BEGIN:VCALENDAR VERSION:2.0 PRODID:Linklings LLC BEGIN:VTIMEZONE TZID:America/Chicago X-LIC-LOCATION:America/Chicago BEGIN:DAYLIGHT TZOFFSETFROM:-0600 TZOFFSETTO:-0500 TZNAME:CDT DTSTART:19700308T020000 RRULE:FREQ=YEARLY;BYMONTH=3;BYDAY=2SU END:DAYLIGHT BEGIN:STANDARD TZOFFSETFROM:-0500 TZOFFSETTO:-0600 TZNAME:CST DTSTART:19701101T020000 RRULE:FREQ=YEARLY;BYMONTH=11;BYDAY=1SU END:STANDARD END:VTIMEZONE BEGIN:VEVENT DTSTAMP:20240325T185833Z LOCATION:Salon A-3 DTSTART;TZID=America/Chicago:20240325T113700 DTEND;TZID=America/Chicago:20240325T120000 UID:HFESHCS_2024 International Symposium on Human Factors and Ergonomics i n Health Care_sess121_INDLEC282@linklings.com SUMMARY:Card Sorting Neonatal Huddle Elements: A Mixed Methods Approach DESCRIPTION:Oral Presentations\n\nCarolina Rodriguez-Paras, Maria Ordoñez Paredes, Madeline Dombroski, Heidi Herrick, and Anne Ades (Children's Hosp ital of Philadelphia)\n\nBackground \n\nCongenital anomalies are the secon d leading cause of neonatal death in the United States after prematurity, yet neonates with congenital anomalies are an understudied population, esp ecially in the delivery room. Newborns with congenital anomalies are a uni que population that add complexity to the usual transition of most newborn s from in utero to ex utero life. Given this, multidisciplinary interprofe ssional teams and specific resuscitation interventions are needed to ensur e optimal patient care. The Children’s Hospital of Philadelphia (CHOP) has a delivery room, the Special Delivery Unit (SDU), dedicated solely to the resuscitation of neonates with congenital anomalies. The SDU is the large st unit of its kind, performing more than 500 resuscitations per year. Wit hin such a complex environment, it is paramount to understand all the role s and responsibilities, as well as the interactions that occur between tea m members, and the way information flows. Task analyses enable an in-depth understanding of all system elements and interactions within a complex sy stem. Task analyses can be divided into several types, including hierarchi cal and cognitive. A hierarchical task analysis (HTA) breaks down each dif ferent task into subtasks, whereas a cognitive task analysis (CTA) examine s the thought process of the person performing the task. HTA enables the understanding of the tasks necessary to accomplish a specific goal, provid ing a detailed breakdown of the tasks, subtasks, and order in which these tasks must be performed. CTA instead focuses on assessment and decision ma king.\n\nThe purpose of this project was to describe all tasks necessary f or resuscitation of neonates with congenital anomalies, illuminating the c omplexity of these resuscitations and highlighting areas of variability. T o complete the task analysis, we utilized several diverse sources includin g the Neonatal Resuscitation Program (NRP) algorithm for neonatal resuscit ation, locally followed optimal care guidelines for the SDU, live and vide o recorded delivery room observations, and interviews with subject matter experts and SDU providers. The combination of all these data sources provi des a novel approach to creating and developing task analyses. \nThe proje ct began as an HTA, but the complexity of the tasks necessitated a combine d HTA-CTA to understand decision points where patient assessment dictated task choice and performance. Incorporating the CTA into the HTA also allo ws insight into which tasks may present higher workload levels.\n \nAs an initial step, we developed an HTA-CTA of the NRP algorithm. We then focuse d on developing an HTA-CTA for the SDU. To ensure capture of the complexi ty of the system and the environment, initial task analysis data collectio n began through direct in person observations of delivery room resuscitati ons in the SDU. These observations were augmented through asking providers clarifying questions as the resuscitation allowed. The next step focused on video review of delivery room resuscitations which enabled in-depth rev iew of specific tasks. For specific tasks, especially those involving pr eparation of equipment and medications, subject matter experts from the respiratory and nursing departments were interviewed.. A neonatologist wit h expertise in neonatal resuscitation and human factors provided oversight to the developing models. The current task analysis consists of 19 tasks, and over 262 subtasks. \n\nFuture work will analyze the variability withi n specific tasks and will explore how this may be related to different con genital anomalies Additionally, the variability within the steps will be i nvestigated to propose human factors quality improvement projects to stand ardize and improve team performance and patient care. Video review and tim estamps will be used to measure variability both qualitatively and quantit atively.\n\nThe task analysis is part of a larger body of work performing a work system analysis (WSA) within the SDU. Future work will incorporate the Systems Engineering Initiative for Patient Safety (SEIPS) to better un derstand the interactions and emerging properties that occur between the p roviders and other systems elements such as technology, task, or the envir onment. \n\nApplication\n\nThe combined HTA and CTA can be used within com plex settings, such as healthcare, to gain better understanding of task an d cognitive load, w and to delineate which roles are responsible for asses sment and decision making. This work demonstrates how multiple data source s, including subject-matter expert interviews, observations, video review, and algorithms, can be used to developed robust system models, not just i n healthcare, but in other industries as well. \nThe resulting task analys is has several potential applications, including assessing situation aware ness and interruptions, flow disruptions, and to optimize workflows. From a systems perspective, the task analysis can also be used to compare the “ work as done” vs “work as imagined,” where the tasks are reviewed by subje ct matter experts and then compared against real life scenarios. \n\nUnder standing all the tasks, the roles involved, and the interactions can produ ce a systems view that outlines emergent properties of the system. Thus, t he task analysis could also be used as a proactive safety tool by identify ing potential failure modes and corrective actions to reduce safety concer ns. \n\nOverview of Presentation\n\nThis poster will describe the integrat ion of a hierarchical task analysis and a cognitive task analysis into a s ingle task analysis and describe its application to a novel environment, a delivery room dedicated to neonates with congenital anomalies. Furthermor e, the posted will demonstrate how diverse data sources can be combined to create a robust task analysis.\n\nTrack: Patient Safety Research and Init iatives\n\nSession Chair: Joseph Nuamah (Oklahoma State University) END:VEVENT END:VCALENDAR