Two joint research studies involving Ashish Gupta, School of Business, and researchers at Mayo Clinic have been selected for presentation at the 2011 NIH (National Institutes of Health) annual meeting of US Critical Illness and Injury Trials Group (USCIITG) at the NIH campus in Bethesda, Maryland Nov 8-9, 2011. The goals of the annual meeting are a) to foster and advance investigator-initiated hypotheses for testing at a national level, and b) establish a process to pursue a national strategic plan for clinical research.

Study 1: Health Information Technology to Build Better Acute Care Delivery Environments (HIT BACeD): A Proposal for a Multicenter Collaborative Initiative

Brian Pickering, MD, Ashish Gupta, PhD2; Ogie Gajic, MD1, Vitaly Herasevich, MD, PhD1; Yue Dong, MD1

1,Mayo Clinic, Rochester; 2, School of Business, Minnesota State University of Moorhead

Study 2: Systematic Approach to Analyze Unwarranted Variations Within ICU Multidisciplinary Rounds

Yue Dong, M.D.,1 Brian W. Pickering, M.D.,1 Ashish Gupta, Ph.D. 2, Vitaly Herasevich, M.D.,1 Ognjen Gajic, M.D.1

1Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, MN, USA,

2 School of Business, Minnesota State University Moorhead

Study 1 Background: The safety and quality of care delivered to patients in our hospitals is under increasing scrutiny.  In a recent statement (Declaration of Vienna), these issues were highlighted as primary concerns for the critical care community.  At the same time, health information technology (HIT) has been proffered as a potential tool with which to optimize health care delivery in the United States.  The validity of this assertion has not been tested in the critical care environment and significant gaps in our knowledge exist. In particular it is not known how the characteristics of key components of the acute care system (health care providers, the patient, HIT, environment and culture) interact to determine the outcome of any given process of care or task. The broad objective of this proposal is to validate a universal framework and facilitate the development and testing of HIT based interfaces, alerts and supports which optimize critical care team performance reduce medical error and improve process outcomes in acute care settings.

Study 2 Background: Multidisciplinary rounds (MDR) in ICU facilitates: information retrieval and sharing; incorporation of data into each patient’s  plan of care; generation of actionable items from plan of care; and resident education.  MDR result in  significant improvements in quality outcomes and resident education, as well as reduction in the length of stay and  mortality. However, the complexity and high acuity of diseases in ICU can be further complicated by several exogenous factors such as the dynamic nature of clinicians workflow, highly technological therapies, frequent interruptions, sophisticated equipment and information systems technology used for processing large quantities of data. This eventually makes the healthcare delivery in ICU more prone to error and threatening to patient safety. Due to  high complexity and dynamic nature of ICU work environment, we believe an ethnography based direct and structured field observation will provide us the suitable  solution to capture some of these  unwarranted variations in the rounding process. Various system approaches such as workflow re-redesign, simulation and modeling, new EMR interface design can then be applied  to reduce the complexity of the round tasks and improve the MDR efficiency for patient care without compromising patient-centered care and education.