A Four-Stage Method for Optimizing and Standardizing a Crash Cart Configuration

Milloy, Shaunna; Bubric, Katherine

doi:10.1080/24725838.2018.1434574

Cited by 5 publications

(12 citation statements)

References 9 publications

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“…al (2010) used a co-design workshop with anesthesia department team members to design a standardized medication drawer. Milloy and Bubric (2018) also involved front-line users, in this case by conducting a simulation and gathering quantitative data via post-evaluation scores. Lefebvre et.…”

Section: Objectivesmentioning

confidence: 99%

Standardizing Crash Carts Using Collaborative Design Methods And Usability Testing

Jamil¹,

Congenie²,

Bartjen³

et al. 2021

Proceedings of the International Symposium on Human Factors and

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Crash carts are mobile containers of medications and supplies used to resuscitate patients in emergencies within health care facilities. Contents and organization of carts often differ across hospitals and even departments within the same hospital. To support our team members in emergencies across our multi-hospital system, we created a system safety initiative to standardize and optimally organize adult crash carts. Our team established a three-phase user-centered research and design approach. First, we facilitated a collaborative design workshop with front line stakeholders to develop an initial cart organization. Second, 59 clinicians across 8 departments interacted with a cart mock-up and provided feedback. Finally, 18 clinicians participated in usability testing of the updated cart in 3 separate full simulations of realistic patient emergencies including an airway emergency (anaphylaxis), cardiac arrest (ventricular fibrillation), and sepsis using manikins. Observations and feedback from all three research phases contributed to a final medical supply list and crash cart design for our hospital system. This work also provides guidance for using co-design methods and usability testing within hospital environments.

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Section: Objectivesmentioning

confidence: 99%

Standardizing Crash Carts Using Collaborative Design Methods And Usability Testing

Jamil¹,

Congenie²,

Bartjen³

et al. 2021

Proceedings of the International Symposium on Human Factors and

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“…Standardizing the configuration of crash carts and mapping them to a clinical mental model have been shown to be beneficial in locating and retrieving the correct equipment when comparing a Broselow pediatric crash cart with a traditional crash cart 15. This approach of human factors incorporation and standardization has also garnered positive feedback from end users in a study of 4 rural acute care sites 16…”

Section: Background and Objectivementioning

confidence: 99%

Optimal Crash Cart Configuration for a Surgical NICU

Lefebvre

Milloy

Joynt

2020

Advances in Neonatal Care

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Background: Neonates admitted to cardiac and surgical neonatal intensive care units (NICUs) are at an increased risk of requiring emergency lifesaving interventions that require the use of both Neonatal Resuscitation Program (NRP) and Pediatric Advanced Life Support (PALS) algorithms. Clinicians working within the surgical NICU must be able to access emergency equipment and medications quickly in order to respond to critical situations. A crash cart that integrates human factors principles and supports both the NRP and PALS algorithms is necessary to promote patient safety for this high-risk population. Purpose: A multidisciplinary quality improvement project constructed an optimal crash cart configuration that embedded human factors principles and supported clinical workflow by reflecting both the NRP and the PALS algorithms in an NICU that cares for cardiac and surgical patients. Methods: A crash cart working group including frontline NICU staff, simulation experts, and a human factors specialist was formed within a surgical NICU. Human factors principles were utilized to align the organization of the cart with the NRP and PALS algorithms to increase the efficiency and intuitiveness of the cart. The new crash cart configuration was usability tested through simulation, revised on the basis of clinical feedback, and then implemented in a clinical setting. Data were collected following implementation of the new crash cart to validate that the new configuration was viewed as a significant improvement. The Plan-Do-Study-Act cycle was used to make improvements and capture outcome indicators. Results: Evaluation data collected both during usability simulation testing and in situ within the NICU clinical environment indicated that the revised crash cart scored higher on Likert scale response questions than the previous crash cart. Implications for Practice: Human factors science, in combination with frontline user engagement, should be utilized to create intuitive crash cart configurations, which are then tested in a simulation environment and evaluated in situ in the NICU. Implications for Research: Further research around crash cart design within NICUs that use multiple lifesaving algorithms would add to the paucity of research around the impact of human factors theory in the utilization of lifesaving equipment and medications within this specific population.

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“…Such problems can emerge in the context of the use of a device or machine, where poor design often leads to ineffective or inefficient use, as well as increased use errors (i.e., mistakes) that can lead to harm. In this issue, Milloy & Bubric (2018) provide an example of a project that produced improved HF in the design of a hospital "crash cart". Problems related to HF can also affect the work environment of personnel, leading to excess workloads that increase injury risks for staff.…”

Section: Ergonomics and Human Factors Inmentioning

confidence: 99%

“…(1) tools and technologies (Milloy & Bubric, 2018;Weiler et al, 2018); (2) tasks (Bargal et al, 2018;Doss et al, 2018;MacDonald & Keir, 2018;Xie et al, 2018); (3) the physical environment (Arsenault-Knudsen et al, 2018;Weiler et al, 2018); and (4) organizational structures (Arsenault-Knudsen et al, 2018;Bargal et al, 2018;Ibrahim Shire, Thomas Jun, & Robinson, 2018;Podtschaske, Salazar, & Rao, 2018). Importantly, diverse areas of study within human factors and ergonomics (perception, cognition, physical ergonomics, organizational ergonomics) are considered within these papers and most papers address more than one area.…”

Section: Ergonomics and Human Factors Inmentioning

confidence: 99%

“…This work may help to guide more robust exposure assessment tools in nursing and the design of safety systems for this group of health professionals. Milloy and Bubric (2018) also engaged nurses as critical, front-line users in their work on optimizing and standardizing a crash cart configuration used for responding to cardiac or respiratory arrest emergencies in clinical environments. Their paper demonstrates how human factors can be used to inform and improve the design of this type of healthcare technology.…”

Section: Ergonomics and Human Factors Inmentioning

confidence: 99%

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