Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants
Abstract Objective The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit. Methods We incorporated components from the sociotechnical model, Safety...
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Veröffentlicht in: | ACI open 2022-07, Vol.6 (2), p.e57-e65 |
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creator | Karavite, Dean J. Harris, Mary Catherine Grundmeier, Robert Wayne Srinivasan, Lakshmi Shaeffer, Gerald P. Muthu, Naveen |
description | Abstract
Objective
The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit.
Methods
We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semi-structured interviews, (2) user profiles, and (3) system use cases.
Results
Thirty-one neonatal intensive care unit clinicians participated in semi-structured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing.
Conclusion
Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system. Applying the sociotechnical model resulted in discovering work system, process, and outcome requirements that would otherwise be difficult to capture, or missed entirely, using traditional requirements gathering methods or approaches to clinical decision support design. |
doi_str_mv | 10.1055/s-0042-1749318 |
format | Article |
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Objective
The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit.
Methods
We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semi-structured interviews, (2) user profiles, and (3) system use cases.
Results
Thirty-one neonatal intensive care unit clinicians participated in semi-structured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing.
Conclusion
Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system. Applying the sociotechnical model resulted in discovering work system, process, and outcome requirements that would otherwise be difficult to capture, or missed entirely, using traditional requirements gathering methods or approaches to clinical decision support design.</description><identifier>ISSN: 2566-9346</identifier><identifier>EISSN: 2566-9346</identifier><identifier>DOI: 10.1055/s-0042-1749318</identifier><language>eng</language><publisher>Rüdigerstraße 14, 70469 Stuttgart, Germany: Georg Thieme Verlag KG</publisher><subject>Case Report</subject><ispartof>ACI open, 2022-07, Vol.6 (2), p.e57-e65</ispartof><rights>The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1178-16596eaad5c5b672a08bbdcf2a75221a7f8e11bb5d8126f9d6afe9ad494015543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0042-1749318.pdf$$EPDF$$P50$$Gthieme$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-0042-1749318$$EHTML$$P50$$Gthieme$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,864,20891,27924,27925,54587,54615</link.rule.ids></links><search><creatorcontrib>Karavite, Dean J.</creatorcontrib><creatorcontrib>Harris, Mary Catherine</creatorcontrib><creatorcontrib>Grundmeier, Robert Wayne</creatorcontrib><creatorcontrib>Srinivasan, Lakshmi</creatorcontrib><creatorcontrib>Shaeffer, Gerald P.</creatorcontrib><creatorcontrib>Muthu, Naveen</creatorcontrib><title>Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants</title><title>ACI open</title><addtitle>ACI open</addtitle><description>Abstract
Objective
The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit.
Methods
We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semi-structured interviews, (2) user profiles, and (3) system use cases.
Results
Thirty-one neonatal intensive care unit clinicians participated in semi-structured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing.
