_terms: D002053:Burn Units / Q000458:organization & administration; D002056:Burns / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D033183:Interdisciplinary Communication; D000069550:Machine Learning; D008490:Medical Informatics / Q000295:instrumentation / Q000592:standards; D012984:Software; D011795:Surveys and Questionnaires; D013597:Systems Analysis; D013647:Task Performance and Analysis; D014584:User-Computer Interface