Evaluating Operator Performance for Patient Telemetry Monitoring Stations Using Virtual Reality

Abstract

Patient telemetry monitoring stations in hospitals have received considerable attention due to the widely reported incidents of patient deaths linked to operator error. Monitoring stations are one of the most critical environments in a healthcare setting, where telemetry technician delayed response or failure to respond may contribute to adverse patient events. The technician's task is to monitor patient vital signs and respond to irregular patient vitals by communicating this event to the patient care team. Poorly designed monitoring stations can potentially increase technician cognitive workload and stress, and decrease performance (time to respond, accuracy of response). This paper introduces a novel approach to evaluate the impact of monitoring station design on telemetry technician performance through the use of neurophysiological measurement (heart rate, heart rate variability, blood pressure, electroencephalography, core temperature, eye tracking) in a virtual reality (VR) environment. VR provides several benefits over conventional 2D simulations and physical mock-ups by providing an immersive environment where design alternatives can be generated with greater flexibility and speed and also without interfering with daily operations in a safety-critical environment. A replicate model of a telemetry monitoring station at MedStar Washington Hospital Center was simulated in VR. Features such as monitor layout, the number of patients simultaneously monitored, and the graphical user interface design, will be modified to evaluate technician performance for each design alternative. The outcomes of this research can be used to inform telemetry room design across several hospital settings and ultimately reduce adverse patient events due to poor telemetry technician performance.

Toward Preventing Accidents in Process Industries by Inferring the Cognitive State of Control Room Operators through Eye Tracking

“…For instance in telemetry, the technician's task is to monitor vital signs of the patient and communicate abnormal patient vitals to the care team. 42 In an operation theater setting (e.g., laparoscopic surgery), the task of a surgeon is to continuously monitor the patient's vital signs during the surgery. 43 Hence, surgeons' vigilance (attention and alertness) carries utmost importance for improving patient safety.…”

“…Alarm management challenges, analogous to those in the process industry, have been reported in the healthcare setting as well. For instance in telemetry, the technician’s task is to monitor vital signs of the patient and communicate abnormal patient vitals to the care team …”