Development of an Electronic Decision Support tool to optimize performance during pediatric resuscitations

1. ALERT Presentation:
Development of an Electronic
Decision Support Tool to Optimize
Performance during Pediatric
Resuscitations
Priti Jani MD, MPH
The University of Chicago Comer Children’s Hospital
INSPIRE @ IMSH 2017 – Orlando, FL, USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. • Resuscitation teams and leaders face challenges in acquiring, retaining and mastering
resuscitation skills and knowledge.
• Pre- and post arrest quality improvement interventions provide ways to circumvent
these challenges.
• Limited research exists on tools and processes used to optimize performance intra-
arrest.
• Electronic decision support tools and cognitive aids have shown promise in their ability
to improve resuscitation team performance (Field et al., 2014, Low et al., 2011, Ward et
al., 1997).
International Network for Simulation-based Pediatric Innovation, Research and Education
Background

3. • Population: Pediatric healthcare providers (MD, RN)
• Intervention: Pediatric resuscitation electronic decision
support tool (DST)
• Control/Comparison: No electronic DST
• Outcome(s): Team and individual performance during
simulated and actual resuscitations as measured by
adherence to national resuscitation guidelines.
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO / Research Question

4. International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
Development of a pediatric resuscitation decision
support tool for IHCA
• Pre-arrest: educational tool
• Intra-arrest: cognitive aid to optimize
resuscitation performance in real-time
• Post-arrest: debriefing tool, +/- recording tool?

5. International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
Development of a pediatric
resuscitation decision
support tool
• Electronic  Dynamic
• Human factors approach
• Determine ideal way to
integrate into resuscitation
team choreography
• MD - team leader
• RN -reader and recorder
• Shared resource v.s two
tools
Testing and training in
simulation
Usability of tool
• Varying skill levels
• Varying scenario
complexity
Simulation-based
resuscitation performance
assessments
• AHA targets
• Clinical Performance Tool
(Donoghue, 2011)

6. International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
Performance in
simulation
• RCT with cross-over
design
• Providers in 3 locations
• General wards
• Adult ED
• Pediatric ICU and
ED
Performance during
actual resuscitations
using historical controls

7. • ALERT Presentation: 1/28/17
• Grant Proposal (if applicable): Summer 2017
• IRB Submission: Fall 2017
• Recruitment / Data Collection: 2018
• Data Analysis 2018-2019
• Abstract Presentation: 2019
• Manuscript(s) Preparation: 2018, 2019
International Network for Simulation-based Pediatric Innovation, Research and Education
Timeline

8. 1. Is this the appropriate study design and what
ideas or changes would you recommend?
2. What strategic approach do you recommend for tool design?
– Who should be on my team?
– What resources are there for app development?
– Ideas for design process, mentors in the field?
3. What are the pros and cons of simultaneously developing a
tool to serve as both a decision support tool as well as a
resuscitation quality assessment tool? Feasible? Advisable?
International Network for Simulation-based Pediatric Innovation, Research and Education
3 questions to improve study

9. • At INSPIRE @ IMSH 2017: Obtain
feedback to refine, strengthen and solidify
study design as well as identify potential
mentors/collaborators
• In 2 months: complete grant application
(K23)
International Network for Simulation-based Pediatric Innovation, Research and Education
Goals to accomplish

10. Name: Priti Jani
Institution: The University of Chicago
E-mail, Phone: priti.jani@uchospitals.edu
Website / QR Code
International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information