Challenges of disposition decision making for pediatric trauma patients in the emergency department

Bat Zion Hose, Pascale Carayon, Peter Hoonakker, Abigail Wooldridge, Tom Brazelton, Shannon Dean, Ben Eithun, Michelle Kelly, Jonathan Kohler, Joshua Ross, Deborah Rusy, Ayse Gurses

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

About 9.2 million children visit the emergency department (ED) in the US annually because of trauma and 20% experience a missed injury. Upon arriving to the hospital, physicians evaluate the child and make the ED disposition decision of whether to admit, operate or discharge. The objective of this study is to report the challenges mentioned by healthcare professionals about ED disposition decision making. We conducted 11 interviews with 12 healthcare professionals and identified 2 challenges of ED disposition decision making. The first challenge was timing of the decision; e.g., an ED nurse explained that a quick decision by physicians is important for providing timely patient care to critically ill children. The second challenge was leadership and team organization; e.g., the OR nurse and surgery resident both mentioned the need to know who to listen to so that they can understand what to do. Analyzing these challenges to ED disposition decision making can help to identify sociotechnical solutions for enhancing team situation awareness.

Original languageEnglish (US)
Title of host publicationProceedings of the 20th Congress of the International Ergonomics Association (IEA 2018) - Volume I
Subtitle of host publicationHealthcare Ergonomics
EditorsSebastiano Bagnara, Yushi Fujita, Riccardo Tartaglia, Sara Albolino, Thomas Alexander
PublisherSpringer-Verlag Berlin Heidelberg
Pages339-345
Number of pages7
ISBN (Print)9783319960975
DOIs
StatePublished - Jan 1 2019
Event20th Congress of the International Ergonomics Association, IEA 2018 - Florence, Italy
Duration: Aug 26 2018Aug 30 2018

Publication series

NameAdvances in Intelligent Systems and Computing
Volume818
ISSN (Print)2194-5357

Other

Other20th Congress of the International Ergonomics Association, IEA 2018
CountryItaly
CityFlorence
Period8/26/188/30/18

Keywords

  • Coordination
  • Decision making
  • ED disposition
  • Patient safety
  • Pediatric trauma
  • Team situational awareness

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Computer Science(all)

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  • Cite this

    Hose, B. Z., Carayon, P., Hoonakker, P., Wooldridge, A., Brazelton, T., Dean, S., Eithun, B., Kelly, M., Kohler, J., Ross, J., Rusy, D., & Gurses, A. (2019). Challenges of disposition decision making for pediatric trauma patients in the emergency department. In S. Bagnara, Y. Fujita, R. Tartaglia, S. Albolino, & T. Alexander (Eds.), Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018) - Volume I: Healthcare Ergonomics (pp. 339-345). (Advances in Intelligent Systems and Computing; Vol. 818). Springer-Verlag Berlin Heidelberg. https://doi.org/10.1007/978-3-319-96098-2_44