Conclusion
Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system. Applying the sociotechnical model resulted in discovering work system, process, and outcome requirements that would otherwise be difficult to capture, or missed entirely, using traditional requirements gathering methods or approaches to clinical decision support design.</description><subject>Case Report</subject><issn>2566-9346</issn><issn>2566-9346</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><recordid>eNp1kMtqwzAQRUVpoSHNtmv9gFJJtmR7WUwfgZRC06zNWI9YQZGC5FLy93VoFt10NTNw72E4CN0zumRUiIdMKC05YVXZFKy-QjMupCRNUcrrP_stWuS8p5TyghWlEDO032YXdhjwJioXR6OG4BR4_Ba18XiMeBu0SXmEoHE7gPcm7EzG324c8MYcs8v4w6i4C250MWA4xInWpumaKP6EV97jVbAQxnyHbiz4bBaXOUfb56fP9pWs319W7eOaKMaqmjApGmkAtFCilxUHWve9VpZDJThnUNnaMNb3QteMS9toCdY0oMumpEyIspij5S9XpZhzMrY7JneAdOoY7c6yutydZXUXWVOB_BbGwZmD6fbxK4Xpw__yPwpoa9g</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Karavite, Dean J.</creator><creator>Harris, Mary Catherine</creator><creator>Grundmeier, Robert Wayne</creator><creator>Srinivasan, Lakshmi</creator><creator>Shaeffer, Gerald P.</creator><creator>Muthu, Naveen</creator><general>Georg Thieme Verlag KG</general><scope>0U6</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>202207</creationdate><title>Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants</title><author>Karavite, Dean J. ; Harris, Mary Catherine ; Grundmeier, Robert Wayne ; Srinivasan, Lakshmi ; Shaeffer, Gerald P. ; Muthu, Naveen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1178-16596eaad5c5b672a08bbdcf2a75221a7f8e11bb5d8126f9d6afe9ad494015543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Case Report</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karavite, Dean J.</creatorcontrib><creatorcontrib>Harris, Mary Catherine</creatorcontrib><creatorcontrib>Grundmeier, Robert Wayne</creatorcontrib><creatorcontrib>Srinivasan, Lakshmi</creatorcontrib><creatorcontrib>Shaeffer, Gerald P.</creatorcontrib><creatorcontrib>Muthu, Naveen</creatorcontrib><collection>Thieme Open Access Journals(OpenAccess)</collection><collection>CrossRef</collection><jtitle>ACI open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karavite, Dean J.</au><au>Harris, Mary Catherine</au><au>Grundmeier, Robert Wayne</au><au>Srinivasan, Lakshmi</au><au>Shaeffer, Gerald P.</au><au>Muthu, Naveen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants</atitle><jtitle>ACI open</jtitle><addtitle>ACI open</addtitle><date>2022-07</date><risdate>2022</risdate><volume>6</volume><issue>2</issue><spage>e57</spage><epage>e65</epage><pages>e57-e65</pages><issn>2566-9346</issn><eissn>2566-9346</eissn><abstract>Abstract
Objective
The aim of the study is to apply a sociotechnical model to the requirements phase of implementing a machine learning algorithm-based system to support sepsis recognition in the neonatal intensive care unit.
Methods
We incorporated components from the sociotechnical model, Safety in Engineering for Patient Safety 2.0, in three requirements phase activities: (1) semi-structured interviews, (2) user profiles, and (3) system use cases.
Results
Thirty-one neonatal intensive care unit clinicians participated in semi-structured interviews (11 nurses, 10 front line ordering clinician, five fellows, and five attending physician). Interview transcripts were coded and then compiled into themes deductively based on components from the sociotechnical model (persons, environment, organization, tasks, tools and technology, collaboration, and outcomes). The interview analysis was used to create four user profiles defining responsibilities in sepsis recognition, team collaboration, and attributes relevant to sepsis recognition. Two user profiles (nurse, front line ordering clinician) included variants based on experience relevant to sepsis recognition. The interview analysis was used to develop three system use cases representing clinical sepsis scenarios. Each use case defines the precondition, actors, and high-level sequence of actions, and includes variants based on sociotechnical works system factors that can complicate sepsis recognition. The interview analysis, user profiles, and use cases serve as the foundation for supporting sociotechnical design to all subsequent human-centered design methods including subject recruitment, formative design, summative user testing, and simulation testing.
Conclusion
Integration of the sociotechnical model-guided requirements gathering activities, analysis, and deliverables by framing a range of sociotechnical components and the interconnectedness of these components in the broader work system. Applying the sociotechnical model resulted in discovering work system, process, and outcome requirements that would otherwise be difficult to capture, or missed entirely, using traditional requirements gathering methods or approaches to clinical decision support design.</abstract><cop>Rüdigerstraße 14, 70469 Stuttgart, Germany</cop><pub>Georg Thieme Verlag KG</pub><doi>10.1055/s-0042-1749318</doi><oa>free_for_read</oa></addata></record> |
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subjects | Case Report |
title | Using a Sociotechnical Model to Understand Challenges with Sepsis Recognition among Critically Ill Infants |
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