title: Checklist as a Memory Externalization Tool during a Critical Care Process.
abstract: We analyzed user interactions with a paper-based checklist in a regional trauma center to inform the design of digital cognitive aids for safety-critical medical teamwork. An initial review of paper checklists from actual trauma resuscitations revealed that trauma team leaders frequently wrote notes on the checklist. To understand this notetaking practice, we performed content analysis of 163 checklists collected over the period of four months. We found nine major categories of information that leaders recorded 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 derived requirements for designing digital cognitive aids to support safety-critical medical teamwork.
authors.affiliation: College of Computing & Informatics, Drexel University, Philadelphia, PA.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sarcevic
authors.affiliation: College of Computing & Informatics, Drexel University, Philadelphia, PA.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Electrical and Computer Engineering, Rutgers University, Piscataway, NJ.
authors.forename: Ivan
authors.initials: I
authors.lastname: Marsic
authors.affiliation: Emergency Trauma & Burn Services, Children's National, Washington, DC.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Burd
mesh_terms: D057189:Checklist; D003422:Critical Care; D004282:Documentation; D006801:Humans; D010808:Physical Examination; D012151:Resuscitation; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy*